The color of our skin is due to the thickness of the top layer of the skin (the stratum corium) as well as to the amount of pigment or melanin in our skin. Increased exposure to the sun or elements can cause a stimulation of both. Sometimes this can result in “blotchy” areas or areas on the arms, legs, or face that are commonly referred to as “liver spots”.
A variety of agents can be used to treat this condition. Topical creams and lotions, which can be purchased over-the-counter that contain glycolic acid, may gradually help to soften and remove these areas. This process may be slow and take several weeks to months. Stronger creams and ointments can be obtained from a physician. These may range from stronger concentrations of glycolic acid to topical exfoliates such as Retin-A’s, including the newer Renova cream. These help to strip away the dead cell layers of the skin and gradually remove the photo damaged skin. More advanced cases can be treated with topical chemical peels such as trichloroacetic acid or, in some cases, laser resurfacing. When the condition is due to increased concentration of pigment, topical creams and lotions are less effective. A classification of creams called hydroquinones can oftentimes be used to help “bleach” the skin. These are prescribed by the doctor and should be applied on a daily basis. When used in combination with Renova, they may be more effective. In very advanced or severe cases, phenol-based chemical peels can be used to remove the pigmented areas. This oftentimes results in exchanging a darkened spot for a lighter one which needs to be covered with makeup.
It is important to realize that a form of skin cancer [melanoma] can appear as a dark spot on the skin. Any questionable areas should be evaluated by your doctor.