Doctor's Answers (2)
First of all, sunscreen can only prevent further progression of your age spots but will not lighten your age spots. I would still urge you to use a high spf sunscreen of at least 50. Secondly, you need to know that laser is not a magic wand which can erase all spots. Combination of treatment is the usual way to deal with age spots. I will combine
1. topical treatment such as hydroquinone based treatment or the triple (hydroquinone, vitamin A, and mild steroid) combination cream, followed by a peptide based topical, together with;
2. an oral treatment such as oral glutathione, or oral polypodium leucotomos, or oral transxenamic acid (if no contraindication), and;
3. pigment laser such as picolaser and also perhaps a vascular laser if there is an underlying redness to your spots. Depending on the types and the extend of your sun spots, there may be a need to have several sessions of laser treatments before you can see a signicant improvement.
All these treatment modalities in terms of costs, potential side effects, number of sessions and the expectations will be discussed with you after a close up assessment in the clinic. However, you may not need to choose all these treatment options after discussion with your dermatologist. Hope you find this information helpful.
Dr. Liew Hui Min
Thank you for the question. I think what is most useful would be to first visit a trusted dermatologist or doctor to accurately diagnose the cause of your age spots, and appropriate treatments can then be advised.
It is possible that you may have been wrongly diagnosed and therefore not given the right treatment so far. As you mentioned that these spots are also seen in your Mom and have not improved with lasers and sunscreen, a few possibilities come to mind. Hori’s naevi, melasma or even seborrheic keratoses can all be reasons for the non-response.
Hori’s naevi ( often genetic) present as blue grey pigmentation located in the deep layers of the skin. Multiple sessions with a narrow pulse width laser such a Q-switched or picosecond lasers would be effective at lightening such pigmentation.
Melasma which again can have a genetic component will actually darken with aggressive lasers and best treated with lightening creams and oral medicines.
Lastly seborrheic keratoses which are actually also known as age spots are easily treated with light cautery or burning.
As you can see, different treatments work for different conditions. Sometimes these conditions may even appear in combination on the same individual. So an accurate diagnosis it most important. Hope this helps!
Dr Stephanie Ho, Dermatologist