UNEVEN SKIN TONE:
Overview
Discoloration of the face can appear as localized brown spots and freckles or as larger patches that resemble a dark "mask" over the face which affects the cheeks, upper lip, forehead and chin. Unwanted brown discoloration can often be camouflaged with foundation, however many patients seek ways to diminish these areas of hyperpigmentation on the face since they can add years to your appearance.
Uneven skin tone and brown spots can be effectively removed using a variety of treatments that include topical products in addition to non-invasive procedures such as lasers, intense pulsed light treatments (IPL) and chemical peels.
Evaluation of your skin is crucial in determining what treatment method is best, since the wrong treatment can make discoloration darker. It is important to understand the cause of the brown spots as well as the depth that they extend into the skin, as this may differ in each individual.
Not all brown spots are created equally, and there are three main sources:
- UV exposure from sunlight and artificial tanning devices can trigger growth of pigment-producing cells, called melanocytes. By stimulating these cells and causing them to increasing production of melanin, UV exposure results in tanning and darkening of the skin as well as new moles and freckles. Although the tan will fade, remnants of too much UV can persist forever in the form of freckles, blotches and new moles.
- Estrogen fluctuations due to pregnancy, birth control pills and hormone replacement therapy can overstimulate melanocytes to create the mask-like darkening of the face which is called melasma. These are literally pools of melanin in the skin. Melanin accumulation in the most superficial layer of the skin (epidermis) is often successfully treated while melanin in the deeper layers of the skin (dermis) can be more challenging.
- Post inflammatory hyperpigmentation is common especially in Asian, Hispanic, and Black skin, which is prone to excessive melanin production after injury and inflammation such as with acne pimples, burns and insect bites. Since knowing the trigger can stop new brown spots from developing, treatment may also include controlling the triggers as well as removing existing brown spots.
