You’re Not A Leopard

You know the saying – a leopard can’t change its spots?

Well, my dear, you are no leopard.

My sister asked me recently “What can I do for my spots?”

Spots may be freckles, melasma, sun spots or age spots. But let’s face it, other than some adorable freckles, most of us want to lighten or eliminate the spots we have on our faces. Not only can they be unattractive, but they can also make us look older than we feel.

I have spots (melasma and sun spots) that I want gone. So far the only thing I’ll acknowledge as a possible age spot is on my hand. Ugh.

I have freckles too, which I don’t mind.

Let’s do an overview on things you can do to remove spots.

As I started on this, I realized it was going to be ridiculously long – so this is Part 1. Part 2 will follow next week!

Part 1. Topical Treatments

These range in effectiveness and very much depend on what kind of spot, how deep it is, how dark it is, how good you are at using it consistently (and preventing NEW spots with the consistent and liberal use of sunscreen!)

The topical treatments may bleach your skin, break down the melanin (the pigment responsible for the dark spot), prevent new melanin, encourage more rapid cell turnover, or reduce inflammation.

I’ve tried them all – in products of course!

Licorice Root Extract

Licorice extract produces a flavonoid (glabridin) that can disperse melanin, inhibit melanin biosynthesis and decrease free radical production by inhibiting a key enzyme.

Don’t believe me, trust the NIH.

One of my favorite products with licorice root is OLEHENRIKSEN Glow2OH Dark Spot Toner [affiliate link]. Now, I don’t think it stays on your skin long enough to do major repairs, but it’s a lovely product and the other products in the line, like OLEHENRIKSEN Sheer Transformation Perfecting Moisturizer [affiliate link], contain licorice root as well.

I use this as part of my daily routine and figure maybe it supports the other products I use! Either way this product line is one of my favorites and a current holy grail!

Flavonoids

Flavonoids, compounds derived from plants, have some anti-inflammatory, antioxidant and hypogimentation effects. (Basically hypo-pigmentation is light spots, hyper-pigmentation is dark spots.) These are being investigated but they show up in skincare products with a more natural bent. They can include, but are not limited to green tea leaf extract, aloe extracts, white birch extract, peony extracts, strawberry extracts, and more.

A favorite product of mine in this category is Kiehl’s Clearly Corrective Dark Spot Corrector [affiliate link]. I’ve used it off and on for over a decade and I can see a difference when I use it. I get overall lightening/brightening with this serum. It doesn’t irritate my skin but it doesn’t budge stubborn sunspots either.

Tranexamic Acid

Tranexamic acid is a man-made form of an amino acid (protein). It has many other uses but has been studied extensively for use combatting melasma. The studies are promising enough that it shows up in OTC skincare but not so miraculous that it’s replaced the gold standard for spot treatment (we are working our way down to it). I’d link studies but honestly there are so many.

It works by inhibiting the synthesis of melanin which prevents it from manifesting in the top layer of skin. It has been studied topically and orally I’m only experienced with the topical use.

There can be side effects to use, though typically not in the smaller amounts in OTC products. It continues to be studied because there are fewer side effects than the “gold standard” treatment.

I used the SkinMedica LYTERA 2.0 Pigment Correcting Serum [affiliate link] on recommendation from my dermatologist. I went through two bottles but didn’t notice any difference so I stopped. I wouldn’t rule this out for that reason alone since everyone’s skin is different. It simply didn’t work for my melasma. In fairness, it was one of the first treatments I tried when melasma first showed up about five years ago. It might be more effective on lighter spots.

Kojic Acid

Kojic acid is a byproduct of fungi from mushrooms. That’s the lay person explanation 🙂 but it’s a natural derivative and therefore a little more gentle than the man made compounds we are working our way up to. Most often it plays a supporting role, working well in combination with a variety of other topical treatments. Don’t be scared by the word acid. It’s not going to burn your skin off or anything – but it can be a little drying so if you are super sensitive, then you will want to work all of these into your routine slowly.

Kojic acid works by inhibiting the production of melanin which results in less pigmentation in the skin.

*I have a mixed ethnic background – asian and scandinavian. As you may guess I am VERY light skinned (prone to faux tanning!). These products can all have different impacts on people with different skin pigmentation and ethnic background so please…do your research as you narrow in…and work with a qualified dermatologist if you have concerns.

I tried the Dr. Dennis Gross Clinical Grade IPL Dark Spot Correcting Serum several years ago and didn’t feel it made any difference for me personally. However, I’ll mention it again in several other categories because it has a powerhouse of ingredients that may make it worth your while. In fairness I probably only used a single bottle. These days, I try products for several months before I pass judgment.

I was young(er) then!

I like the La Roche-Posay Mela-D Pigment Control Serum and I would recommend it to someone just starting on this journey. The biggest issue I had with it is that it disrupted so many other aspects of my skincare regime! There are some intense instructions with it so if your routine is already set, this one might not slip in easily.

Arbutin

Arbutin is the kinder, gentler sibling of the gold standard for hyperpigmentation treatment. It decreases melanin formation by inhibiting a key enzyme. It is less toxic than hydroquinone but its effectiveness is still being studied. It can both prevent and fade pigmentation and is generally well tolerated.

Peter Thomas Roth PRO Strength Niacinamide Discoloration Treatment has niacinamide, alpha-arbutin, kojic acid, tranexamic acid. I haven’t tried it…yet…but it’s next in rotation and sitting in my “to be tested” bin! I will keep you posted.

Ferulic Acid

I almost didn’t include ferulic acid in this list because it doesn’t eliminate spots, rather it prevents them. I think it plays an important part in keeping us spot free – but it’s not going to alter the ones that are already there. In nature, it comes from the walls of certain plants – but the version we have in skincare is lab-produced for ease and stability.

This works best when paired with other antioxidants. My favorite combinations are in the SkinCeuticals CE Ferulic [affiliate link], Paula’s Choice C15 Super Booster [affiliate link], Timeless Skin Care 20% Vitamin C Plus E Ferulic Acid Serum [affiliate link], and La Roche Posay Pigmentclar Serum Visible Dark Spot Reducer [affiliate link].

The vitamin C serums I listed all rotate through my skincare regime and the La Roche Posay definitely made a marked improvement in my hyperpigmentation. I will repurchase it as soon as I’m through my current trial (more on that later!)

Vitamin C is another ingredient that can help some of these be more effective but it only plays a supporting role so I’m NOT including it in this list.

Azelaic Acid

Azelaic acid is a skincare sweetheart these days because it works on a rane of skin conditions. For hyperpigmentation, it works by inhibiting an enzyme that leads to pigmentation. While there can be side effects, it’s a mild acid and dermatologists say that most people can tolerate it. Of course, the OTC strength you get will be much milder than what a dermatologist can prescribe so you’re pretty safe if you’re buying off the shelf.

There is an interesting study with azelaic acid in combination with retinoids that shows it might actually BEAT the gold standard in combination, but the concentrations and combinations used would require a prescription.

I’ve used The Ordinary Azelaic Acid Suspension 10% without any issue. The price point is good but I didn’t find any amazing results. I might try it again in combination with tretinoin but that’s not for the faint of heart. It’s also found in Dr. Dennis Gross Clinical Grade IPL Dark Spot Correcting Serum.

Glycolic acid

Glycolic acid is a mild alpha-hydroxy acid that can be used in combination with other things to gain some benefits in skin-lightening property. It’s particularly good for post-inflammation discoloration because it’s a gentle exfoliator. It helps slough off outer layers of skin which eventually leads to brighter, newer skin.

It helps accelerate pigment dispersion and reduces the formation of melanin.

Glycolic acid is a regular part of my skin care regime and while I think it helps promote brighter and more youthful skin, I don’t believe that (for me) it has helps with lightening my melasma. That said, it is in some of my favorite products, working side by side with other pigment fighters, so maybe I’m wrong!

Specifically for the purpose of treating hyperpigmentation, it’s in these products I’ve already mentioned. OLEHENRIKSEN Glow2OH Dark Spot Toner [affiliate link], Dr. Dennis Gross Clinical Grade IPL Dark Spot Correcting Serum, and La Roche-Posay Mela-D Pigment Control Serum all have glycolic acid.

Niacinamide

This is another one that almost didn’t make the list because while there is some evidence that it works on hyperpigmentation in the short course, it seems to hit a wall longer term by reaching its maximum benefit around a month. After that, it’s about as good as it gets. However, for anti-aging, it’s a huge component to help fight wrinkles.

Most people can tolerate it but it’s definitely one that you might need to break your skin into. I find that I can’t use niacinamide in combination with other topicals – so I have to alternate days/nights that I use it. Again, for someone with a more simplified skin care routine, this might slot in very easily and play a great supporting role in overall skin brightness.

It’s an ingredient in the SkinMedica LYTERA 2.0 Pigment Correcting Serum [affiliate link] as well as Dr. Brandt Skincare Dark Spots No More® Triple Acid Spot Minimizing Concentrate (which also has azelaic and tranexamic acids) and the Peter Thomas Roth PRO Strength Niacinamide Discoloration Treatment.

Tretinoin

Tretinoin is a form of vitamin A and shows up in combination with other things to treat hyperpigmentation. Mostly this is used to fight wrinkles by improving skin turnover but…there are a lot of considerations. Tretinoin is a prescription based treatment which needs to be worked up to. So while it can boost the effectiveness of other topicals for hyperpigmentation, you need to work closely with a dermatologist. By itself, it’s not going to fade spots. AND…it can cause irritation and inflammation if used incorrectly or if your skin is sensitive – which can increase hyperpigmentation.

I wanted to mention it but I’m not including products with it for this list.

Hydroquinone “The Gold Standard”

Alright, we’ve arrived at the end, the holy grail. You might wonder why I didn’t just start here, but there are plenty of reasons.

Hydroquinone works to lighten your pigmentation by decreasing the number of melanocytes present, which in turn reduces your melanin.

It takes some time for the ingredient to take effect and it continues to improve while you use it. So far this is all good news, right?

However, there is controversy about its toxicity. Some countries have banned it outright. Here in the US, it’s considered safe but the usage recommendation is that you take breaks from it. That alone was enough to put me off.

I tried it at a 2% concentration in over the counter creams but found they didn’t show any appreciable difference after 60 days. I find that many of the other creams work well enough to make me avoid it.

However, I’m in the middle of testing Musely which has 12.5% hydroquinone in its formula and requires a prescription but I’m only a couple of weeks into it and don’t have anything to share. If you try other things and still can’t get your pigmentation to budge, then I would make an appointment with a dermatologist and discuss if hydroquinone is appropriate for you.

Recommendation for my sister

I promised my sister I would give HER a recommendation after all of this nonsense. I am more familiar with the products in her skincare regime and her general approach to self-care. So for you, my beloved sister, I think you should start with Kiehl’s Clearly Corrective Dark Spot Corrector [affiliate link]. You may need to be patient and wait 2-4 months to see any differences (remembering to use that sunscreen EVERY DARN DAY!). If you are feeling less patient, then I would use the La Roche Posay Pigmentclar Serum Visible Dark Spot Reducer [affiliate link]. These are two products I’ve used with good success for quite a while now. (Remember to take dated before and after pictures!)

To be continued – Part 2 – Treatments – next week!!