I do not live in MA, but I came across your page and was very interested! I hope you can answer a question for me. I have very tiny freckles on my upper cheek bones, barely noticeable, but in the past year or so I have developed one larger freckle or “sunspot” on my right cheek bone. I’m curious as to what I should do about this and hope you could give me some insight on things I could do/use to fade this. I’m 20 years old, and live in Minneapolis MN. And very worried. Hope to hear back from you! Thank you.
The spot you described sounds like a sunspot. The cheek bones are a common area where these are found because the sun hits this area at less of an angle than other parts of the face. There is no need for concern unless the spot looks asymmetrical, has irregular borders, and/or has different shades of pigment – in which case you should get checked out by a dermatologist just to be on the safe side. Freckles that are the result of sun exposure can be removed the same as sunspots; however birthmarks are different.
There are different treatments you can do to get rid of sunspots – some patients want to treat with slower methods that require no down time, whereas other clients want to have the lesions removed in as few office visits as possible.
For clients that want faster and more visible results, I recommend laser, such as the Q-Switch Ruby laser or Alexandrite laser. With the laser, usually only one treatment is needed, but there is a healing times of 7-10 days. The laser will target just the pigmented spot and cause the spot to darken. The spot then forms a microcrust and falls off. The spot looks worse before it looks better; however, makeup can be used to cover it up. A second or third treatment is sometimes needed if the spot is deep in the skin. Unfortunately, no laser can remove sunspots on dark or very tan skin. For those that like to spend time in the sun during the summer (which is usually everyone), I would suggest waiting until the fall to have a treatment.
Medical-grade TCA peels can also be used to remove sunspots and freckles. There are other benefits to TCA peels as well such as smaller pore size, even skin tone, and reduce fine lines and wrinkles. The number of treatments depends on the person and the desired results. Three treatments are needed for most sun-damaged skin. After each treatment, there is a 7-10 day downtime.
Cryotherapy, or liquid nitrogen, using the single freeze thaw method can be used to remove sunspots. The downtime and number of treatments is similar to that of the TCA peel.
IPL, or intense pulse light, is also used to give what’s called an IPL photofacial. These treatments usually cover the entire face and require five or more treatments to produce the desired effect. Similar to the laser, you cannot have tanned or dark skin in order to be treated. The downtime for an IPL photofacial is minimal to moderate depending on the person. Usually there is a period of 24 hours where the skin appears red. While the skin heals, some areas of the skin, namely areas with pigmentation, will darken and may form a crust.
Microdermabrasion and less intensive peels can be used to fade superficial sunspots. There is no downtime with microdermabrasion; however, a series of at least six treatments is necessary to fade the spots. Medical facials and low-grade peels may have a day or two of peeling depending on the intensity used. The number of treatments will depend on precise therapy used. There are many other benefits to microdermabrasion and medical facials/low-grade peels that will improve the overall texture and appearance of your skin. In both cases, a daily home care regimen should be used in conjunction with these treatments to maximize effectiveness.
Topical creams which can be used with some treatments or alone to lighten spots include retinoids (such as tretinoin, tazartene, and adapalene) and bleaching agents (such as hydroquinone and azelaic acid). These are prescription strength products and should only be used as directed by a medical professional. If you are taking any these products, make sure to tell your nurse or aesthetician prior to any cosmetic treatment.
Over-the-counter “brown spot removal” creams can lighten some spots that are not deep in the skin; but because they don’t contain a high concentration of lightening agents, the effects are usually minimal and regular application over a long time frame is required.
If you wish to simply remove sunspots, then laser is the most cost effective and least time consuming; however, if you wish to improve the texture and tone of your skin as well, then you may want to try one of the other methods. Another thing to note is that all of these treatments will make your skin more sensitive to the sun, so you might want to wait for the fall before starting a treatment if you have plans to spend time in the sun this summer.
Unfortunately, I don’t know of any cosmetic laser clinics or medical spas in Minneapolis to recommend you. Make sure that where ever you go, they are clean and have experience in this field. Although the risks are not high, laser sunspot removal requires more skill than laser hair removal.
Please note that it is important that your practitioner correctly identifies the pigmented lesion as a sunspot prior to sunspot removal treatment. Removal of a lesion by any of the means above does not necessarily remove the risk for skin cancer. Furthermore, if pigmentation is the result of a condition called melasma, laser, ILP, and other therapies can actually make this condition worsen.
Good luck and feel free to contact me with any more questions!