Age Spots
Going, Going, Gone
Ours is a culture with little appreciation for spots. None of us likes getting a spot on our record, on our reputation or on our shirt. And we certainly don't like seeing spots when we're looking into a mirror!
But as we age, many of us do begin to see spots, especially on our hands and faces. And whether we call them liver spots, age spots or sun spots, the reaction is likely the same: We want a spot remover.
Technically known as lentigines, age spots are the result of excess pigment being deposited in the skin during years of sun exposure. So along with treatment, dermatologists also recommend avoiding exposure to the sun.
Note: Though the majority of age spots are harmless blemishes that require no more than a trip to the dermatologist, early stages of skin cancer can masquerade as innocent-looking age spots. If any spot enlarges, thickens, changes color, bleeds or itches, have it checked by a doctor. For extra protection, also include a skin examination in your annual checkup.
The good news is, if your spots really are just age spots, dermatologists today have an assortment of treatments at their disposal that can fade them, if not remove them completely. These include topical application of tretinoin, a vitamin A acid known as Retin-A.
Fade 'Em Away with Retin-A
Originally developed as an acne medication to unplug clogged pores, Retin-A has found resounding success as an anti-aging ointment. Though not a fountain of youth, Retin-A works to eliminate fine wrinkles, blemishes and age spots by stimulating cell turnover in a metabolic process that still is not entirely understood, says Retin-A creator Albert Kligman, M.D., Ph.D., professor of dermatology at the University of Pennsylvania School of Medicine and an attending physician at the Hospital of the University of Pennsylvania, both in Philadelphia.
To remove an age spot, dermatologists often recommend applying the strongest dosage of Retin-A that you can tolerate directly on the spot. The area will proceed to peel, and after a few months, the spot should diminish and possibly even disappear.
If you're like the people who were in a research group at the University of Michigan Medical Center in Ann Arbor, you may even see results after just one month. In a ten-month study of 58 people with age spots, researchers found that the majority of people treated with Retin-A experienced lightening of these spots after one month. After ten months, 83 percent of those treated with Retin-A experienced lightening of their age spots, and 32 percent had at least one spot disappear.
Retin-A can be even more effective when used in combination with other treatments, says John F. Romano, M.D., clinical assistant professor of dermatology at New York Hospital-Cornell Medical Center and St. Vincent's Hospital, both in New York City.
"I often have people apply glycolic acid in the morning and Retin-A at night. Or I may combine it with a bleaching cream," says Dr. Romano.
Retin-A cream comes in a variety of concentrations, the weakest being 0.025 percent and the strongest being 0.1 percent. It's available only by prescription, so you'll need to work with your dermatologist to find the dosage that's right for you.
And because Retin-A continually sloughs off the outermost, dead layer of skin, it can not only eliminate existing spots but also nip new spots in the bud. The downside of this process is that an area of skin previously sheltered from evaporation and the elements is exposed. That's why a common side effect of Retin-A is dry, sun-sensitive skin that can be irritated and scaly. Though this effect typically diminishes with time, if you're using Retin-A, you'll likely need a moisturizer. Sunscreen is also a must once you start using Retin-A.
| Food Factors Unfortunately, there are no magical foods that, if eaten, will fade age spots. There are, however, a few that can increase your sensitivity to the mother of age spots, the sun. Here's what you might want to avoid before playing in the sunshine. Hold the lime. Certain fruits and vegetables--particularly celery, parsnips, carrots and limes--contain psoralens, chemicals that can increase your sensitivity to the sun. Unless you're sensitive to psoralens, eating these foods before going out in the sun is not likely to be a problem, says Douglas Darr, Ph.D., director of technology development at the North Carolina Biotechnology Center in Research Triangle Park. You'd best wash your hands--which are already susceptible to sun exposure and age spots--after handling these foods, however. Anyone's skin can be more susceptible to burning after direct contact with psoralens. |
Protect Your Skin with Vitamin C
If vitamin D is the sunshine vitamin, then vitamin C is the sunblock vitamin, say some researchers--many of whom also proclaim it the healthy skin vitamin.
"In general, vitamin C is important for keeping the skin younger looking," says Lorraine Meisner, Ph.D., professor of preventive medicine at the University of Wisconsin Medical School in Madison. She recommends a safe daily vitamin C intake of about 300 to 500 milligrams to maintain skin quality.
Medical researchers have also found vitamin C to be of some help when applied topically. It has been shown to significantly reduce the amount of so-called free radical damage that occurs from sun exposure. Free radicals are naturally occurring unstable molecules that steal electrons from your body's healthy molecules to balance themselves. Unchecked, they can cause significant tissue damage. Antioxidants--vitamin C is one--neutralize free radicals by offering their own electrons and so protect the healthy molecules from harm.
"Since vitamin C prevents skin damage from sun exposure, it's reasonable to suspect that it can also prevent the consequences of that damage, including wrinkling and age spots," says Douglas Darr, Ph.D., director of technology development at the North Carolina Biotechnology Center in Research Triangle Park. Dr. Darr advocates using topical vitamin C as an adjunct to sunscreen.
One such topical vitamin C product is Cellex-C, a 10 percent vitamin C lotion. It's available without a prescription from dermatologists, plastic surgeons and licensed aestheticians (full-service beauty salon operators) and by mail order from Caleel-Hayden, L.L.C., 518 17th Street, Suite 1700, Denver, CO 80202 (1-800-235-5392). For optimum sun protection, the lotion should be applied once a day, along with a sunscreen, according to Dr. Meisner, one of the developers of Cellex-C.
Also, though snacking on citrus fruits may help keep your skin healthier, don't count on being able to eat enough oranges to protect you from the sun, says Sheldon Pinnell, M.D., chief of dermatology at Duke University Medical Center in Durham, North Carolina, and another of the developers of Cellex-C. "The cream allows you to get 20 to 40 times the levels that you would achieve by ingesting vitamin C," he says.
| Prescriptions for Healing The only vitamin that has been proven to erase age spots is vitamin A, applied topically as the prescription drug tretinoin (Retin-A). But there are several nutrients that can do the next best thing: prevent the sun damage that leads to age spots. Here's what some experts recommend as the best dosages. Nutrient Daily Amount/Application
Oral
Selenium 50-200 micrograms (l-selenomethionine) Vitamin C 300-500 milligrams Vitamin E 400 international units (d-alpha-tocopherol) Topical
Vitamin A 0.025%-0.1% cream (Retin-A), depending on skin type Vitamin C 10% lotion (Cellex-C) Vitamin E At least 5% cream or oil, applied after sun exposure MEDICAL ALERT: Selenium can be toxic in daily doses exceeding 100 micrograms, so if you'd like to try this therapy to protect your skin, you should discuss it with your doctor. If you are taking anticoagulant drugs, you should not take oral vitamin E supplements. |
Damage Control with Vitamin E
Vitamin E, an antioxidant vitamin added to everything from nail polish remover to shampoo, is also helpful in preventing sun damage.
Researchers have shown that vitamin E oil can prevent inflammation and skin damage if applied within eight hours of sun exposure. Because vitamin E itself produces free radicals when exposed to ultraviolet light, however, researchers recommend that you apply it following, not before, sun exposure.
Vitamin E oil can be bought over the counter in drugstores, as can vitamin E-fortified creams. Research has shown that if the cream or oil contains at least 5 percent vitamin E, it can also be effective in reducing post-sun damage.
You can also reap some of vitamin E's sun-protective properties by taking supplements, adds Karen E. Burke, M.D., Ph.D., a dermatologic surgeon and dermatologist in private practice in New York City. "It's highly effective as an anti-inflammatory agent, and it reduces sun damage to the skin," she says. Dr. Burke recommends that people take 400 international units of vitamin E in the form of d-alpha-tocopherol daily.
Good dietary sources of vitamin E include polyunsaturated vegetable oil, wheat germ, spinach and sunflower seeds.
Try Some Selenium Sun Protection
You might want to boost your dietary intake of the antioxidant mineral selenium as well, says Dr. Burke.
"Selenium can prevent solar damage, pigmentation and dark spots, but because the selenium content of soil varies across the country, not everyone is getting enough to be beneficial," says Dr. Burke, citing the Southeast in particular as an area deficient in selenium.
To quench the free radicals caused by sun exposure and to prevent skin damage, Dr. Burke recommends daily supplements of 50 to 200 micrograms of selenium in the form of l-selenomethionine, depending on where you live and your family history of cancer. Selenium can be toxic in doses exceeding 100 micrograms, so if you'd like to try this therapy to protect your skin, you should discuss it with your doctor.
To get more selenium in your diet, try tuna; a three-ounce can serves up a full 99 micrograms. Or treat yourself to an ounce of baked tortilla chips for a whopping 284 micrograms.
