How to remove sunspots on the face and décolleté?

One of the most frequent reasons I see in the office is to remove sunspots on the face. And what I hear most frequently during the first consultation with my patients is something like:

- Doctor Sebastian, since a few years ago I have noticed that these dark spots have started to appear on my face and I don't know how to remove them. I am now very sun conscious and wear sunscreen every day. In addition, I have tried different products recommended to me at the pharmacy to "remove the spots" but I have not seen any improvement. Also, I have visited a doctor and he gave me a treatment, but these spots are still there. I don't know what to do anymore. 

And this is where I usually respond to them:

- Unlike other types of facial blemishes, sun spots will not be removed with creams or home treatments. For their removal, an effective dermatological treatment is necessary. Now I will tell you what it is all about. 

Skin care starts with understanding what is happening to you and having a correct diagnosis made by your specialist. Only then can you take effective measures to remove sun spots.

removing sun spots on the face and décolleté

What will I talk about in this article?

Now, medically speaking, these famous sun spots, senile spots, old age spots or liver spots are medically referred to as solar lentigines. Solar lentigines are caused by many years of exposure to the sun, even from the moment we are born. That is why dermatologists say that the skin has memory and all the sun (UV radiation) that we accumulate will manifest itself at some point in our lives. 

If you have sun spots you will be interested in reading this article because we will see how to remove sun spots on the face effectively. 

What are sunspots or sun lentigines?

Sunspots or solar lentigines are flat, harmless brown lesions which appear on areas of the skin frequently exposed to the sun. They may also be called age or liver spots, although they really have nothing to do with the liver. 

Although they usually appear in people over 50 years of age, they can also appear in people over 50 years of age. younger people who spend a lot of time in the sun without sunscreen or use tanning booths. This is something that dermatologists are very concerned about because we are seeing it more frequently every day and it increases the risk of skin cancer. 

What do sunspots on the face look like?

Here are some pictures of my patients so you can see what we mean when we talk about sunspots or sun lentigines.

Patient seeking removal of sunspots on the face, also known as sun lentigines.

Patient presents with a single solar lentigo on the right cheek. 

Patient with multiple solar lentigines on the face due to sun exposure.

On the other hand, this other patient has multiple solar lentigines.

As you can see in the photos, sometimes these sunspots can occur in young people and usually appear in small amounts. 

As we continue to accumulate sun, or rather ultraviolet radiation, these spots will continue to appear and affect the entire face. 

Can they appear in other parts of the body?

Yes, solar lentigines usually appear on all areas of the body that are chronically exposed to the sun, although the most conspicuous places are the face, décolleté and back of the hands. 

Solar lentigo on the back of the hand
cleavage of a patient with many sunspots or sun lentigines

What is the most effective treatment to remove sun spots on the face?

Treatment begins with visit a dermatologist so that you can make a correct diagnosis of facial blemishes. This is very important because there are many different types of facial blemishes and each one has a specific treatment.

True story! Not long ago, a patient came to my office with a facial blemish that did not improve despite the fact that he was receiving lasers at an aesthetic center. When I first evaluated this lesion with dermoscopy I realized that it was not a solar lentigo or sun spot, but of true melanoma (skin cancer).. Fortunately, these cases are not so frequent but I am constantly encountering misdiagnoses and that is why the spots do not get better. In this case my patient required surgery to remove the cancer and is now doing very well. 

Solar lentils, to be eliminated completely need destructive treatment, either with lasers, deep dermatological peels or cryotherapy. Quote There are more methods but these are the main ones. 

Let's review some of them and their advantages.

1- Lasers and intense pulsed light

The use of lasers and intense pulsed light are the best treatments for patients who have sun-induced facial spots (sun spots) and wish to remove them.. They allow us to treat the entire surface of the face in a single session, very effectively and with excellent results. 

Here you can see me performing an intense pulsed light treatment on a patient who had facial sun spots.  

Dr. Sebastian Podlipnik ready to remove sunspots on the face with intense pulsed light

How do lasers work to remove sun spots on the face?

The mechanism of action of lasers and IPL is based on the energy of light to target a certain skin color known as a chromophore. For example, in the case of facial blemishes the laser energy is directed against the brown color. 

When the target color or chromophore is heated very selectively it will cause the unwanted cells to fragment and then your body will eliminate them in the following days of the procedure. 

TI explain the whole process in the following illustration. 

Diagram of the skin showing pigment in the superficial layer.

1

Surface pigment
IPL laser applied on the skin to remove blemishes

2

IPL realization
After IPL is performed, the removal of pigment in the skin is shown.

3

Pigment removal
After the IPL procedure, skin without pigment is visible.

4

Resolution

What results will I get with lasers or IPL?

Once the treatment is done, the spots may be a little darker during the first few days. During the following days you will have some scabs on the spots that will fall off during the next 7 days. 

During the following weeks your skin will continue to regenerate and the spots will improve noticeably. Let's take a look at some examples that will be much more illustrative and easier to explain.

Case 1
Many stains
Before and after results of an intense pulsed light treatment to remove sunspots on the face

In this first case we can see how after 1 session of intense pulsed light (IPL) the spots have improved a lot and also the quality of the skin. 

Case 2
Many sun spots and redness due to sun damage
Facial blemishes caused by sun exposure. Before the procedureFacial blemishes caused by sun exposure. After the procedure

In this other case we can also see the significant improvement in the facial blemishes of this patient after 2 sessions of intense pulsed light (IPL). In addition we can also see how the redness (vascular component) of sun damage improves. 

When can I return to work?

After a laser or intense pulsed light treatment, your skin tone will be more uniform and since the light does not damage other tissues, you will improve quickly and patients can immediately return to their daily activities. 

It is important to protect yourself properly from the sun, avoiding direct sun exposure, during the sunny season. following 4 weeks after treatment

After laser treatment, will I never have spots again?

This question is very important because with these treatments, you will improve a lot, but if we do not do a proper maintenance treatment, the stains may reappear.

 When we do a laser, we are treating the visible signs of sun damage to make it look healthier and blemish-free. However, sun damage produced by ultraviolet radiation has been accumulating in our skin from the moment we are born. This sun damage is irreversible and is found inside our "sun-aged" cells, which in the future will produce new facial blemishes if we do not take care of ourselves. 

But don't worry, usually what we recommend to our patients after a laser or intense pulsed light treatment is the following: 

  • Maintenance sessions: This is the same as going to the gym. If you want to have a good body it is important to take care of it and train regularly. If you want to keep your skin healthy and free of sunspots you have to repeat these procedures from time to time. I recommend doing one session a year to keep improving the quality of your skin. 
  • Treatment with preventive creams: Another pillar will be the use of creams to improve the quality of photodamaged skin. Among our star compounds are antioxidants, such as vitamin C in the morning and retinoids at night. In my facial blemishes book I explain these routines in depth. 

2- Cryotherapy to remove solar lentigines

Cryotherapy is based on the application of liquid nitrogen to freeze different skin lesions in a controlled manner. It is very popular and used by all dermatologists. It is a treatment that can be considered in those patients who have few solar lentigines and the rest of the skin is healthy. 

Among the disadvantages is that the treatment is somewhat more aggressive than with laser or IPL and sometimes there can be persistent marks for a longer period of time. 

3- Powerful selective peelings

Dermatological deep peels are another option we can try to remove sun spots. We have to remember that these lesions are found in the deepest layer of the epidermis and that is why more powerful acids need to be applied in order to reach these spots. 

If they are performed by dermatologists specialized in peelings, they are very safe and can be a very good option. Among the best known is trichloroacetic acid at 35%. 

What can I do to prevent sunspots?

And as always, we come to the most important but hardest part to do; !Prevention!

If you had been properly photoprotected during our lifetime, you would probably not be reading this article right now. Today we know that these spots are not caused by age, but by chronic sun exposure. 

Sun protection is the most important measure you can take to prevent the formation of age spots. It is important to remember that the sun's rays affect the skin even on cloudy days, so give your skin the daily protection it needs. If you don't know how to choose a good photoprotector, I leave you this post in my blog where I show you the best options in photoprotection.

In addition, as I told you previously, the application of retinol creams and the use of antioxidants such as vitamin C. will also help prevent the appearance of sunspots. 

Final words and my recommendation to remove sunspots on the face

As I have already told you the most important thing to have good results is to make a correct diagnosis. There are many, many different causes of facial blemishes, including the dreaded melanoma or skin cancer. 

That is why before you start using homemade treatments or expensive "anti-sunspot" creams that will not help in this case, go to your dermatologist for an assessment and an effective treatment to remove sunspots on the face. 

If we do things right from the start we will end up saving money and you will get much better results. 

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Sebastian Podlipnik - Skin cancer

Sebastian Podlipnik

Dermatology Blog

I am a dermatologist and cum laude MD and author of multiple research studies. I specialize in skin cancer, laser technologies and cosmetic dermatology. The intention of this blog is to bring you closer to topics of interest in dermatology and research.

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