Dr. Angela is back today with her second installment on brown spots.
I’ve noticed new brown spots that the dermatologist said are not cancer, but I really don’t like them. What now?
As always, you should have the area checked to ensure that it is indeed benign, first. Then the course of action depends on what the spot looks like. If it is raised above the surface of the skin, it can be removed with a shave excision. This means that the portion that is above the surface of the skin is “shaved” off and the base of the lesion is cauterized. This does not require stitches and heals in 7-10 days. Most of the time these areas heal well and are difficult to see once the healing process is completed. Sometimes, these lesions can come back or the skin can have a slight indention if the lesion was particularly deep. The indention generally fills in to match the surrounding skin with time. If the lesion is flat with the skin surface or has returned after a shave excision, a “full thickness” excision can be performed where the lesion is removed in its entirety with a small incision and sutures. The sutures usually come out in 5-7 days and the incision fades over a period of weeks to months to appear as a fine, white line that is not noticeable. Although in both cases, you are trading a lesion for a small scar, either the shave excision or full thickness excision result in much less noticeable outcome than the lesion was originally.
What if I have a number of flat brown spots?
Another option is laser treatments for brown spots. These are good for multiple, clearly benign, flat sun spots. Resurfacing lasers improve the appearance of brown spots. IPL, or intense pulse light, treatments are “lunchtime lasers” that help with lightening brown spots, improving redness and improving skin texture. These are quick and have very minimal downtime, but require 7-10 treatments. Even then, the results are not as dramatic as some of the lasers with more downtime. Nonablative fractional lasers, like the Fraxel Dual, have a few days to a week downtime and are a series of 3-6 treatments, but can deliver a more dramatic improvement in brown spots and skin texture. A CO2 or YAG laser allows your body to completely replace the top layer of skin, so can be a very powerful way to completely or nearly completely remove brown spots, as well as have soft, smooth brand new skin! Lasers like the Q switched YAG or Q switched Alexandrite specifically target the brown pigment and can have dramatic results without affecting the surrounding skin. The brown spots form a “scab” and fall off in a week or so. The brown spots are often gone or dramatically improved. You may only need one treatment or may need a few. The number of treatments varies based on how many lesions you have and how dark they are. So your treatment can be tailored to you, the condition of your skin, your desires about treating just the brown spots or skin texture also and your lifestyle.
For more information or to set up a procedure, visit Dr. Angela’s site.