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All Spots Are Not Created Equal

It is not a secret. Tanning does not do a body good. But truth be told, many of us still envy the look of the beach bronzed sun goddess. Oh, that golden glow. Being an expert in aesthetics, I know spending countless hours worshiping the sun is like asking the sun gods to hurry up and turn you into a prune. While dried-out plums may do wonderful things for your digestive system, it is not a look many of us can pull off. Ultraviolet light causes your skin to go into “fight or flight” mode, producing melanin and creating the tanned look. But as we age, long-term sun exposure leaves behind a trail of unwanted spots.

You may look in the mirror and shout, “Out damned spot, out!” But unlike William Shakespeare’s Lady Macbeth, our spots are very real.

If you have alabaster skin, images of coffee stains on beautiful porcelain china come to mind. Before racing to diagnose these spots, remember all spots are not created equal.
Seborrheic keratoses, lentigines (liver spots) are brown and benign. Herbert Hochman, a top dermatologist in New York City with over 35 years of experience says, “They are of no medical significance. They occur in most adults, and their size and location is part of one’s genetic program.” They are not caused by exposure to sunlight. If your client’s spots fall into this category, you can breathe a sigh of relief.
But there are some spots that should raise a red flag. Actinic or solar keratoses are red, rough, sandy-feeling spots caused by sun exposure. They are usually benign, but may evolve into skin cancer. They should be monitored by a dermatologist and biopsied, if thought to be suspicious. Twenty percent of untreated keratoses develops into squamous cell cancer. These scaly patches usually appear on the head, face, decolletage and back of the hands.
You may be saying to yourself, I know better than that! I never lie out in the sun without my big hat and SPF 30. However, most of us spend more time exposed to the sun than we realize. Did you ever notice those awful tan lines you get just from running to the grocery store or gardening? There is a reason the phrase “golfer’s tan” was coined. Maybe you even purchased some self-tanner to even out your look. But have you ever really thought about what daily exposure to the sun does to your skin?

It is important to remember that sun spots do not happen overnight. They take years to form. And “old people” are not the only ones who can get sun spots. According to the Mayo Clinic, exposure to the sun can cause the appearance of so called age spots in ages ranging from young to old. These spots are not life threatening, but they are unattractive. And, there is no quick and easy way to get rid of them. Treatments, over time, can produce results. They require money, recovery time and patience, which is a hard concept in this quick-fix world in which we live.
Skin care specialists may recommend laser therapy to fade spots. Laser therapy destroys melanin-producing cells without damaging the skin’s surface. The go-to treatment option for many is a gentle erbium fractional lasers. These glass fractional lasers treat sun damage, fine wrinkles, and aging not only on the face, neck, chest and hands, but also on the arms, legs, and back. Dermatologists say they improve skin texture and tone and reduce precancerous lesions by replacing sun-damaged skin with new skin.
A series of treatments – up to five sessions – are performed, usually one every three to eight weeks. There is reported discomfort and minimal risk. The cost can vary from city to city. This treatment option however is not for everyone. One side effect is hyperpigmentation, which is a slight discoloration of the skin.
More affordable options include prescription grade lightening creams. They gradually fade the spots. Hydroquinone is an effective bleaching agent, but using a cream that contains concentrations higher than two percent is potentially risky.
The United States Food and Drug Administration released a report in 2006 recommending additional studies of prescription-strength hydroquinone. The FDA linked hydroquinone to ochronosis, a skin condition that causes darkening, thickening and disfigurement of the skin. Sun exposure needs to be limited if not avoided.
Another option is the chemical peel. In fact many spas offer a lunch time chemical peel. They are so mild a client can literally go on a break, get a peel and go back to work. The entire procedure is usually performed in less than an hour — and often less than 30 minutes. For optimal results, three to five peels should be recommended to the client. They are performed at regular intervals, which may be once every two weeks, monthly, or less frequently.
Intense Pulse Light Photofacial technology uses lasers and pulsed lights to remove unwanted skin imperfections. A light emitting wand is placed over the area of skin needing repair. The procedure is fairly quick and painless. Clients will be able to return to everyday activities immediately after. Results can be seen after about four treatments.
Bottom line: vanity has a price tag. There are a number of options out there and clients are willing to pay for clear glowing skin-free of brown spots and signs of sun damage.

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