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I’m Chiquita Banana, and I’ve come to say
Bananas have to ripen in a certain way.
And when they are flecked with brown
and have a golden hue,
Bananas taste the best, and are the best for you

So you ask, “ What does the Chiquita song have to do with Plastic Surgery?”  Well, those flecked brown spots may make a banana look inviting, but the same brown spots on a person are a whole different story.  First of all, not all brown spots are created equal. 

Some are just “age spots,” also called ”liver spots,” and are evidence of a youth spent in the sun without sufficient skin protection.  These can be treated with fading creams and laser treatments which specifically lighten these unsightly blemishes. This laser type treatment, called intense pulsed light (IPL) therapy, can be used on the face, arms and chest area and helps restore a more even complexion.  Prevention of new sunspots developing consists of sun blockers and appropriate clothing. 

Other people have brown spots called  “freckles” and these spots are just the way that person tans. People of Irish decent are most likely to have this type of skin.  Their skin has only a limited capacity to tan in an even color; rather their response to the sun is to develop freckles. Laser type treatments (IPL) can eliminate some of the freckles and fade the appearance of the rest.  The best that this type of person can do to maintain an even complexion is to protect their skin by wearing appropriate clothing and sun blocking agents.

Some spots change color, getting darker, even black and are uneven in shape. These types of strange spots should be examined by a physician, especially if you have a family history of melanoma, the worst type of skin cancer.  The treatment for melanoma is surgery. Regular skin checks are a must once a person has had the diagnosis of melanoma. 

There is a fourth type of undesired skin pigmentation called Melasma.  This type of excess pigmentation takes on the appearance of a mask or a patch and can appear around the cheeks, forehead, upper lip, nose, chin and jaw line.  Also referred to as the “mask of pregnancy”, melasma is most common in women and is associated with times of hormonal stimulation, including pregnancy, birth control pills and hormone replacement therapy.  It tends to be a family trait, with more than 30% of people with melasma reporting a family history of it. There is an association between the melasma of pregnancy and hormonal stimulation and thyroid dysfunction as well.  Men can also have melasma, and it tends to occur in people with a more olive or brown complexion. Besides hormones, some other medications can trigger melasma including antibiotics tetracycline and minocycline and some anti-seizure medicines.  But sun exposure is the big culprit and plays a huge role in melasma’s seasonal variation. The bottom line is that melasma doesn’t really have a cure. There are many ways to control it and lessen its appearance, but if a person refuses to seriously avoid the triggering affect of sun exposure, then those efforts will go to waste. 

So if you think that you have melasma, what should you do? First seek the council of a physician, to confirm your suspicions.  If you have melasma, you must protect your face from the triggering effects of sun exposure. This includes hat, visors and sun blocks like zinc oxide and titanium dioxide.  Next, you must realize that treatment is a matter of control not cure, and that successful treatment will require patience. If your melasma was triggered by exposure to certain medications, then consult your physician about stopping them.  If your melasma was triggered by a past pregnancy, you cannot give that child back! Rather you must keep the child and work on other methods of evening your complexion.  Those methods will probably include some topical cream medicines like hydroquinone, kojic asic, azelaic acid, or Retina A.  Often combination therapy will offer the best way to even your complexion. Remember that it may take 3-6 months of treatment to achieve a more even complexion.  Other methods, which may help jump start your treatment, may include superficial peels, microdermabrasion, and laser type therapies.

In conclusion, an uneven complexion can be very troubling and some spots like melanoma can be dangerous if not lethal.  If you have any questions about a new spot, please see your physician. If they are not sure, then they will refer you to a specialist.  The need for a biopsy will be determined by your physician, and a treatment strategy can be made specially for your skin type. Remember, no one can help if you are not willing to protect your skin from harmful sun exposure.