February 27, 2018

How to Even Out Your Skin Tone with Laser Treatments and Peels

Fade spots and discoloration—the top skin doctors reveal new treatments and at-home remedies that work magic.

With all the different types of peels and lasers available, knowing the best way to treat your skin’s discoloration isn’t exactly straightforward. Before you invest in a pro treatment, you’ll want to key in on what condition you have and what options are available to you. Here, an explanation of three causes of discoloration and their treatment options, plus products you can use at home to maximize the results of an in-office session. (Related: The Best Beauty Treatments to Do On Your Lunch Break)

Sunspots
These can appear as isolated marks—one or two marring the cheeks, forearms, or backs of hands—or as more of a mob, a diffuse mottling all over the face, neck, or chest. They result from years of sun exposure “causing genetic changes in the DNA of pigment-producing cells, which lead to increased melanin production,” says Estee Williams, M.D., a dermatologist in New York City. (And yes, UV rays can harm your skin when you’re indoors.) Turning up later in life than ordinary freckles, they tend to be darker and more irregular, with blurry edges. And unlike their cute counterparts, sunspots don’t fade at summer’s end. (Note that if a freckle is roughly the size of a penny or changing in any way, it should be examined by a derm, and possibly biopsied, to rule out skin cancer, Dr. Williams says.)

Pro Fix: With sunspots, excess pigment pools in the skin’s top layer, so it’s usually easy to remove with lasers. Q-switched lasers (such as the ruby for lighter skin or the Nd:YAG for deeper tones) can knock out solitary spots in one to three rounds ($300 to $450 for up to five spots). For widespread dappling, nonablative fractional lasers, like the FraxelDual ($1,500 per session), spare the skin’s surface while obliterating underlying pigment and can usually remove up to 90 percent of spots in one visit, Dr. Williams says. Expect about a week of ruddiness and peeling after the procedure. The Clear + Brilliant, a less intense fractional laser, leaves you pink for only a day but requires at least three sessions (price: about $500). (Read more about how laser treatments can benefit your skin.)

Melasma
This appears as brown patches, often on the cheeks, forehead, or chin, or above the lip, and it can be deep-seated and relentless, making getting rid of it a challenge. Melasma often occurs during pregnancy or menopause or with the use of birth control pills. That’s because hormonal fluctuations ignite estrogen receptors on melanocytes, which are the skin’s pigment-making cells, Dr. Williams explains. The sun is another trigger, but UV rays aren’t solely to blame: Recent studies show that visible light (emitted by the sun, screens, and bulbs) and infrared rays, which register as heat (from the sun, as well as electric heaters and fire), can both fuel melasma. “Visible light is especially harmful, since it creates a delayed tanning effect that’s even more intense than UVA,” says Whitney Bowe, M.D., a derm in NYC. (That’s only one of the ways your phone could be ruining your skin.)

Pro Fix: Many derms start with mild chemical peels, which are safe for sensitive skin and effective: Dr. Williams finds that glycolic acid peels in increasing strengths every few weeks can achieve 50 to 100 percent improvement. For severe melasma, Dennis Gross, M.D., a derm in NYC, often turns to a stronger retinol peel, while Robert Anolik, M.D., a cosmetic dermatologist in NYC, calls the Clear + Brilliant laser “the greatest treatment option I’ve seen to date”—but stresses that it should be used only by a cosmetic dermatologist who understands the nuances of the device and the condition.

Postinflammatory Hyperpigmentation
Also called PIH, this refers to the marks that pimples—and bugbites and hot tool burns—often leave in their wake. “PIH is the most delicate of all discolorations, since
the slightest insult can draw pigment,” Dr. Gross says. It’s most prevalent in darker skin tones and can occur anywhere on the face or body, even under the eyes. “Any mechanical trauma can stir it up,” Dr. Williams says. This includes mindless eye rubbing from seasonal allergies.

Pro Fix: This pigment can settle in deep, making it hard to reach. “Avoid situations that cause it. Don’t pop pimples, and keep fresh wounds and burns moist with emollients,” Dr. Williams says. If the color is shallow or the trauma was recent, gentle fractional laser treatments can help diminish marks. Or try in-office peels, which are great if you have acne, since they unclog pores as well.

At-Home Spot Stoppers
Whichever pro treatment you choose, protect your investment—and prolong the results—with this brightening plan.

Sunscreen: Battling discoloration is pointless without daily use of a broad-spectrum sunscreen like Neutrogena Sheer Zinc Dry-Touch Sunscreen SPF 50. ($8; target.com)

Antioxidants: “Sunscreen alone isn’t enough for those sensitive to infrared heat, visible light, and pollution,” Dr. Bowe says. Neutralize them with antioxidants (try Bioeffect EGF+2A Daily Treatment. ($230; neimanmarcus.com)

Peel: Weekly exfoliation with a gentle peel speeds brightening. Try Dr. Dennis Gross Alpha Beta Universal Daily Peel. ($88 for 35 packs; sephora.com)

Acid: Tranexamic acid—an amino acid in SkinMedica Lytera 2.0 Pigment Correcting Serum—can prevent UV, hormones, and trauma from kick-starting pigment cells. ($154; skinmedica.com)

Retinol: “Retinol breaks up dark spots and normalizes cell turnover, ensuring new, bright skin rises to the surface,” says Jennifer Linder, M.D., a dermatologist in Scottsdale, AZ. Try PCA Skin Retinol Treatment for Sensitive Skin. ($109; pcaskin.com)