Freckles, age spots, and other darkened skin patches can become darker or more pronounced when skin is exposed to the sun. This happens because melanin absorbs the energy of the sun's harmful ultraviolet rays in order to protect he skin from overexposure. The usual result of this process is skin tanning, which tends to darken areas that are already hyperpigmented. Wearing a sunscreen is a must. The sunscreen must be "broad spectrum" (i.e. it blocks both ultraviolet A and B). A single day of excess sun can undo months of treatment.
Most prescription creams used to lighten the skin contain hydroquinone. Bleaches lighten and fade darkened skin patches by slowing the production of melanin so those dark spots gradually fade to match normal skin coloration. Prescription bleaches contain twice the amount of hydroquinone, the active ingredient, as over-the-counter skin bleaches. In more severe cases prescription creams with tretinoin and a cortisone cream may be used. These may be somewhat irritating to sensitive skin and will take 3-6 months to produce improvement. There are now several highly effective laser treatments. The q-switched ruby and other pigmented lesion lasers often remove pigment without scarring. A test spot in an inconspicuous place will need
(published with permission in writing from:http://www.aocd.org)
