Of all the frustrating skin problems you can face, discoloration and uneven skin tone is one of the most elusive. Unlike pimples, which have a start date and an end date where you can see the pimple starting to heal, discoloration can come out of nowhere. It can linger for a long time (sometimes years). And topical treatments don’t always seem to respond to it. “There are many reasons for getting brown spots on the skin,” says Dr. Hyemin Pomerantz, a board-certified dermatologist at Viva Skin Dermatology and Aesthetic. “Treatments are tailored to what’s causing discoloration.”
Here outlines Dr. Pomerantz two main causes of discoloration and recommended treatments for each.
“One of the most common conditions I see in my practice is facial discoloration after acne flare-ups,” said Dr. Pomerantz. “These brown spots may go away over time, but it can take up to a few months. They linger longer on people with darker skin tones. The most important thing in treating this is preventing new acne lesions by following a good acne treatment regimen. because new acne spots will lead to discoloration, even if you’ve had old discolorations treated.
Dr. Pomerantz said she’s looking for treatments that can treat both acne and discoloration. “A prescription retinoid used to prevent acne also works to clear discoloration faster,” said Dr. Pomerantz. “I love a microneedling RF (radio frequency) device for patients with discoloration associated with acne scars.”
Another condition that Dr. Pomerantz says what she often sees is melasma. “This is a brown discoloration that commonly appears on eyebrows, cheekbones and upper lip,” said Dr. Pomerantz. “It can be caused by hormones during pregnancy or combined oral contraceptives. If it’s caused by a hormone-based drug, I want to make sure the patient can safely come off the drug before pursuing other treatments. To date, there is no treatment that causes melasma to disappear. The focus is to blur it enough so that it’s less noticeable. Depending on patient preferences, we decide on combinations of topical medication, oral medication and microneedling RF or q-switched laser treatment. Melasma can darken if a laser or device treatment is too strong, so this must be done very carefully.
Be sure to do your research and choose board-certified dermatologists who have extensive experience with laser treatments before booking an appointment.
Prevention is key
It is always easier to prevent a skin problem than to treat one. And when it comes to brown spots, skin can darken with sun exposure, so year-round sun protection is a must.
“Sun avoidance, hats, sunscreen, long-sleeved shirts and pants are recommended,” said Dr. Pomerantz. “An interesting aspect of sunscreen is that the SPF number indicates how well the sunscreen blocks UVB light. The sun also emits UVA light, which contributes more to wrinkles and skin discoloration than UVB. The FDA does not require manufacturers to report UVA coverage.
One sunscreen to try: Mesoestetic Mesoprotech Melan 130 + Pigment Control, which the brand says has a UVA-PF of 67.