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Q&A: What causes dark spots on skin and what works to fade them?

Dermatologists often hear patients express concern that their sun spots were caused by a recent sunburn. In reality, these spots occur after years of repeated sun exposure.

Dermatologists often hear patients express concern that their sun spots were caused by a recent sunburn. In reality, these spots occur after years of repeated sun exposure.
Dermatologists often hear patients express concern that their sun spots were caused by a recent sunburn. In reality, these spots occur after years of repeated sun exposure.Read moreGetty Images
    by Elizabeth Jones, For The Inquirer
    Published 

Sunspots, or lentigines, are dark spots that develop on sun-exposed skin. Sunspots occur in adults and are not harmful.

I often hear patients express concern that their sunspots were caused by a recent sunburn. In reality, these spots occur after years of repeated sun exposure. If you compare the exposed side of your forearm versus the protected underside, you can see the impact of chronic sun exposure on the development of sunspots. If left untreated, sunspots slowly darken over time with continued sun exposure.

To reduce the appearance of sunspots, start with the ABCs of facial skin care:

  1. A for retinoids, or vitamin A derivatives.

  2. B for broad spectrum sunscreen.

  3. C for vitamin C.

Of course, always keep in mind that the best way to tackle sunspots is prevention. Wearing UPF clothing and sunscreen is essential to preventing these spots from arising or darkening over time.

Retinoids enhance skin cell turnover, reduce pigment production, and boost collagen formation in the skin. If you are new to retinoids, try an over-the-counter option first as these are better tolerated by the skin, before moving on to stronger prescription retinoids. Apply a pea-sized amount over the entire face at night and moisturize to combat the common side effects of dryness and irritation. Use every other night initially and slowly increase to nightly use.

Vitamin C is an antioxidant that protects the skin against environmental stressors including UV rays, pollution and smoke. These over-the-counter topicals also stimulate collagen and reduce pigment production. Avoid vitamin C products in clear bottles as the packaging should protect the product from light exposure.

Consistent use of the ABCs for facial skin care ultimately leads to a healthier, brighter and firmer appearance of the skin. Know that a few days’ use of topical products will not make a dramatic impact. Many patients express disappointment that a retinoid didn’t work after only a month or so. These products need to be applied for months and ideally years for the greatest benefit.

There are also various in-office treatments that can offer faster improvement compared with topicals alone. Cryotherapy or “freezing” can be used, but this method carries a higher risk of dyspigmentation compared with more advanced device-based techniques. Chemical peels with ingredients such as retinoids, glycolic acid, and trichloroacetic acid are also effective. Lasers and light-based devices are commonly used to treat sunspots. Keep in mind that you may need more than one treatment to get the results you desire.

When considering treatment, timing and preparation are key. Be aware of treatment costs, as insurance plans rarely cover cosmetic services. If you are preparing for a special event, start months in advance and be aware of any downtime post-procedure. Board-certified dermatologists and physician specialists have advanced knowledge of peels and devices to tailor treatment to your unique skin type and goals.

If you are concerned that a spot may be cancerous, don’t wait. Call your dermatologist to have it checked.

Elizabeth Jones is an assistant professor in the department of dermatology and cutaneous biology at Jefferson.