Old Think: Out, out, damned spot! Hydroquinone (HQ), a topical skin whitener, has been center stage for the last 50 years. But it's not without controversy: Some women with darker skin tones find that the ingredient actually darkens their skin, and most recently, the FDA listed HQ as a possible carcinogen.
New Think: At home: The search is on for a gentler, safer alternative to HQ. Botanicals such as mushroom extracts, kojic acid, mulberry root extract, and arbutin (found in cranberry leaf) are less effective than HQ, but they will lighten spots over time. Try Dr. Andrew Weil for Origins Plantidote Mega-Mushroom Treatment Lotion (with mushroom extract), $30; Lumecin Overnight Brightening Gluco-Protein Treatment (with mulberry root extract), $45; and Euoko W-00 Active Starch White Masque (with arbutin), $70.
At the Doctor's Office: Lasers target the pigment within the spot, making it scab up and eventually disappear (scarring is uncommon).
Future Think: "My wish is that everyone would wear sunscreen religiously so they wouldn't get brown spots to begin with," says Bank. As for those existing spots: "I'm hoping for a laser that works instantaneously, so you won't have to go through any scabbing," he says.
Fine Lines and Wrinkles
Old Think: When acne medication Retin-A hit the market in the 1980s, doctors started noticing an unexpected side effect: fewer wrinkles. Since then, retinoids (derivatives of vitamin A) have been a top choice in fighting lines and wrinkles. Unfortunately, accompanying irritation and dryness makes it a tough topical to stick with.
New Think: At home: Topical creams made with silicone and mica particles fill in wrinkles like spackle — at least until you wash them off. Try Olay Regenerist Filling + Sealing Wrinkle Treatment, $20. For long-term smoothing, retinol, an over-the-counter retinoid, is more potent than most topical creams yet less irritating than prescription retinoids, thanks to amped-up formulas that keep the molecule stable and provide a slow time-release function, explains Bank. Try L'Oréal Paris Advanced Revitalift Anti-Wrinkle Concentrate Clinical Action, $17, and Neutrogena Healthy Skin Anti-Wrinkle Intensive Night Cream, $17. Another new approach: combining ingredients that stimulate skin-supporting collagen, such as peptides, with antioxidants that protect the skin from wrinkle-inducing environmental damage. "Until recently, products didn't prevent new damage while the repair was taking place," says Bank. Try iS Clinical Super Serum Advanced, $130, with antioxidant vitamin C and collagen-stimulating copper; and SkinCeuticals Phloretin CF, $150, with vitamin C, ferulic acid, and collagen-boosting phloretin, a root-bark ingredient.
At the Doctor's Office: Injectable fillers literally fill in wrinkles. The most popular are hyaluronic acid fillers (HAs) such as Restylane, Perlane, and Juvéderm. HAs bind with water in the skin to create volume that lasts for six to 12 months.
Future Think: Combining powerhouse topical ingredients to work synergistically is a trend that Stuart Kaplan, M.D., a Beverly Hills-based dermatologist, thinks we'll see more of. "Your skin cream will become like a multivitamin," he explains. Up next in fillers? HAs that also contain lidocaine or novocaine, to limit the ouch factor — a common complaint of those injectable fillers.