How Can I Treat Spots at Home?
Try hydroquinone. This bleaching agent, available in department and drugstores or by prescription, works by interfering with an enzyme that helps your skin produce melanin, the brown pigment that shows up as spots. (Dr. Hirsch recommends using hydroquinone in conjunction with a prescription-strength retinoid, such as Renova or Tazorac, which helps lighten by exfoliating the skin.) "Hydroquinone is the gold standard for pigmentary disorders," says Rebat Halder, M.D., professor and chairman of the department of dermatology at Howard University. Look for it over the counter in concentrations up to 2 percent; prescription versions will usually have 4 percent.
Tip: Be careful to apply it only on the specific areas you want to lighten. "Hydroquinone is bleach," says Dr. Hirsch. "It can't distinguish the skin you want to bleach from the skin you don't." For precise application, she recommends using a Q-tip — or even an inexpensive eyeliner brush — to dot it directly on the spots.
To try: AMBI Skincare Fade Cream ($5, drugstores) or Murad Age Spot and Pigment Lightening Gel ($58, sephora.com).
Consider the alternatives. If you are sensitive to hydroquinone or prefer not to use it (see "Is Hydroquinone Safe?" below), you can improve the appearance of spots (probably less dramatically) with other over-the-counter treatments, including kojic acid, licorice extract, mulberry, vitamin C, and soy. "These are excellent alternative or additional therapies for pigmentation," says Dr. Wattenberg. "They do not all directly inhibit the enzyme that produces melanin, but they often produce results and are worth a try."
To try: SkinCeuticals Phyto + ($68, skinceuticals.com), which is enriched with kojic acid; Avon Anew Alternative Photo-Radiance Treatment SPF 15 ($25, avon.com) with licorice extract and glycolic acid; or Kiehl's Bright Brightening Botanical Moisture Fluid ($40, kiehls.com), which contains licorice, vitamin C, and mulberry.
Retinols — the less potent, OTC form of retinoids — are also worthwhile options, especially if your skin can't tolerate the stronger versions. But keep in mind that results will be more about radiance and evenness (think softer, less noticeable spots), and less about the pigmentation being completely bleached away, says Dr. Hirsch.