No Filter Necessary: How to Undo Dark Spots, Redness, and Uneven Skin Tone
Get perfect skin
If you get daily compliments on your perfect complexion, you can probably stop reading now. For the rest of us—who have spent more time in the sun than we care to admit, watched the birthdays tick by, or slacked just a bit (or, heck, a whole lot) on an anti-aging routine—dark patches, a dull appearance, and flushing that won't go away can be beauty headaches.
"At least 50% of my office visits involved redness or dark spots," says Jeanine Downie, MD, a dermatologist in Montclair, N.J. The good news? You're not destined to get splotchier and ruddier over time. With some smart strategies (and well-picked products), it's easier than ever to reverse the most common issues and reclaim great skin. Let's get glowing.
Patches on the skin that look darker than your normal complexion, from pin-head-sized to larger than a pencil eraser, are all filed under dark spots, or the technical term, lentigines. Their root cause: the sun. UV rays stimulate melanocytes—pigment-producing cells in the skin—to go into overdrive, producing extra pigment and resulting in pesky spots over time, says Joshua Zeichner, MD, a dermatologist in New York City.
Larger splotches that cover both cheeks, the bridge of your nose, and your chin may be melasma, which occurs thanks to a combination of sun exposure and hormone fluctuations—which is why melasma is common when you're pregnant, on birth control pills, or going through menopause.
No matter what kind you have, darks spots can show up seemingly overnight. "The damage from the sun's rays is cumulative," explains Doris Day, MD, a dermatologist in New York City. That means it can take years for them to form under the skin (remember lying out in the sun with your high school girlfriends?), then one day—poof!—you've got a splotch, and then another, and another.
How to undo dark spots
Fix dark spots at home: Pledge your loyalty to sunscreen with an SPF of 30 or higher—and wear it daily, whether it's sunny or not, year-round. Apply in the morning over moisturizer, under makeup. And don't forget to reapply. If you're not up for slathering on a creamy sunscreen atop your makeup, a powder version in a brush-topped tube (Sweat Cosmetics Twist-Brush + Translucent Mineral Powder SPF 30, $42; sephora.com) can be a convenient solution—just swipe it to refresh your protection. Besides sunscreen, adding an over-the-counter cream containing licorice, niacinamide, arbutin, resveratol, or vitamin C to your skin care regimen can help gradually fade the spots. Apply Garnier SkinActive Clearly Brighter Dark Spot Corrector ($15; walmart.com): It contains a blend of vitamins C and E to diminish spots within two weeks.
Fix dark spots at the derm's office: Get a prescription lightening cream that contains 4% hydroquinone. (Despite some controversy over the ingredient, most dermatologists say it's safe when used under a doctor's supervision.) "Apply it carefully, only to the dark areas," cautions Dr. Zeichner, "otherwise you can end up with a lightened halo effect." Another option: laser treatments with an Nd:YAG laser. This device sends a beam of light that is absorbed by the color brown into the deepest layers of skin, essentially destroying the pigmented cells that created the spot. Note that it isn't a quick plan of attack: You'll need six to eight treatments for total reversal (at a cost of $300 and up per session), with a maintenance treatment once or twice a year.
Uneven skin tone
A mottled, speckly look that covers a large area, from your cheeks to your whole face, unevenness can give skin a sallow or tired cast. The sun is, yet gain, the biggest culprit. Years of UV exposure, inadequate SPF, and a genetic bent toward an uneven tone can cause the skin's melanocytes to crank up their pigment-production, dulling skin all over.
Undo uneven skin tone
Fix uneven skin at home: Diligent sunscreen use (and reapplication) is a must. Lightening ingredients such as licorice, vitamin C, and niacinamide may help, as can OTC peels, which lift off the surface layers of skin, so the unevenness fades. Try Dr. Dennis Gross Alpha Beta Ultra Gentle Daily Peel ($88 for 30 applications; sephora.com). And watch the amount of time you spend in overheated areas—not just hot showers and saunas, but also in the kitchen. A steamy pot of pasta, for example, emits heat, which can stimulate futher pigmentation production, notes Dr. Downie.
Fix uneven skin at the derm's office: Since uneven pigment can cover a large area of skin, derms often suggest a combination of prescription drugs (say, a hydroquinone cream with a retinoid) to combat the pigment and reduce inflammation, which can exacerbate splotchiness. For a quicker fix, you may want to consider an in-office glycolic peel. "A dermatologist can tailor the strength of the peel to your skin's individual needs," says Dr. Downie, something you can't do with a DIY version. You'll likely need several treatments, and there's no downtime (save for an hour or so of slight redness). For more severe pigmentation issues, you can go with a fractionated laser such as Fraxel that "punches microscopic holes into the skin, which, when they heal over about three to four days, obliterate spots and increase collagen production," explains Dr. Zeichner. You'll typically need three to five treatments spaced every two to four weeks, at a cost of about $1,000 and up per session.
Just what it sounds like: an OMG-I'm-so-embarassed flush...that doesn't go away, ever, no matter how dark or light your skin is. This uber-rosiness can be caused by two main things: rosacea, a condition of the blood vessels underneath the skin (typically on the cheeks and chin), or—you guessed it—the sun. UV rays can cause vessels to dilate, creating the red squiggles you see on skin (they're incorrectly called broken capillaries—they aren't actually broken, they're just permanently expanded).
Fix redness at home: Gentle skin care is the name of the game, so use a mild cleanser and moisturizer. Stick with a physical sunscreen that contains zinc or titanium dioxide, ingredients that sit on top of the skin to deflect the sun's rays and are best for delicate skin. (Chemical sunscreens, which contain ingredients like oxybenzone and octocrylene, get absorbed into the skin to fight UV rays but can irritate sensitive types.)
Fix redness at the derm's office: Newer prescription topical creams, including Soolantra and Mirvaso, can help bring down inflammation and redness in the skin. Soolantra works gradually to reduce redness, while Mirvaso constricts blood vessels instantly, so you can get an immediate (albeit temporary) effect. Some derms prescribe low-dose antibiotics, which "help reduce the redness because they address the underlying inflammatory aspect of rosacea," says Ava Shamban, MD, a dermatologist in Beverly Hills. Interestingly, a topical, derm-prescribed retinoid can work well for rosacea patients, as the drug—which can sometimes dry out the skin in the beginning of treatment—can also have an anti-inflammatory effect. For more serious improvement, lasers such as the VBeam and Excel V emit light that's absorbed by the red pigment in the skin, destroying it underneath the surface. As with most laser treatments, you'll need three to six sessions, from $250 and up, spaced about a month apart to see a discernible improvement.