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by Talia Emery, M.D.
If we didn’t love the sun, we wouldn’t live in Southern California. And though we all know that sun exposure in general is dangerous for our skin, we also know that sunshine is a natural antidepressant and that spending time in the sun can be therapeutic.
The likelihood is that everyone reading this article has had extensive sun exposure over his or her lifetime, and most of us have the spots—on our face, chest, hands, or elsewhere—to prove it. So what can we do about the effects of this damage? And when should we be worried about them?
Most importantly, you want to be sure the spots you’ve accumulated are not cancerous. The three major types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma, the last of which is the least common but most dangerous.
Basal cell carcinomas are usually pearly, dome-shaped bumps that often contain blood vessels, or they can appear as patches of raw, dry skin on the back or the chest. Squamous cell carcinomas generally start as large reddish patches that are scaly or crusted, or they can look like a scab on a red, inflamed base.
Melanoma is identified using ABCDE signs. These spots tend to be Asymmetric: if you draw a line through the middle of the lesion, the two sides will not look the same. Look at the Borders: edges of early melanomas tend to be uneven, with scallops or notches. Melanomas often are multi-Colored, containing different shades of brown, black, blue, red, or other colors. Their Diameter is most often larger than the size of a pencil eraser, and their look and characteristics will Evolve over time. If any of your moles or spots are non-healing or changing, or if they exhibit characteristics of skin cancer, be sure to tell your doctor immediately.
Fortunately, it is much more common that sun-induced brown spots are non-cancerous and simply a cosmetic nuisance. We often call them “sun freckles” or “age spots” because they are recognizable signs of aging, sun-damaged skin. The good news is that most of these brown spots can be lightened or eliminated with a little modern science.
Intense pulsed light “laser” therapy is the gold standard for rapidly and effectively lightening brown spots of the face, neck, chest, and hands. Most commonly known as a photofacial, this treatment uses energy in the form of light and heat to break up the deep pigment and allow it to rise to the skin’s surface. When the pigment is brought to the surface, it is able to exfoliate naturally, leaving behind fresh, non-pigmented skin.
Lighter spots on the face, or any spots that remain after laser therapy, will often improve with long-term daily use of a skin care product formulated to target excess pigment in the skin. These products contain varying amounts of specialized ingredients, and your skincare expert can help you choose the product that’s right for you.
Of course, no matter how much sun damage you have, it’s always wise to use daily sunscreen to prevent further damage.