by Joel Bain Herron, MD
Over the course of our lives, the time spent in the sun accumulates, leading to various forms of sun damage, including unsightly brown spots, also known as Lentigos or “liver spots,” thanks to their liver brown color. When we are younger, excess sun exposure may manifest subtly as freckles, which will come and fade depending on the amount of sun exposure we get. But as we age, many of us develop permanent freckles or lentigos. These do not fade with time and accumulate through the years in sun-exposed areas such as the face, hands, chest, and upper shoulders.
Naturally, the best way to address lentigos is to limit sun exposure, and it’s always wise to wear good quality sunscreen and protective clothing whenever you’re planning time outdoors. But once you’ve accumulated a collection of brown spots, what can be done?
Treating Lentigos Topically
There are topical interventions to reverse some of the signs of aging and sun damage. Some of the most popular are topical bleaching creams, Retin-A-containing creams, and topical acids. These may be applied individually, or via a triple combination cream available at the office. The combination of topical agents results in a more aggressive approach to rejuvenation and more effective results.
A slightly more aggressive approach would be a series of superficial chemical peels with our aesthetician. These are referred to as “lunchtime peels,” as the amount of redness and downtime is minimal. Many patients have these done over the lunch hour and are still able to return to work that afternoon. The superficial chemical peels are meant to be done as a series of treatments, and gradual improvement will be seen with each session.
Laser Spot Treatment for Lentigo
For those looking for more dramatic results, we offer a series of more aggressive interventions. One of the most effective treatments we offer is a session with the YAG laser, which often results in an eighty to ninety percent improvement even with one treatment. The downside of treatment with a YAG laser is each spot that is treated will form a small scab, and it usually takes ten to fourteen days for the scabs to heal. Obviously, if we treat a large number of lesions, it will result in a noticeable postoperative appearance until these are healed. Also, the YAG laser treats one spot at a time. We may be able to treat hundreds of lesions in a session, but it does not cover the entire area of the face, hands, etc.
Full Area Laser Treatments
For those looking to rejuvenate an entire area, we offer treatments with the Secret RF or fractional CO2 laser. Both of these treatments treat an entire area at once. They result in an overall rejuvenation with tightening and smoothing of the skin as well as an improvement in the discoloration caused by sun damage.
The Secret RF treatment combines the benefits of micro-needling with radiofrequency. While the microneedles are inserted into the skin, radiofrequency (RF) is delivered directly to the collagen. This results in contraction, rejuvenation, and stimulation of new collagen. The reason it is called “secret” is that there is a minimum amount of downtime. Typically, patients are only pink for several hours to a day. Women may apply makeup as soon as four hours after treatment. Most people would be able to have treatment in the morning and go out to dinner that evening without drawing much attention.
Treatment with the fractional CO2 laser is another option for rejuvenating an entire area. Settings can be tailored to effectively address discoloration as well as overall rejuvenation. However, it does result in some significant downtime. There is approximately one week where patients may not wish to be out in public. There will be some redness, peeling of the skin, and the treated area must be covered in ointment. There is also more discomfort with this treatment as compared to the others.
If brown spots are getting you down, there’s no need to live with them! Our providers and offices can offer a wide variety of options to address lentigos. If you’re interested, please schedule an appointment with our aesthetician or one of our providers to assess your individual needs.