Over-the-counter creams contain 2 percent hydroquinone which is a bleaching agent. Prescription creams may use single agents, such as Retin-A (tretinoin) or combinations of medications such as hydroquinone with tretinoin plus a cortisone cream.
Over the counter bleaching creams are usually well tolerated and may gradually lighten age spots over a couple of months however, they are not very effective. Prescription formulations are often more effective but may have more side effects (such as redness, drying, and peeling) and are expensive. Creams may not work for everyone and the risks and benefits need to be discussed with your physician.
Your physician can administer a peel using a variety of different chemicals to remove age spots, discoloration, wrinkles and fine lines. Chemical peels may gradually smooth and firm the skin and lighten age spots. The superficial peels, such as a glycolic acid peel, can be performed during your lunch hour and there is no recovery time. Deeper peels are more effective but require longer recovery. See more details under discussion chemical peels.
Different kinds of peels carry different risks. Superficial peels are usually quite safe however, you may need a series of superficial peels (done approximately once a month) before you'll notice any improvement. Costs can add up if you choose a series of peels. The risks and benefits vary depending on the kind of peel needed so discuss them in detail with your physician.
IPL is one of the newer forms of facial rejuvenation. Unlike lasers, which use intense, focused light, IPL is intense broadband light. Although IPL delivers energy to both the superficial and deep layers of the skin, the epidermis is spared from damage requiring virtually no recovery time. In the studies performed so far, IPL can smooth the skin and fade age spots, freckles, melasma, and even broken blood vessels and with good sun protection, improvements usually last for about a year.
Because IPL does not damage the outer portion of the skin (epidermis), it is safer than laser therapy. There may be some pain during the procedure but no recovery time. Unlike laser therapy, however, you may need multiple treatments (average is 4-6 at three weeks intervals) to achieve the full benefit. The cost is variable, but is usually more expensive than peels and less expensive than lasers. As with any surgical procedure, the risks and benefits of IPL therapy need to be discussed in detail with your physician.