This article originally appeared in the Winter 2015/2016 issue of Real Style magazine. Become a Real Style subscriber and get the hottest fashion, beauty and celebrity news, enter exclusive subscriber giveaways and be the first to receive the full digital version of Real Style magazine. Click here to subscribe for free! 

From acne to age spots, there’s a whole host of skin culprits that are marking up your face. Catalina Margulis explores the myriad ways to erase them.

My skin is a map of my past: freckles from my youth, acne scars from my adolescence, melasma from the pill and pregnancies, hyperpigmentation from sun exposure, and now the latest, most devastating: age spots. Fearing that soon my face will resemble one large, coagulated freckle, I call on my expert friends for advice.

“Sun damage, as well as inflammation from trauma and acne, can disrupt the pigment cells, causing brown spots and lentigines,” says Toronto dermatologist Dr. Martie Gidon. “Pigmented precancerous spots can also develop as well as melanoma, an abnormal growth of the melanocytes in the skin that is usually dark but occasionally can be colourless.” Dr. Gidon notes that the darker the skin type (such as mine), the more likely you are to develop pigmented spots after trauma. Hormones too can aggravate the issue, with oral contraceptives and pregnancy contributing to melasma.

“One of the first ‘marks’ we can observe in children is freckles,” says Marie Bertrand, skin care expert at SkinScience Clinic (www.skinscience.md), who adds that freckles are usually darker in the summer and fade in the winter, and are genetically pre-determined. “Freckles are actually sun-induced, but different people have a different ‘threshold’ (or cumulative amount of sun exposure) before they develop freckles. Blonds and redheads will usually develop freckles much faster than darker types.”

Freckles, however, are cute. Acne: not so cute. And the tiniest breakout leaves me with a trace that looks like a faint brown stain. According to Bertrand, these spots are temporary (unlike true acne scars, which leave a permanent indentation) and will naturally fade over time. She explains that these acne-induced brown spots are also known as post-inflammatory hyperpigmentation (PIH), a condition of the skin when an inflammatory event leads to an enhanced amount of brown pigment (melanin) produced, even when the inflammatory event is gone. Of particular note, she says they can become darker if the patient doesn’t use sunscreen diligently.

And then, as if the stretch marks weren’t enough, pregnancy too brings a whole new level of skin changes, including a common skin condition called melasma, or pregnancy mask. “It is caused by the combination of estrogens, sun and light exposure, and is a very common skin disorder,” says Bertrand. “Melasma presents itself as a symmetrical hyperpigmentation of the face and neck, and can also be triggered by birth control pills and other hormonal changes (you don’t need to be pregnant to develop melasma) combined with sun and light exposure. This is why melasma tends to become darker during the sunnier summer months.”

On the sunny side of 40, I never considered myself age spot-worthy, but after a recent visit with my dermatologist to uncover “What is it?” he declared the spot just that. How is this possible? Contrary to what you might think, Dr. Gidon says that aging spots, called seborrheic keratosis (thickened skin that can be brown or light coloured) and also known as liver spots, are actually not caused by the sun. “We don’t really know the cause but they are probably gene related since they can occur in families,” she says, adding, “Some people are prone to them. They remain if not treated.”

Unlike age spots, sun spots, called lentigines, are indeed caused by sun damage, says Dr. Gidon, and will remain, enlarge and can darken with age if not treated and if sun protection is not used.  They can even occur years after sun exposure, she says.

So now that I know what I have, it’s time to explore solutions. While the experts seem to agree on the best products and treatments for different skin issues, they note that the treatment program itself will, and should, vary from one person to another. “It is important to adapt textures to skin types, and choose lighter, water-based textures (solutions, lotions) for normal-oily skin, and richer texture (creams) for normal-dry skin,” says Bertrand.

While experts agree it is possible to remove spots, they also seem to agree that it can never be guaranteed. “A lot of [it has] to do with a patient’s genetic [makeup] and compliance to the products and routine,” says Bertrand.

Bertrand also cautions jumping into treatments without getting checked out first. “It is important to see your family doctor or a dermatologist for a full body/mole check before under taking treatments of brown spots/ age spots to make sure you are not cosmetically treating something that should be medically removed,” she says.

She also adds that pregnant patients should stay away from cosmetic ingredients that could be problematic in pregnancy, including salicylic acid, retinoic acid and derivatives of vitamin A, hydroquinone, resorcinol, among others.

As always, as Dr. Gidon points out, avoiding the sun and using sun protection is key to preventing recurrence. So I’m stocking up and booking appointments. It’s time to reign in my spots before there’s more of them than me. 

Whether it’s acne or age spots you’re looking to erase, here’s what the experts recommend to help turn back the clock.

ACNE/BROWN SPOTS:

Prevention: To prevent spots in the first place, Bertrand recommends avoiding picking at acne lesions and wearing oil-free, non-comedogenic sunscreen daily.

Try:
Topical: Fading of brown marks can be accelerated with lightening products such as hydroquinone, kojic acid, glycolic acid, tretinoin, rumex and vitamin C.
Procedures: Dermaplaning, chemical peel (salicylic acid, retinoic acid), red light acne treatment for acne scars, microdermabrasion (which can be infused with lightening serum, or an exfoliating treatment like Oxygeneo with lightening gel), and lasers such as the Clear + Brilliant or Fraxel laser. “Laser is a more aggressive treatment and can be the most  effective,” says Dr. Gidon.

MELASMA:

Prevention: Bertrand says that there is no cure for melasma, although she adds that it usually resolves completely after menopause (when estrogen levels go down). Avoid the sun and use a mineral sunscreen daily, since melasma is triggered by visible light as well as UV rays, and the only sunscreen ingredients that block visible light, she says, are mineral sunscreens (zinc oxide and titanium dioxide).

Try:
Topical: Lightening products such as hydroquinone, kojic acid, glycolic acid, tretinoin, rumex and vitamin C.
Procedures: Dermaplaning, chemical peels (vitamin C, kojic acid, lactic acid, glycolic acid), low level red light, and lasers such as the Clear + Brilliant or Fraxel laser.

SUN SPOTS:

Prevention: Here again, avoiding the sun and using sunscreen daily is paramount to prevention.

Try:
Topical: Lightening products such as hydroquinone, kojic acid, glycolic acid, tretinoin, rumex and vitamin C.
Procedures: IPL photofacial, dermaplaning, chemical peels (vitamin C, kojic acid, lactic acid, glycolic acid, retinoic acid), microdermabrasion (which can be infused with lightening serum, or an exfoliating treatment like Oxygeneo with lightening gel), lasers such as the Clear + Brilliant or Fraxel laser, and liquid nitrogen.

AGE SPOTS:

Prevention: While not sun-induced, there are things you can do to help reduce the appearance of age spots.

Try:
Laser and liquid nitrogen.