"Doctor, I've been trying for months remove blemishes from the face And I no longer know what cream to try. I've spent over 300 euros." This is a conversation I have in consultation almost every week. The patient opens her toiletry bag and takes out three, four, sometimes six different products, all promising the same thing: to eliminate dark spots in 3 days, 7 days, 14 days. None have worked.
The problem isn't that there isn't a solution, but that Not all stains are the same.. A solar lentigo, hormonal melasma, post-inflammatory hyperpigmentation, or (in the worst-case scenario) a facial lentigo maligna are conditions with completely different mechanisms. And each one requires a different treatment. Therefore, before discussing "how to remove dark spots on the face," you need to understand what you're seeing in the mirror.
In this article, I explain, from my experience as a dermatologist specializing in pigmentation in the Hospital Clínic de Barcelona, what types of stains exist, how to prevent them, what really works (and what's marketing), and what you can really expect from each treatment.
Why do facial blemishes occur?
80%
Visible facial aging comes from the sun, not the passage of time
It's an idea that's hard to accept in consultations. Patients who have always taken care of themselves, who say they've never been in the sun "directly," look in the mirror at 35 and see spots that weren't there yesterday.
Ultraviolet radiation from the sun, or tanning beds, It is the main cause of blemishes on the face. Hyperpigmentation usually appears starting at age 30, precisely when the skin begins to show the consequences of accumulated sun exposure during adolescence. Sun damage doesn't show up the day you sunbathe; it shows up 15 or 20 years later. That's why dark spots always look worse at the end of summer, and that's why sunscreen from March to October is non-negotiable.
There is a second factor that weighs heavily on women: the Hormones. Estrogen and progesterone stimulate melanin production. This is why pregnancy, hormonal contraceptives, or certain replacement therapies can trigger diffuse brown spots, typically on the cheeks and forehead, which do not always disappear after childbirth.
Finally, there is a genetic component: people with fair skin or hair Those who have suffered sunburns in childhood start with an increased risk throughout their lives. That history doesn't disappear. What can be done is to protect yourself better from today on.
- Hyperpigmentation
- Localized increase in skin pigment (melanin). It is the general medical term that encompasses all types of brown facial spots.
- Melanogenesis
- Biological process by which skin melanocytes produce melanin. It is activated by UV radiation, high-energy visible light, and certain hormones.
- Skin types
- Skin classification according to its response to the sun (I to VI). Phototypes III-VI (darker skin) have a higher risk of hyperpigmentation from visible light.
- Phytophotodermatitis
- Skin reaction caused by contact with certain plants (lemon, celery, parsley) plus sun exposure. Leaves persistent brown spots that are very difficult to treat.
- Hydroquinone
- Topical depigmenting agent that inhibits tyrosinase, a key enzyme in melanin production. It is the gold standard for melasma and hyperpigmentations.
Quick Glossary
Brown spots on the face, or hyperpigmentation, occur when some areas of the skin produce more melanin than usual. Melanin gives the eyes, skin and hair their color.
What types of stains are there?
A few weeks ago, a 42-year-old female lawyer came to my office, convinced she had melasma. She had been months using a cream with hydroquinone without supervision. The spot she was worried about wasn't melasma; it was an incipient lentigo maligna. If she hadn't consulted, in five years it would have been a melanoma.
This story summarizes why the Pre-treatment diagnosis is not a detail; it's everything.. Most dark spots are benign, but some are not. And not all benign ones respond the same way. A treatment for solar lentigo can worsen melasma. A cream for melasma does nothing for a pigmented basal cell carcinoma. As a dermatologist specializing in melanoma skin cancer, I'll tell you in advance that the actual list of causes has hundreds of entries, but these are the ones I see almost every day in consultations.
- Melasma: Symmetrical and irregular hormonal-based spots, common during pregnancy and with contraceptives, and worsened by the sun. They are chronic and require specific treatment. I explain everything in my post dedicated to Step-by-step treatment of melasma.
- Post-inflammatory: after an inflammatory process, spots may appear on the skin. such as severe acne, irritation from waxing or a rash.
- Solar lentigo or sun spots: almost all of my patients blame age for these spots, but they are not actually produced by aging, but by the progressive accumulation of ultraviolet radiation from the sun and tanning beds. They respond excellently to IPL laser. I delve deeper into my post about How to remove sunspots on the face with laser and IPL.
- Ephelides: also known as freckles. They are absolutely normal and tend to appear early in life.
- Skin cancer: fortunately Melanoma is not as frequent but it is the most important and can also manifest itself as a brown spot on the face. Like specialist in the Melanoma Unit of the Hospital Clínic de Barcelona. I see many of these lesions and it can be very difficult to differentiate them from sun spots if you are not a specialist dermatologist.
The 4 types of facial spots
Quick guide to identifying your stain
Dr. Sebastian Podlipnik · Dermatologist · sebastianpodlipnik.com
⚠ Consult your dermatologist urgently if a spot meets any ABCDE criteria
- ASymmetry: one half of the stain is not equal to the other
- BIrregular edges: ragged, blurred, or poorly defined
- CHeterogeneous color: multiple colors in the same lesion (brown, black, red, white)
- Ddiameter of 6 mm, about the size of a pencil eraser
- EEvolution: changes in size, shape, or color, or bleeds over time
How to prevent spots from appearing on the face?
There is a phrase I repeat in every consultation: "The best treatment for a stain is to prevent it from appearing.". It seems obvious, but most patients come to my office after years of neglecting this step. And then they're surprised when the results of the most expensive laser last only a few months.
Prevention is not a supplement to dermatological treatment: it is the base on which any treatment makes sense. If you do laser, if you use hydroquinone, if you undergo a chemical peel, and then go out the next day without sun protection, you're throwing your money away. In the following lines, I'll explain what types of light cause spots (there's more than one), how to protect yourself from each, and what products I recommend to my patients in consultations.
This article contains affiliate links. If you purchase through them, I receive a small commission at no additional cost to you. I only recommend products that I use or that meet rigorous dermatological criteria.
If you are careful and limit your sun exposure, you will never have a brown spot to begin with.
Year-round sun protection
If you are careful to limit your exposure to the sun, you will probably never get a brown spot. Regular application of sunscreen and protecting your skin when the sunlight is most intense are the most effective things to do to avoid getting a brown spot.
But beware, the sun is not the only source of radiation or light that can cause facial blemishes. Now I will explain what types of staining light exist and what they are. check this link if you want to know more about sun protection.
The sun
The sun is the main culprit in the development, progression and maintenance of facial blemishes. When we expose ourselves to the sun we are exposed to Ultraviolet (UV) radiation that will cause damage to our DNA and the release of oxygen free radicals in our skin.
To defend ourselves, our skin activates a defense mechanism against this radiation, producing a tan. So, even if you like your summer tan, you should be aware that lhe skin has memory and it will gradually accumulate all this radiation that we are providing it with. All this cellular damage will surface years later in the form of brown spots on your face.
Many of my patients claim that they tan in order to produce vitamin D, However, more sunshine is not synonymous with more vitamin D.
Tanning booths (UVA rays)
Both ultraviolet A (UVA) and ultraviolet B (UVB) radiation cause cellular damage that can cause facial blemishes but also skin cancer.. When you lie in a tanning bed, you are mainly exposed to UVA rays, which are more harmful and penetrate deep into the surface of the skin, damaging the cells underneath and prematurely aging your skin.
Tanning booths use high-pressure sun lamps that can deliver up to 12 times the annual dose of UVA rays compared to the dose you receive from sun exposure. We would therefore be accelerating the production of spots and increasing the risk of skin cancer by up to 75%.Quote Although Spain has no legislation to deal with them, other countries, such as France have banned the use of UVA booths for several years.
Blue light
High-energy visible light, also called blue light (HEVL), does activate melanogenesis and can worsen hyperpigmentation, especially in phototypes III-VI. But here we need to set things straight because there's a lot of misinformation surrounding this topic.
Let's start with the most compelling data point. A systematic review published in Photochemical & Photobiological Sciences, directed by the group of Dr. Henry W. Lim (one of the world's leading authorities in photomedicine), applied the OHAT framework (the standard for assessing health risks) to all available studies on blue light from electronic devices. The conclusion was clear: Exposure to blue light from screens was NOT identified as a danger to skin pigmentation, melasma, or photoaging. (Ceresnie et al., 2022).
A second job from Photobiology Dermatology Laboratory of the University of Malaga quantified the effective blue light irradiance on the skin according to its source: blue light represents 25% of solar radiation, while electronic devices emit around 30% of their radiation in this band. The key difference lies in the intensity: A few minutes outdoors at midday far surpass hours of continuous screen time. (de Gálvez et al., 2022).
Does the sun or screens stain your skin?
What the scientific evidence says
THE SUN
Dominant Source
25% of solar radiation
It's high-energy blue light
Activates melanogenesis and worsens pigmentation, especially in phototypes III-VI
SCREENS
Minimal impact
OHAT Systematic Review
the risk assessment standard
Not identified as a danger to pigmentation, melasma, or photoaging
Sources: Ceresnie et al. 2022 (Photochemical & Photobiological Sciences, Henry Ford Health) · de Gálvez et al. 2022 (Univ. Málaga)
Dr. Sebastian Podlipnik · Dermatologist · sebastianpodlipnik.com
Most “blue light” cosmetic products capitalize on an outsized fear of their real impact. The correct message is simple: concentrate your efforts on proper daily sun protection, not on sunscreen. This includes frequency (at least twice a day) and adequate amount: 2-3 ml on the face and 1.5 ml on the neck and décolletage.
Recommendations to protect yourself from different types of light
A daily preventive routine should include the application of a broad-spectrum sunscreen with SPF 50 every morning. It should also have a mineral base that includes protection against UVA, UVB, blue visible light (HEVL) and infrared (IR-A).
- Use sunscreen: apply sunscreen daily at the end of your care routine in the morning.
- Repeat: reapply every two hours on sun-exposed areas.
- Covering the skin: wear wide-brimmed hats, sunglasses and protective clothing against ultraviolet rays.
- Avoid: avoid sun exposure during the hours of highest UV index (between 11 am and 4 pm).
2. Depigmenting creams with antioxidants
La vitamin C can be used as a topical antioxidant that helps prevent free radicals from causing oxidative damage to the skin (which can lead to wrinkles and dull skin and blemishes, among other things). It also inhibits the enzymatic processes that produce melanin in the skin, so it can help prevent and reduce hyperpigmentation.
How to use it: Apply a few drops daily to cleansed skin, preferably before applying sunscreen in the morning.
My favorites:
3. Retinoids or vitamin A derivatives
Retinoids can work wonders to prevent and improve brown spots on the face by stimulating collagen production and accelerating cell turnover. Retinol can irritate the skin at first, so start using these products gradually.
How to use it: Apply every night before going to sleep. Start a few times a week and then increase the frequency progressively until every night.
My favorites:
4. Other pharmacy creams
Chemical exfoliants typically use various types of mild acids to remove dead skin cells in the top layer of skin. Removing this layer can help reveal healthier, more even-toned skin and disguise blemishes. Although many of these are less potent than retinol, they can also cause skin irritation.
Depigmenting creams that use chemical exfoliants may contain the following ingredients:
- alpha hydroxy acids (AHA)
- beta hydroxy acids (BHA)
- azelaic acid
- glycolic acid
- lactic acid
- mandelic acid
- salicylic acid
These products can be purchased over-the-counter or in more potent forms from a dermatologist. It is important to use chemical peels sparingly, as the skin needs time to rebuild and repair itself. Using a product more often than intended may cause irritation or inflammation. If you experience any side effects, stop using that product.
I have followed all the above steps but I still have spots!
Don't worry: there are many treatment options left. Most of my patients with stubborn blemishes improve by following the protocol detailed in my book, even before needing an in-person consultation. There you'll find the step-by-step diagnosis, morning and night routines according to your skin type, and what to truly expect from each treatment.
If the book doesn't solve your case, or if you live nearby and prefer an in-person consultation, you can also book a dermatology visit.
How to remove spots on the face with an expert dermatologist?
Now, if you've made it this far, it's time to reinforce the treatment and search for more potent and effective procedures to remove blemishes on the face more rebellious. Depending on the initial diagnosis that we will make in our office, we will start an individualized treatment plan and once you have improved, we will propose a maintenance treatment.
1. Magistral formulations with hydroquinone
Hydroquinone is one of the most most commonly used treatments to treat hyperpigmentation on the face for the last 50 years. This depigmenting cream is widely used in master formulas by dermatologists, often in combination with kojic acid, tranexamic acid and retinoic acid. At the biological level, hydroquinone acts by inhibiting an enzyme called tyrosinase, which contributes to the production of melanin. Naturally, the less tyrosinase is produced, the less melanin is produced.
La triple combination of hydroquinone 4%, tretinoin 0.05% and fluocinolone 0.01% (the classic Triluma) is the only FDA-approved treatment for melasma and continues to be the gold standard for its proven efficacy across all phototypes. (Mahajan et al., 2022).
In some cases, the effects of hydroquinone can be seen in as little as two weeks. However, the Most patients should wait at least 8 to 12 weeks of use to see a visible difference. The speed of response will depend on some factors such as the extent of the hyperpigmentation, the depth of the spots and how long you have had the spots.
Alternatives for those who can't tolerate hydroquinone They exist. A controlled trial showed that thiamidol 0.2% redujo la severidad del melasma un 43% en 90 días, superando al 33% de la hidroquinona 4%, con mejor tolerancia (Lima et al., 2021). And a meta-analysis of 673 patients found that the azelaic acid it can be even superior to hydroquinone in reducing MASI (Albzea et al., 2023). Topical tranexamic acid, niacinamide, and kojic acid are also clinically supported alternatives (Suliman et al., 2025).
This depigmenting cream is especially indicated for facial spots after pregnancy and other diffuse hyperpigmentations. Due to its potential for irritation, it is necessary to be supervised by a dermatologist to avoid complications. Here is the case of a patient who had multiple spots on her face secondary to chronic sun exposure and aggravated by her hormonal profile.
Dermatology tip: This master formula for skin lightening is typically used for 2 to 3 months, always under the supervision of a dermatologist. Once discontinued, it will be necessary for you to continue caring for your skin with photoprotection and a specific cream.
2. Lasers
A more aggressive option for improving and removing brown spots on the face is laser treatment, which uses concentrated light energy. Some laser treatments are directed against the pigment itself, while others work by removing the skin layer by layer.
Lasers are the best treatment to improve brown spots on the face caused by chronic sun damage (sun spots or age spots). Lasers use a beam of light that has a specific target or chromophore (pigment) that ends up destroying it and then the particles are eliminated through the skin. If you are interested in learning more how lasers work and what other indications they haveYou can see my page dedicated to this subject.
For melasma specifically, a controlled trial demonstrated that Nd:YAG picosecond laser (1064 nm) was superior to picosecond alexandrite laser and 2% topical hydroquinone%, with a good safety profile in phototypes III-IV (Liang et al., 2023).
Dermatology tip: Keep in mind that 1 to 3 laser treatments (possibly even more) will be required, with four to six weeks between sessions, and should only be performed by qualified laser professionals.
3. Microneedeling or microneedling
It is an excellent option for patients who have darker skin or who for other medical reasons cannot undergo the previously described procedures. It is a minimally invasive treatment that uses very fine titanium needles. which creates a series of micro lesions that increase the skin's collagen production and improve elasticity.
To obtain the best results in case of facial blemishes, the microneedling is often combined with topical treatments. Once the small channels through the skin have been created, it is possible to infuse ingredients with depigmentation activity, such as tranexamic acid or vitamin C.
Dermatology tip: A minimum of 3 treatments separated by at least 6 weeks should be performed.
4. Chemical peels and masks for medical use.
Depigmenting exfoliating treatments and professional-use masks remove the top layers of skin. Over time, these treatments can stimulate collagen production, improve cell turnover and reduce the appearance of dark spots on the skin. However, always beware of an overly potent chemical peel, which can burn the skin.
The most common active ingredients in professional peels are glycolic, mandelic, salicylic and lactic acid and trichloroacetic acid. Although at-home peels are available, they are gentler and will only remove superficial dead skin and will not go deep enough to treat brown spots on the skin.
Of course, be aware that chemical peels can be irritating, especially on sensitive skin, so if you have a history of rosacea or sensitive skin be sure to talk to your dermatologist to assess if this is the best treatment for you.
Dermatology Tip: Several sessions are usually performed (between 3 to 6) spaced one month apart. If more potent peels are performed, fewer sessions will be necessary, but there is a higher risk of complications.
5. Oral treatments
That's right, there are also oral treatments to treat spots on the face, especially those secondary to melasma or pregnancy spots. The tranexamic acid is an oral medication that inhibits melanin synthesis and the transfer of pigment to the top layer of the skin. Since melasma occurs when skin cells produce too much melanin, this makes tranexamic acid an ideal way to counteract brown spots on the skin.
A recent meta-analysis that brought together 22 clinical trials with 1,280 patients confirmed that oral tranexamic acid is the most effective route for reducing melasma severity, superior to topical or intradermal use (Calacattawi et al., 2024). Previous studies had already shown this significant improvement (Wang). In a retrospective review in Singapore, 91.7% of 561 patients who took oral tranexamic acid showed significant improvement (Zhang).
What is the appropriate dosage? A network meta-analysis established that the The optimal dose is 250 mg three times a day for 12 weeks., with 250 mg twice daily as an acceptable alternative in patients with low adherence (Wang et al., 2022). It should always be prescribed by a dermatologist after ruling out contraindications such as a history of thrombosis or the use of high-risk hormonal contraceptives.
As an adjuvant, the Polypodium leucotomos, an oral plant extract with photoprotective and immunomodulatory properties, can complement melasma treatment and daily photoprotection, according to a recent systematic review (Zundell et al., 2025). I delve into oral tranexamic acid in my post about melasma treatment.
Quick summary: what treatment do we apply depending on the type of stain
| Spot type | First-line treatment | Time to visible results |
|---|---|---|
| Solar lentigo | IPL Laser or Picosecond Nd:YAG | 1-3 sessions (4-12 weeks) |
| Melasma | Triple topical combination + oral tranexamic acid + photoprotection | 8-12 weeks (chronic, requires maintenance) |
| Post-inflammatory | Azelaic acid, niacinamide, or thiamidol | 8-12 weeks |
| Freckles | Prevention with daily sun protection | They fade in winter, they are not eliminated |
| Lentigo maligna / melanoma | Urgent dermatological evaluation and biopsy | It depends on the oncology treatment |
Dermatology tip: we normally use tranexamic acid as a second-line treatment in patients with melasma. It can also be used during the summer months when strong depigmenting creams should be discontinued.
I want to remove spots on my face but I don't know where to start.
If you've come this far looking for a clear answer, the next step is to understand your specific case. Not all stains respond the same way, not all treatments work for all types, and many patients lose months and money trying the wrong products. The facial spot book condenses the same protocol I apply in my practice.step-by-step diagnosis, morning and night routines by spot type, what to realistically expect from each treatment, and the most common mistakes that prevent seeing results.
Facial blemishes book
For all those who are far away or do not have the possibility to go to a dermatologist, I have written this book on facial blemishes.
In it I explain in depth the different causes of facial blemishes and leave you with specific guidelines for creams to start at home.
And, can home remedies remove spots on the face?
Now a final word about "natural" treatments or homemade products to remove blemishes on the face. Many of the home treatments recommended by different blogs or internet sites may not have any proof of efficacy or, more seriously, may not have any proof of efficacy, have side effects. Examples include lemon, baking soda and the apple cider vinegar. Actually, there are no scientific studies to back up claims that these treatments work.
In some cases, these depigmenting treatments may even can aggravate skin blemishes. In some patients these components can be irritants and produce a contact dermatitis (phytophotodermatosis) like lemon juice or some natural exfoliants. Consequently, they could generate a reaction called post-inflammatory hyperpigmentation that will worsen the spots and is then very difficult to improve.
Other products may also contain ingredients that can damage the skin or overall health, such as mercury or corticosteroids. The application of these can cause iatrogenic acne, facial rashes and produce irreversibly fragile skin over time.
Myths vs. Reality
Regarding facial blemishes
By Dr. Sebastian Podlipnik
"Lemon lightens dark spots."
It is phototoxic: it can worsen them after sun exposure (phytophotodermatitis).
"They pass alone with time"
Without treatment, lentigines tend to grow and melasma becomes chronic.
"Screens cause blemishes"
OHAT Systematic Review: Not a Hazard to Skin Pigmentation
"Sunscreen only in summer"
The UVA rays are present year-round, even on cloudy days, and can penetrate windows.
"A pharmacy cream is enough"
Effective treatments require 8-12 weeks with a dermatological regimen.
"The laser eliminates forever"
Without daily sun protection, the dark spots will reappear. Lifelong prevention.
sebastianpodlipnik.com · @drsebastian_derma
The 6 most common beliefs about facial spots that I hear in consultations, debunked. Save and share this infographic with anyone who needs it.
Frequently Asked Questions About Facial Stains
Can facial blemishes be removed permanently?
Yes, but it depends on the type of stain and commitment to prevention. Solar lentigines respond excellently to IPL lasers and are usually eliminated in a few sessions. Melasma is chronic and requires maintenance treatment. Without strict daily sun protection, recurrence is almost certain, even after successful dermatological treatments.
How long does it take for facial blemishes to disappear?
It depends on the treatment. With topical hydroquinone 4%, improvement is observed in 8-12 weeks. IPL laser shows visible results from the first session for solar lentigines. Melasma requires 3-6 months with a combined approach. No stain disappears in 3 days as the marketing promises.
Why do spots appear on the face?
The main cause is accumulated exposure to ultraviolet radiation from the sun. Other factors include hormones (pregnancy, contraceptives), genetics, skin inflammation (acne, dermatitis), and blue visible light from the sun, which also stimulates melanin production. Screens, on the other hand, have a much lower impact than the sun.
Does lemon remove spots on the face?
No. Lemon juice is phototoxic and can cause phytophotodermatitis: even more intense and persistent brown spots after sun exposure. No controlled study demonstrates its depigmenting efficacy. Safe cosmetic acids include glycolic, mandelic, and azelaic, always with photoprotection.
Are facial spots dangerous?
Most are benign (lentigines, melasma, ephelides). But some pigmented lesions are skin cancer: facial lentigo maligna, superficial spreading melanoma, or pigmented basal cell carcinoma. Any asymmetrical, rapidly growing, multicolored, or bleeding spot requires urgent dermatological evaluation.
What is the best dermatological treatment for dark spots?
There isn't a single best treatment; it depends on the diagnosis. For solar lentigines, IPL laser is the first choice. For melasma, the triple topical combination (hydroquinone + tretinoin + fluocinolone) + oral tranexamic acid + strict photoprotection. For post-inflammatory hyperpigmentation, azelaic acid or niacinamide.
Final recommendations for the removal of facial blemishes
If you had to take just one rule home from this entire list, let it be this one: Use a broad-spectrum sunscreen every day of the year.. Not on the beach, not on sunny Saturdays. Every day. Even cloudy ones. Even in winter. Sunscreen is the only "anti-aging treatment" with solid scientific evidence, and coincidentally, it's the cheapest of them all.
If you've gone years without protection and already have visible spots, it's not the end of the world. Modern dermatology offers increasingly precise tools: picosecond lasers that pulverize pigment in microseconds, compounded formulas adjusted to your phototype, oral medications with meta-analysis evidence. The next step is to get a correct diagnosis with a Dermatologist specializing in hyperpigmentation that can guide you on what treatment makes sense for your case.
With the right decisions, facial blemishes are no longer a recurring problem.. Most of my patients, after the first few months of treatment, forget about the issue and only maintain two habits: daily sun protection and an annual check-up. This is the life I'm inviting you to: not an obsession with dark spots, but a simple routine that allows you to look in the mirror without worrying about them.
Related articles for the spot cluster
- Treatment of melasma: if your spot is hormonal (pregnancy, birth control) or diffuse and bilateral.
- How to remove sun spots on the face: if they are solar lentigines or sunspots, and you are interested in laser or IPL treatment.
- The best sunscreensfundamental for prevention and maintenance after any treatment.
207 Responses
Hello! I have acne scars, but they are mild. I would like a treatment that is not too aggressive for the skin.
Hi Lidia,
There are many options you can explore, as I explain in this article. The most important thing is to be evaluated by a dermatologist who can explain the different, less aggressive options (peels, microneedling, etc.).
Best regards
In my case, I have freckles. Some time ago, I was diagnosed with melasma. I had a dark spot above my upper lip and was on hydroquinone treatment, but it irritated and reddened the area where I applied the cream a lot. Defeated, without finding a cure or at least for the spot to improve, I forgot about it. Then, I was gifted a cream, and along with wearing a mask (due to the pandemic), using sunscreen, hats, and an umbrella to avoid the sun, I FINALLY managed to eliminate that dark spot. I'm still using the little cream and avoid the sun at all costs.
Hello Sol,
I am very glad that you are much better with your melasma now. I always explain to my patients that in the treatment of facial blemishes, the patient plays a fundamental role, and if we don't have good sun protection, it's very difficult to improve the blemishes.
Good morning, the article is very interesting, thank you for sharing so much information.
I would like to ask for your advice regarding a scar on my face from a kitchen burn. I treated it with Silvederma and Linitul for about a week, and the skin that appeared is pink. I'm applying rosehip oil.
I don't think it's doing anything and I'd like to know if I can add something more effective.
Thank you very much for your attention
Hello Esther,
It seems to me that you've done everything very well. The most important things to do while the scar is pink are to protect it from the sun, avoiding direct sun exposure, and also to use broad-spectrum sunscreen. Among the scar gels, oils, and creams, I recommend one called Dermatix silicone gel which allows for the creation of an optimal healing environment. Use it every 12 hours for at least 3-6 months.
Best regards
Hello, I had a chemical peel 10 years ago and the spots are back now, what should I do, what do you recommend, thank you
Hi Karla,
I absolutely recommend going to the dermatologist to get re-evaluated and see what type of spots you have right now. In the meantime, use plenty of sunscreen and avoid tanning your face.
Best regards
I am from Venezuela, Maracaibo, and I can no longer stand these spots. I don't get
Hello Mayito. I can understand how difficult it is to live with these facial blemishes. Without a doubt, if you have the opportunity to visit a dermatologist, it's ideal for effectively treating the blemishes. I know Dr. Elizabeth Guadagnini in Maracaibo, and she is very good. For now, what you can do is protect yourself a lot from the sun by using sunscreen every day until you have a visit with the specialist.
Best regards
All this information is very helpful. I've had melasma on my cheeks for over 10 years. The dark spots are very dark and quite large. Of all the creams you mention here, which ones can you recommend to me?
Estimada Fabiola,
From what you're telling me, you must have long-standing and quite extensive facial hyperpigmentation. As for creams, we always recommend using sunscreen every morning, even in winter and on cloudy days. However, in your case, the most recommended course of action will be to see a dermatologist so they can assess your dark spots and offer you a potent depigmenting treatment.
Best regards
I've got some very ugly, dark spots near my cheeks that cover a large area. What's the best thing to do?
Hi Karina,
For now, the important thing is that you protect yourself a lot from the sun and that you make an appointment with your dermatologist.
Best regards
Very interesting article, and I have a question. Can LED masks currently on the market worsen facial blemishes?
Hello Maria Jose,
The truth is, it's a very interesting question. LED lights (Light Emitting Diode) are becoming trendy for many conditions (Acne, Melasma, Alopecia, etc.), however their effectiveness is somewhat controversial.
First of all, it's important to know that not all LED lights are the same, and depending on the type of light they emit, they can even worsen melasma. I don't want to get too into this topic, but to understand the concept, it's necessary to know what electromagnetic spectrum of visible light. Visible light wavelengths range from 380 nanometers (nm) at the blue end of the spectrum to about 700 nm at the red end. Therefore, LED lights emitting blue light can worsen melasma, as I explained in the article.
Nowadays there are Very few studies show efficacy in the treatment of melasma with LED, therefore I do not consider it a first-line treatment for facial blemishes.
Many greetings and I hope I have answered your question
Good evening Doctor, I appreciate your help. For a few months now, I've been getting brown and white spots that started between my back and forearm, reaching the right side of my breast and now extending over my shoulders and neck. Some of these spots protrude, itch with redness, and then turn white. The ones on the side of my breast are a map-like brown.
Dear Keila,
In your case, it's important that you go to a specialist so they can make a proper diagnosis. There are many different causes of brown and white spots on the skin, and each one has a different treatment.
Best regards
Hello, I have dark spots on my face due to medication (sertraline photosensitivity). I had a chemical peel, and I didn't have any unusual reactions, but I didn't notice any improvement. I have a follow-up appointment this Monday, but I'm already desperate. What can I use to reduce them? They cause me a lot of insecurity, and I feel very self-conscious about these spots. :'(
Hi Maria,
I perfectly understand what you must be going through. I would love to be able to help you, but without evaluating you in person, it's difficult for me to see your case properly. However, I can tell you a few things that might help you.
Drug-induced hyperpigmentation, specifically by selective serotonin reuptake inhibitors (SSRIs) such as sertraline, is a very rare phenomenon and occurs in very few patients treated with these drugs. Some scientific articles describe that this can happen due to an increase in melanin production with or without an increase in the number of active melanocytes. Normally, this pigment is deposited in the dermis (the second layer of the skin), and this is important when choosing a treatment.
If this diagnosis is indeed confirmed by a dermatologist, it is necessary to do the following:
1- Discontinue sertraline or the medication causing it and see your doctor so they can replace it with another.
2. Begin intensively protecting yourself from the sun with broad-spectrum sunscreens and accessories like hats, sunglasses, etc. This way, we can prevent the pigmentation from progressing further.
3 - Have patience and wait a few months to see if the pigmentation resolves. Sometimes it's better not to do anything in the initial stages due to the risk of worsening the pigmentation from the inflammation that many of these treatments cause.
If after a few months we see that the pigmentation does not improve, good results have been described with laser treatment (e.g., alexandrite laser or Q-switched ruby laser). To date, there is not much evidence that chemical peels improve drug-induced pigmentation.
Without a doubt, I would like to help you more, but without a proper visit, it is impossible to make a treatment recommendation and confirm the diagnosis.
Warmest regards, Maria, and I wish you all the best.
Hello! After a peeling treatment, my face was left with a blotch. The problem is that looking at images, my blotch looks like skin cancer and I have others in different places 😕. At the same time, on the same day, I had laser hair removal all over my body and upper lip. Could the blotch be hyperpigmentation, or should I see a specialist? Will the blotches go away?
Hello Evelyng,
It is important to know that there are hundreds of different causes of blemishes, which is why we spend a lot of time in consultations making correct diagnoses before providing generic treatments to remove them. Each type of blemish has a specific treatment, and that is why we need to see it in person first. My recommendation is that you always consult a specialist before undertaking any treatment.
Best regards
Hello!
I have dark spots all over my face. I went to a dermatologist and they prescribed me hydroquinone. I used it for two years and the superficial spots disappeared, but I stopped using it and the spots returned. I went to another specialist, and when I told them I was using hydroquinone, they told me to stop because it's bad. They proposed laser treatment. I had 5 laser sessions, and the spots are still there. I don't know what to do to reduce the spots anymore.
Dear Janeth.
Without knowing your case in person, I imagine you suffer from melasma. Melasma is less a disease that has a cure and more a condition that we will have to manage and maintain through some treatment throughout our lives, always protecting ourselves very well from the sun.
Hydroquinone treatments are widely used by dermatologists and, when used correctly, are safe and effective. The problem arises with indefinite use, without breaks, which can even worsen the condition in some patients.
Laser treatment will depend heavily on each patient and their skin type. It's not really the first choice for treating melasma, but it can work well for many patients.
Without a doubt, it's a difficult condition, but the most important thing is always to have patience and perseverance, and to seek out a good professional who can guide you and create a long-term treatment plan.
Hello!
I would like to know, I had laser treatment on my face to remove sun spots!
And instead of getting rid of them, I stained my face more, and now I have bigger, dark brown spots.
Hello Diana!
I hope you’re doing very well. Without a doubt, the issue of facial spots and their treatment is very complicated, and complications can arise from the treatments. Without examining you in person, it’s difficult to know what type of spots you have (solar lentigines, melasma, chloasma, etc.). Solar lentigines typically respond very well to various lasers, whereas melasma or chloasma can actually worsen. Without a doubt, the most important thing when removing facial spots is to have a dermatologist evaluate you, clearly explain your diagnosis, and thoroughly discuss the benefits and risks of each technique to prevent hyperpigmentation as a result of the treatment. If you currently have large, dark spots on your face, it’s very important to have them evaluated by a dermatologist as soon as possible so you can begin effective depigmentation treatment.
Best regards
Good afternoon, about six years ago a spot appeared on the side of my nose, but I feel like it has grown a bit. I've also developed more spots on my face and also on my neck that look like warts. I feel horrible!
I'd like a recommendation for a treatment, whether it's a cream or anything else. Thank you very much.
Isabel,
I hope you are doing very well. The best recommendation here is clear. You have to go to a dermatologist to evaluate your spots and do a treatment for them. Without evaluating your spots, we won't be able to recommend a good treatment and remove these «warts» in the consultation. Look at the following article I wrote about why It is not recommended to remove or burn warts and moles. at home without a prior diagnosis.
Hi, in my case, the spots were caused by microneedling—I don’t know why. I went to the doctor to improve my skin, not because of the spots, and the doctor suggested this treatment. The first session went well, but the second one triggered the terrible dark spots I now have on my face. I mentioned the dark spots during my follow-up appointment, and it seems the doctor wasn’t sure how to reverse the damage done to my skin. Now I’m worried. Is there a treatment that can reverse this damage? Has anyone else gone through something similar, even though every skin type is unique?
Thank you
Dear Janina,
I'm sorry to hear you had this kind of reaction with microneedling. There are many reasons why your face might hyperpigment after a procedure, such as post-inflammatory hyperpigmentation, sun exposure hyperpigmentation, or an allergic reaction. To be able to start a treatment and improve your skin, it's very important that you see a dermatologist so they can establish the precise diagnosis of what is happening to you. This way, they can give you a treatment.
Best regards
I've had the same thing happen to me. I went for some minor acne scars that weren't very deep, and it left me with a brown spot on one side of my face. I took all the recommended precautions after the microneedling. I don't know what to do. The doctor is telling me I'm stressed and that's why the treatment isn't working well, and that she's going to refer me to another dermatologist to see if I have better luck. But I don't want to go to someone else; she's the one who has to fix the problem, the one who performed the procedure and now left me with this little spot.
Hello Miguelina. One of the complications that can occur after any cosmetic procedure (laser, microneedling, peels, etc.) is post-inflammatory hyperpigmentation. If this has happened, it is very important to assess the problem in person to be able to manage it in the best possible way. Without a doubt, a very important thing is to protect yourself well from the sun and avoid tanning. Also, depending on what your dermatologist sees, they may also prescribe lightening creams or oral treatment for the same thing. Above all, you need to be patient because these spots can take several months to resolve. Finally, stress does not play an important role in the generation of facial blemishes. .
Best regards
Thank you very much for the response. She first did two microdermabrasions on me. After the second one, a small brown spot appeared on my cheek. I asked her why it happened and to remove it. Then, when I went for microneedling, she applied a lightening cream, as she told me, and the spot was removed. However, over the following days, another spot appeared, a little larger, a little lower than where the first one was. If she knew that could happen, she should have told me before doing the procedure. I would rather have a few small holes on my face than spots. It's stressful, and even though it's a brown spot that I can cover up, I still feel bad and don't want to have it.
Without a doubt, when we perform dermatological/aesthetic procedures, we always try to improve the problem. Unfortunately, there are situations where complications such as post-inflammatory hyperpigmentation can occur. Without seeing your case in person, it's difficult for me to give you specific recommendations. In general, these spots tend to disappear over time with significant sun protection. To make more specific recommendations for creams or other treatments, it would be necessary for you to visit.
Best regards
I have that problem too, and the spot settled into the hypodermis. Hydroquinone made it deeper, and neither kojic acid nor diacetyl boldine has done anything. I've seen two dermatologists, and there have been no changes. I don't know what to do.
Hello Janina,
Without seeing your case in person, I can't offer much of an opinion. There are many different types of skin spots, each with a different treatment. It's true that hydroquinone is a very good treatment, but in some cases, it can also worsen the spots. At this moment, I don't know your current condition to give you specific recommendations. I hope to have a virtual visit system soon that will help me be closer to my patients and allow us to resolve these types of doubts remotely.
Hi! Right now, the spot is starting to fade from the dermis. I keep my skin moisturized and always use sunscreen and a sun umbrella. A month ago, I started using a 10% glycolic acid solution with phytic acid at night. I live in the Dominican Republic.
I don't want to use hydroquinone. But I need to use a stronger depigmenting agent, at least to prevent the dark spot from getting darker. Or what peel do you recommend that I can get from a doctor or aesthetician to apply for me. Thank you!!🤗
Excellent content about skin blemishes. Thank you for sharing, regards.
Thank you so much for your comment, I'm glad it's helpful.
Greetings
Where is your clinic located?
Hello María del Pilar,
Thank you very much for your interest. The clinic where I work is located in Barcelona, Spain. You can see it on the contact page.
After finishing treatment with Hydroquinone, what type of cream should I use? Thank you
Hi Margery,
This will largely depend on each individual case and your skin type. Without a doubt, you must maintain strict photoprotection year-round and avoid tanning your face. As maintenance creams, we really like those with retinoids at night and also some with vitamin C in the morning. Check out my recommendations in this article.
Hello Doctor, how are you? I have acne scars on my face and I would like you to help me. I don't know what else to do. I am 36 years old. Thank you, good night, and blessings.
Hi Estela,
I would be delighted to help you and I'm giving you several options. Just 1 week ago I finished my Free printable face blotter download at the following link. In it, I largely explain why blemishes occur and treatments to eliminate them. I also have consultation in Barcelona, Spain Or I also have one Online consultation so you can connect from anywhere in the world.
Hello, good evening. What do you recommend for the white spots on my face? I started with a small spot and it's already getting bigger. I've been recommended a variety of creams and none have improved it. I await your advice 😔😔😔
I recommend you see a dermatologist, as there are many different causes of white spots on the face. Depending on the diagnosis, they will determine the best treatment for your case.