There are several products to lighten age spots, and the best choice depends on factors such as skin sensitivity, extent of damage, and budget. Bleaching creams, retinoids and chemical peels will all lighten age spots. Age spots develop as excess melanin builds up in the skin, typically as a result of sun exposure.
Bleaching creams are available over the counter, and are affordable and effective. Products containing hydroquinone provide the most noticeable results of over the counter bleaching creams. It takes about one month to see results from hydroquinone creams, and six months to reach peak effectiveness. The downside of using a cream containing hydroquinone to lighten age spots is that it can cause redness and irritation. Other over the counter bleaching creams with the active ingredients vitamin C and kojic acid are less likely to be irritating, but they do not provide as dramatic results.
Over the counter and prescription retinoid creams are also effective at fading age spots. Originally developed to treat acne, they are used off-label to lighten age spots by speeding the turnover of cells, which prevents the melanin containing cells from building up and exfoliated existing spots. Like bleaching creams, it takes several months to see the final results from retinoids.
Many people experience itching, scaling, and redness when they begin using retinoid creams. Once the skin becomes accustomed to the products, this typically goes away. Initially, using the products every two to three days gives skin time to become accustomed to the products and reduces the risks of irritation.
Using both a bleaching cream and a retinoid can lighten even stubborn age spots. Apply a bleaching cream in the morning and a retinoid in the evening for best results. Watch for signs of irritation. If irritation occurs, use both products less frequently, gradually building up to using both daily.
For extensive or extremely dark hyperpigmentation, topical creams may not be enough to lighten age spots. In these cases, chemical peels, performed in a doctor's office, are an effective alternative. The drawbacks of chemical peels are the costs and healing time. After the chemical peel is performed, expect the skin to be inflamed, shiny, and irritated for a few days to a few weeks, depending on the type of peel performed.
It is important to use sunscreen daily while lightening age spots. Sun exposure is the leading cause of age spots, and the heightened sensitivity of skin while using these products makes it susceptible to additional age spots. Continue to use sunscreen daily after age spots fade to prevent a recurrence.