Brown spots are a type of skin condition called hyperpigmentation, and they often form in response to years of unprotected sun exposure. There are an array of chemicals available in topical treatments that help fade brown spots. Some of the more effective include hydroquinone, dithiaoctanediol, gluconic acid, alpha hydroxy acids, azelaic acid and retinoids, notes Audrey Kunin, M.D., of the DermaDoctor website. However, for actual removal of brown spots, you may need to have a chemical peel.
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There are three primary types of chemical peels for remedying brown spots. The chemical applications remove layers of affected skin, allowing new, unaffected skin to grow back in its place. The different types vary in strength and penetrate to varying depths. As the American Society of Plastic Surgeons explains, the weakest, most superficial peels use alpha-hydroxy acids, including glycolic and lactic acid; mid-strength chemical peels, known as TCA peels, use trichloroacetic acid; the strongest peels use a chemical solution called phenol. The specialist performing the peel will advise you on the best option for your specific circumstances.
Some doctors perform chemical peels, and most dermatologists and plastic surgeons perform the procedure. Generally, anesthesia is unnecessary, as alpha-hydroxy acid peels aren't particularly painful, while stronger chemical solutions also numb the area, according to the American Society of Plastic Surgeons. Sedatives are sometimes administered, though. During the procedure, the doctor will thoroughly cleanse your skin, then apply the chemical solution to the area. Stinging, warm or cold sensations are all typical. The chemical solution will peel away treated skin, and the procedure usually lasts10 to 15 minutes. Sometimes your doctor will apply a dressing to the following the procedure. Multiple treatment sessions are often required.
Side Effects and Complications
After-effects of a chemical peel typically last for one to three weeks, according to the Consumer Guide to Plastic Surgery. Some pain or discomfort is to be expected. Chemical peels temporarily increase the skin's sensitivity to sunlight, making sunburns more likely. In addition, treated skin is often red, sore, flaky, scaly and swollen. Possible complications include temporary or permanent discoloration, scarring and reactivation of herpes in infected patients, explains the Cleveland Clinic.
Preparation and After-Care
The specialist performing a chemical peel will give detailed instructions for the time leading up to and following treatments. In general, you are advised to quit or reduce smoking before the procedure, discontinue certain medications and supplements, follow a skin care regimen and apply topical creams to help prepare your skin. Antibiotics or other medications may be prescribed for the day before the peel.
After chemical removal of brown spots, sun protection is important due to the skin's increased sensitivity to ultraviolet radiation. Medications may be prescribed to soothe pain or inflammation. Phenol facial peels may require limited use of facial muscles, as with talking and eating, notes the American Society of Plastic Surgeons. Use any recommended dressings or wound protection.
Other procedures besides chemical peels can remove brown spots, which are not ideal for all patients. In particular, chemical peels are not as well-suited for those with dark skin as they are to fair-skinned people, notes the Cleveland Clinic. Dermabrasion and microdermabrasion are alternatives that operate on the same basic principle as chemical peels. They erode away affected skin and allow new, clear skin to grow back. Cryosurgery kills skin with excess pigmentation with a freezing agent, and laser surgery burns away imperfect skin while stimulating new tissue growth.