Dear Dr. Dave and Dr. Dee,
I just noticed some light brown spots on the sides of my face and top of my hands. Is there anything that I can do to get rid of these age spots?
Age spots or liver spots are often caused by chronic sun exposure and start showing up around the age of 50. These flat brown patches are called lentigines or solar lentigines. Face and hands are common areas of occurrence, but lentigines can also appear on the arms, back and feet.
To prevent further age spots from developing, avoid sun exposure and always use products with sunscreen protection factor of 15 or higher.
Some over-the-counter (OTC) creams may help lighten the spots (see rating below). But, to remove age spots the most effective treatments include topical prescription medications, freezing with liquid nitrogen, laser therapies, microdermabrasion, or chemical peels.
One study found lasers were more effective than liquid nitrogen (Todd, et.al., 2000). Another study assessed treatment outcomes of solar lentigines from reviewing clinical papers published over a 20-year period. Overall consensus seemed to favor cryotherapy (freezing with liquid nitrogen), with evidence that lasers were also effective. In addition, topical solutions with retinoids such as adapalene and tretinoin were suggested as alternatives and as maintenance therapy after the primary treatment (Ortonne, et. al., 2006).
Dr. Valerie Callender supports the use of topical depigmentation creams because they are the least disruptive to the patient, can improve the condition, involves no downtime, and has few side effects. Prescription creams to lighten solar lentigines include adapalene (i.e. Differin) tretinoin (i.e. Retin-A), and hydroquinone (i.e. Melanex, EpiQuin Micro). There are also creams that have combinations of these ingredients (i.e. Tri-Luma, Solage, Lustra-Ulta), which may be more effective than using a single ingredient (Callendar, 2006).
OTC creams that received an average of 4.0 stars out of 5 from at least 10 consumers from Amazon.com are below. Each contains 2% hydroquinone, except Nadinola has 3%:
5 TOP RATED FADE CREAMS (alphabetical)
1. Ambi Fade Cream Oily Skin
2. Dermisa Skin Fade Cream
3. Esoterica Daytime Fade Cream
4. Nadinola Extra-Strength Skin
Discoloration Fade Cream
5. Palmers Skin Success Eventone
Skin Fade Cream