How Can I Treat Spots at Home? continued...
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.
To try: Neutrogena Visibly Even Night Concentrate ($12, drugstores).
To skip: So-called brightening or lightening cleansers. They won't hurt you — but they also won't do anything more than wash your face. "They're not on the skin long enough to make a difference," says Dr. Hirsch.
Protect your results. "Sunscreen is essential," says Paul M. Friedman, M.D., clinical assistant professor of dermatology at the University of Texas at Houston. "Sun exposure can trigger production of the pigment you are trying to eliminate — and almost any treated dark spot can recur if exposed to UV light." And, yes, you still need the stuff if you have darker skin. A recent Johnson & Johnson study of hyperpigmentation in African-Americans found that participants who simply added an SPF 30 sunscreen to their daily routine (and used no other additional treatments) saw significant improvement in their pigmentation, skin tone, and radiance after eight weeks.
To try: La Roche-Posay Anthelios SX Daily Moisturizing Cream SPF 15 ($29, CVS), Aveeno Positively Radiant Daily Moisturizer SPF 30 ($14, drugstores), or Roc Retinol Correxion Hand Repair with SPF 15 ($15, drugstores).