This 3-part series explains in detail the common pigmentary issues we take care of at IYAC.

Melasma, Hori’s Nevus, Age or Sun Spots

This section takes care of the age or sun spots, or any other brown raised spots that come about from growing older or being out in the sun.

What is Age or Sun Spots?

As we age, years in the sun add up.

Chronic sun damage manifests as brown spots on exposed skin (face, arms, decolletage, chest, back, legs) and are known as age/sun/liver spots or lentigos. They don’t hurt or itch.

Another common brown spot is seborrheic keratoses, common benign skin growths that increase with age. Early growths are small, light brown and minimally palpable. These early growths are often mistaken as “pigments”.  They can become bigger and take on a darker, brown-black and warty appearance with time. These lesions don’t respond to traditional lasers and are usually treated by a procedure called electrocautery.

What’s IYAC’s approach to Age or Sun Spots?

At IYAC, we tackle an assortment of pigments with a multimodal approach.

Topicals:
– Pharmaceutical-grade creams containing cysteamine^1,2 (antioxidant) prevent and lighten pigments.

Orals:
– Skin supplements can help to resist new pigment formation.

Skincare:

– Skin well-nourished and hydrated is less prone to new and stubborn pigments.
            – Use clean skincare that’s been formulated to contain botanical ingredients, with no nasties and with anti-pigment, moisturising and rejuvenation benefits.
– Sunscreen: Apply sufficiently (2 finger lengths to face and neck) with high SPF, UVA and UVB protection. Reapply regularly throughout the day.
 

Lasers:

– There are FDA-approved lasers to treat age or sun spots – the Q-switch Nd: Yag 1064nm laser³ and the pico pico laser⁴.
– These lasers break down pigments and lighten over time.
– Generally, at least 3 to 6 sessions are needed to visibly lighten the pigments.
– At each visit, depending on the type of laser and intensity that’s decided, pigments can:
 . Turn 2 to 3 shades darker & form scabs; when the scabs fall off, the skin may remain clear or darken before gradually lightening up in 2 to 8 weeks  or                           
 . Turn 2 to 3 shades darker & gradually lighten up in 2 to 8 weeks or  Develop petechiae (small red dots under  the skin) & heal over 3 to 7 days, then gradually lighten up in 2 to 8 weeks.                  

How about Seborrheic Keratoses?

As long as they can be felt, even if they are marginally raised or palpable, these brown spots will not respond to traditional lasers or IPL and must be vaporised with an electric pen, in a process known as electrocautery.

The treated skin is left with a small wound, that will scab and heal over in about 5 days.

Occasionally, the healed skin may turn darker after the treatment. This is usually temporary and total clearance can be sped up with medicated creams and further lasers.

Speak with us at IYAC to let us guide you on a journey to clean and healthy skin.

References:

1. Besouw M, Masereeuw R, van den Heuvel L, Levtchenko E. Cysteamine: an old drug with new potential. Drug Discov Today. 2013 Aug;18(15-16):785-92. doi: 10.1016/j.drudis.2013.02.003. Epub 2013 Feb 14. PMID: 23416144.
2. Mansouri P, Farshi S, Hashemi Z, Kasraee B. Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial. Br J Dermatol. 2015 Jul;173(1):209-17. doi: 10.1111/bjd.13424. Epub 2015 May 29. PMID: 25251767.
3. Levin MK, Ng E, Bae YS, Brauer JA, Geronemus RG. Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: A retrospective photographic review. Lasers Surg Med. 2016 Feb;48(2):181-7. doi: 10.1002/lsm.22454. PMID: 26922302
4. Alegre-Sanchez A, Jiménez-Gómez N, Moreno-Arrones ÓM, Fonda-Pascual P, Pérez-García B, Jaén-Olasolo P, Boixeda P. Treatment of flat and elevated pigmented disorders with a 755-nm alexandrite picosecond laser: clinical and histological evaluation. Lasers Med Sci. 2018 Nov;33(8):1827-1831. doi: 10.1007/s10103-018-2459-z. Epub 2018 Feb 9. PMID: 29423841.