Your skin is the largest organ in your body and is continuously exposed to the environment, particularly the sun. Although many are eager to spend time under the sun during the summer months, it is vital to prioritize protecting your skin to avoid age spots. Just like time, though, age spots are unavoidable. But you have options to help your skin look younger. Learn how you protect your skin with sunscreen, and how vitamin C and retinol can help reverse the damage caused by the sun.
Causes of hyperpigmentation
The skin protects your body from the external environment. As a complex organ, the skin has multiple structures and cell types, divided into three layers: the epidermis, dermis, and subcutaneous tissue. The epidermis is the part of the skin that contains skin cells and melanocytes, the cells that produce pigment, otherwise known as melanin.
Hyperpigmentation is when your skin develops darker patches than the surrounding skin's normal color. This darker color is due to excess melanin, the pigment that produces skin color, which can range depending on your normal skin color. Age spots, the most common types of hyperpigmentation, are caused by overexposure to the sun—usually without proper protection and can be found on the hands, neck, and face.
When these spots become larger, they can be referred to as melasma, which can be due to hormonal changes from pregnancy, birth control, or other medications like anti-seizure medications, thyroid disease, stress, and even tanning beds. Other causes of hyperpigmentation include acne scars that may leave dark spots after healing, surgery scars, and freckles.
Sunscreen is a must
Photoprotection with sunscreen is essential in the prevention of hyperpigmentation since these hyperpigmented spots can be aggravated by UVA, UVB light, and visible light. Ensure that when applying sunscreen, you have an SPF of at least 15 or higher. If spending time outdoors, ensure to apply several times a day and wear hats during outdoor activities, avoiding exposure to UV radiation during peak hours of 10 a.m. to 2 p.m.
Ensure that the sunscreen you apply is a broad spectrum as it will protect you from the sun’s ultraviolet radiation, especially UVA and UVB. A broad-spectrum sunscreen will form a chemical barrier that will absorb or reflect UV radiation before it reaches your skin and causes damage to it. The sun protection factor, or SPF, is the level of sunburn protection that your sunscreen will provide. The higher the SPF factor, up to 50, the greater than sunburn protection.
It's important to point out that the SPF does not correspond to the amount of time you can spend under the sun before reapplying but rather the amount of sun exposure you are protected from. Solar exposure can vary over time and during the day, with higher amounts of exposure occurring are noon and early afternoon as opposed to early morning and late afternoon.
The intensity of solar exposure also depends on geographic location, with intensity being highest in areas closer to the equator. Solar exposure is also greater on clear days as opposed to cloudy days. Other factors that impact your sun exposure include skin type, amount of sunscreen applied, and frequency of application.
How vitamin C reverses age spots
Vitamin C, also known as ascorbic acid, plays a significant role in many bodily functions. Some of these functions include the synthesis of collagen, the protein that serves as the building block for many of the structures in the body. It also stimulates certain enzymes, antioxidant activities, and immune cells to attack germs.
Although most plants and animals make their own vitamin C, it is an essential nutrient for humans since we cannot make this vitamin ourselves. Thus, we must consume it in our diet, usually from citrus fruits, oranges, lemons, limes, grapefruit, tomatoes, broccoli, cabbage, potatoes, and spinach.
On your skin, vitamin C can provide photoprotective effects, strengthen the skin, and can be used to remove hyperpigmented spots. Vitamin C will work with copper to inhibit enzymes that reduce the formation of melanin, the molecules responsible for providing skin pigmentation.
Vitamin C is an unstable compound when exposed to the sun or light. Usually, you will note that dermatology lotions that include vitamin C will include compounds like soy or licorice. Vitamin C will be applied topically on the skin for hyperpigmented spots since it interrupts key steps in creating more melanin.
Vitamin C is available in serums and creams at a concentration ranging from 1–40%, but efficacy is only noted up to 20% of vitamin C. When exposed to light, it will be oxidized and turn yellowish; thus, it can be found with other vitamins like E, B, and beta-carotene.
How retinol reverses age spots
Retinol is a type of retinoid that helps with uneven skin pigmentation or tone and helps smooth skin. Retinols are usually a lower form of the potency of retinoids, which are vitamin-A-derived products used as topical products for the skin.
Retinoids are required for many bodily processes, including vision, growth, inflammation regulation, and how cells grow and divide. Unlike vitamin C, retinoids work to increase how fast your cells regenerate and prevent the transfer of vesicles that contain melanin into skin cells. Retinoids also increase the number of cells in the epidermal layer, leading to more protection and a stronger foundation of the skin.
Different types of retinoids have offered benefits against hyperpigmented spots on the skin. Retinol inhibits UV light from causing further damage to the skin structure and stimulates the production of collagen in the skin, the building block of many of the body’s structures.
Some of these include tretinoin 0.1% cream, which has shown good efficacy against hyperpigmented lesions due to acne scars in African American men and women. Since some of the side effects of retinoids include increased irritation, newer formulations have been developed, including a lower concentration of tretinoin, 0.05% cream (Atralin®), with technology that allows the active compound to be distributed more uniformly on the skin and tazarotene 0.045% (Arazlo®) lotion.
In the Journal of Skin Pharmacology Physiology, researchers study the efficacy of combined retinol plus vitamin C on the skin of postmenopausal women with signs of aged and photoaged skin. After three months, the researchers noted that, in aged skin, cellular changes occurred that were consistent with increased cells in the epidermis, leading to the reduction of the appearance of wrinkles.
On photoaged skin, researchers noted that after six months, there was a deposition of collagen in the dermal level, resulting in less appearance of wrinkles due to sun aging. Of note, the researchers did not mention the reduction in age spots, but this was not the primary outcome of this study.
Potential side effects of vitamin c and retinol
One of the main goals of treating hyperpigmented spots is to maximize efficacy while minimizing irritation and other side effects from serums, creams, and lotions containing vitamin C or retinoid. A huge misconception with these products is that irritation signals that the retinoid is working. But sometimes, irritation can just mean that a change is needed.
If you use an over-the-counter treatment, consider changing brands if irritation persists. If you are prescribed a retinoid product or vitamin C-derived product by your dermatologist, then speak with them if you are experiencing excess irritation or if it persists after stopping use.
Other things to avoid when using these products are alcohol-based skin products like toners and astringents, which can lead to skin dryness and further irritation of the skin. Irritation can worsen hyperpigmented spots in some people. Remember that new formulations of retinoids like low concentration tretinoin may be less irritating than older formulations. Also, try to use pH-balanced and fragrance-free facial cleansers and non-comedogenic moisturizers.
Most importantly, remember to wear sunscreen anytime you venture outdoors. Remember that a higher SPF value does not necessarily reflect the amount of time you can spend under the sun; instead, it reflects the amount of sunburn protection you will get from sunscreen. Suppose your sunscreen is not broad-spectrum or is an SPF of less than 15. In that case, a warning message is required by the Food and Drug Administration (FDA) to appear on the label, warning of the risks of spending time in the sun and increasing the risk of skin cancer and early skin aging.
Enjoy the summer months, protect your skin when spending time outdoors, and if you notice the effects of sun damage, you have options with vitamin C and retinol to reverse the signs of sun damage. Finally, ask your pharmacist how you can save on over-the-counter retinol and vitamin products or prescription retinoid creams.
Gabriel Espinoza, MD has experience in caring for patients in both primary care and emergency settings. Some of the topics he has focused on during his medical career include various areas in public health, pediatrics, and wellness. He has co-authored a chapter on the utility of point of care ultrasound in the diagnoses of various eye conditions. The content written by Dr. Espinoza is for informative and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.