Facial Spots: Causes and Treatment Options for Teens

The skin keeps developing spots?

Hello, doctor.
I am a 19-year-old teenager.
My skin used to be very good, but for the past six months, I have been developing very faint spots on my face.
Since I have been retaking exams this whole year, I haven't been exposed to much sunlight, so it is unlikely that these are sunspots.
However, my lifestyle is not very regular, and I tend to stay up late.
I looked online and found that there is a possibility of liver spots, but the appearance of liver spots I found does not match mine.
I would like to ask the doctor if there are any topical medications that can remove these spots besides laser treatment.
I know that substances like hydroquinone can help, but I am concerned because my skin is quite thin, and I fear that using retinoids, alpha hydroxy acids, or hydroquinone may further thin my skin barrier.
So, I came here to consult with you, doctor.
Thank you!

Niming, 10~19 year old female. Ask Date: 2016/03/30

Dr. Wu Yuxin reply Dermatology

It is not yet clear what type of spots you have; you should first seek medical evaluation to confirm the diagnosis before any recommendations or treatment can be provided.

Reply Date: 2016/03/30

More Info

Understanding facial spots, especially in teenagers, can be a complex issue that often requires a multifaceted approach to diagnosis and treatment. Given your description of the faint spots that have developed over the past six months, it’s important to consider several potential causes and treatment options.

Possible Causes of Facial Spots
1. Hormonal Changes: At 19, you are still experiencing hormonal fluctuations that can lead to changes in your skin. These fluctuations can cause pigmentation changes, including the development of spots.

2. Stress and Lifestyle: You mentioned being in a state of re-examination and having irregular sleep patterns. Stress can exacerbate skin issues, leading to conditions like acne or pigmentation changes. Lack of sleep can also affect skin health, making it more susceptible to various issues.

3. Post-Inflammatory Hyperpigmentation: If you have had any previous acne or skin irritation, the spots could be a result of post-inflammatory hyperpigmentation, which is common in young adults.

4. Liver Spots (Lentigines): While typically associated with sun exposure, liver spots can also appear due to other factors, including genetics and hormonal changes. However, given your limited sun exposure, this may be less likely.

5. Other Conditions: Conditions such as melasma or even certain skin infections could also lead to the appearance of spots.

Treatment Options
1. Topical Treatments: While you are concerned about using strong acids like retinoids or hydroquinone due to your thin skin, there are gentler options available:
- Vitamin C Serums: These can help brighten the skin and reduce the appearance of spots without being too harsh.

- Niacinamide: This ingredient can help improve skin texture and tone, and it is generally well-tolerated by sensitive skin.

- Azelaic Acid: This is a milder option that can help with pigmentation and is often recommended for sensitive skin types.

2. Sun Protection: Regardless of the treatment you choose, using a broad-spectrum sunscreen daily is crucial. UV exposure can worsen pigmentation issues and lead to further skin damage.

3. Lifestyle Changes: Improving your sleep hygiene and managing stress through relaxation techniques or regular exercise can have a positive impact on your skin health.

4. Professional Treatments: If topical treatments do not yield satisfactory results, consider consulting a dermatologist for professional options such as:
- Chemical Peels: These can help exfoliate the skin and reduce pigmentation.

- Laser Treatments: While you mentioned wanting to avoid lasers, they can be effective for certain types of pigmentation. Discussing your concerns with a dermatologist can help you find a suitable option.

5. Regular Dermatological Check-ups: Since your skin is changing, regular visits to a dermatologist can help monitor your skin's condition and adapt your treatment plan as necessary.

Conclusion
In summary, while there are various potential causes for the faint spots on your face, a combination of lifestyle adjustments, gentle topical treatments, and professional advice can help manage and reduce their appearance. It’s essential to approach this issue holistically, considering both your physical and mental well-being. Always consult with a dermatologist before starting any new treatment to ensure it is appropriate for your skin type and condition.

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