Whether brown or red, most of the hyperpigmented areas that show up on our skin—even pesky spider veins—are the result of one thing: sun damage. (If you don’t believe us, just look at your derrière, which remains blissfully even-toned and freckle-free well into the golden years.) One exception is rosacea, a chronic condition that causes flushing and inflammation of the cheeks, nose, chin, and forehead.
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Dark, puffy under-eye circles Mild Moderate Severe |
Redness/ruddiness Mild/moderate |
Brown spots Mild discoloration Moderate/severe discoloration |
Treating Uneven Skin Tone
Chemical Peels
Examples: Vitalize, Vi Peel, PCA, TCA (trichloroacetic acid), Jessner’s, glycolic acid, salicylic acid, AHA (alpha-hydroxy acid).
What they are: Treatments that apply a chemical solution to the skin, causing the damaged outer layer to peel away.
Best for: Minimizing hyperpigmentation caused by sun damage and melasma and improving skin tone, texture, and clarity.
What to expect: Peels range from mild (Vitalize) to very deep (Jessner’s). After a gentler peel, redness and tingling may last 24 to 72 hours, followed by mild to moderate peeling for up to a week. Three to five peels are typically recommended. Intensive phenol-based peels are accompanied by redness, oozing, and swelling for up to two weeks. One or two treatments get good results.
When results kick in: About a week for milder peels, a month for more intensive peels.
Results last: One to two years.
Cost: $75 to $500, depending on depth.
Vascular Lasers
Examples: V-Beam, KTP Diode, Iriderm.
What they are: Specialized wavelengths of light target hemoglobin, the active component in blood, to coagulate the blood vessels below the skin’s surface.
Best for: Erasing broken capillaries and red hyperpigmentation, decreasing overall redness and flushing such as that seen in rosacea, and fading port-wine stains.
What to expect: You’ll feel a warm sensation during treatment, which typically takes up to 30 minutes, depending on the size of the area. Expect mild redness, which fades in a couple of days. The number of treatments depends on the severity of the redness. For significant rosacea, two to three sessions may be needed, four to six weeks apart.
When results kick in: One to three weeks.
Results last: About a year if you’re prone to broken capillaries or rosacea, longer if you’re treating discoloration from the sun.
Cost: $250 to $750, depending on the size of the treatment area.
Resurfacing Lasers, Hyaluronic-Acid Fillers, and blepharoplasty
These treatments can be used for discoloration, including dark under-eye circles. See write-ups in “Options for Erasing Wrinkles” and “Treatments for Sagging Skin.”
