Spotty Progress
So you’ve been on a ‘skin brightening’ regime for a few months now and your brown spots are demonstrating a frustrating indifference. You’re not alone. The next common step is to relegate the creams to the medicine cabinet, or wherever your particular ‘Island of Misfit Toys’ lies in the bathroom, and let them molder until the pain of the cost has ebbed sufficiently enough to throw them out.
The truth is - and what major cosmetic companies would rather you didn't know - success in treating brown spots is well, spotty, at best. Why is it such a tricky complaint?
First, not all brown spots are created equally – as you’ve probably already noticed. Freckles are quite different from sun spots, which are usually lighter, more amorphous and can be a different texture completely. Then there’s the ‘pregnancy mask’ or melasma, which is often broader, patchier dark areas that develop in the cheek and forehead area (though not exclusive to those areas, nor to pregnant women).
Then there’s discoloration from injury – often referred to as a ‘stain’. A stain can result from acne, not the redness of inflammation but a brown mark which remains long after the acne has resolved (the technical name for this is Post Inflammatory Hyperpigmentation and the tendency for PIH is more common in darker skinned types).
So, different types of discoloration have different depths in the skin. In my experience, a discoloration from injury is usually more superficial than a sunspot, which is usually more superficial than a freckle – but there are no hard and fast rules here (e.g. the depth of the injury induced ‘stain’ may depend on the depth of the injury). What we see is the tip of the iceberg and it’s very difficult to know how deep that brown spot goes – it could have roots deep in the dermis and be very difficult to remove without risking a scar.
This is why the ability of the cream to penetrate is very important. If it is not reaching the source, it can’t change the behavior. In which case, it may lighten the pigment in the layers it can reach, but it won’t stop the spot from occurring – you’ll get fading but it will still be visible.
To get more than a 40% or so fading of discoloration usually takes a more aggressive approach – something that a department or drugstore product just isn’t going to provide. In the next few articles we’ll review what’s out there – the over the counter products, the prescription options and the clinical treatments – and their effectiveness for spot removal.
