How can brown spots on the hands be eliminated?

Among the earliest visible signs of skin ageing or chronic sun exposure, brown spots on the hands can be a source of aesthetic discomfort. Before considering more invasive medical procedures, certain cosmetic active ingredients can visibly attenuate their appearance. By targeting excessive melanin production or favouring the exfoliation of pigmented cells, these compounds offer a gradual yet effective approach to even out the skin tone of the hands and prevent the emergence of new spots.

• The vitamin C,

  Vitamin C, or ascorbic acid, is one of the most extensively studied active ingredients for its brightening effect on pigmented spots. It works by inhibiting tyrosinase activity, the enzyme that catalyses the conversion of tyrosine into melanin in the skin. Moreover, its antioxidant properties enable it to neutralise the free radicals generated by UV radiation or pollution, which also stimulate melanogenesis. When applied regularly to the backs of the hands in serum or cream form, vitamin C can help to diminish pigmented spots.

  A recent study evaluated the efficacy of a serum containing 15% pure vitamin C, 1% vitamin E and 0.5% ferulic acid on pigmented spots on the backs of the hands of 60 volunteers aged between 40 and 80 years. Applied twice daily for six months, this treatment proved effective in improving the uniformity of skin colour on the hands. The vitamin C, when combined with other antioxidants such as ferulic acid and vitamin E, thus appears promising for reducing hyperpigmentation.

• The azelaic acid and the glycolic acid.

  Azelaic acid is a naturally derived active ingredient with interesting depigmenting properties to diminish brown spots on the hands. It also acts by inhibiting the enzyme tyrosinase and has anti‐inflammatory and antioxidant activity, allowing it to target different types of hyperpigmentation, including post‐inflammatory marks. Glycolic acid, for its part, is an AHA recognised for its exfoliating effects, enabling it to remove melanin‐laden cells from the skin’s surface. It also accelerates cell turnover in the basal layer of the skin, the deepest layer of the epidermis, where the melanocytes that produce melanin are located.

  A 24-week study was conducted involving 60 patients with melasma. Although this condition did not affect the hands, the pigmentary mechanisms involved are comparable. Participants were divided into two groups. The first group received a 30% glycolic acid peel every three weeks, in addition to twice-daily application of a cream containing 20% azelaic acid. The second group used only the cream. Assessment was based on the MASI score (Melasma Area and Severity Index). While both groups showed improvement, the reduction in score was markedly greater in those who received the combined glycolic and azelaic acid regimen.

• The arbutin acid (or alpha-arbutin).

  Often described as a natural hydroquinone, arbutin’s remarkable efficacy against brown spots is due to its affinity for the active site of tyrosinase. Arbutin thus acts by competitive inhibition : by binding to the enzyme’s active site, it blocks its activity and consequently melanin synthesis. A study conducted in India on 36 women with brown spots highlighted arbutin’s depigmenting properties.

  Over a 56-day period, participants applied a cream containing 10% 3,4,5-trihydroxybenzoic acid glucoside (THBG) and 2% α-arbutin twice daily, alongside a once-daily SPF 50+ sunscreen. The protocol’s efficacy was evaluated using a Mexameter to measure melanin levels and the MASI score. The results showed a significant reduction in skin pigmentation and MASI score, with no adverse effects observed.

• The liquorice extract.

  Known by its INCI name Glycyrrhiza Glabra Root Extract, liquorice extract contains 95% glabridin, a compound involved at multiple levels in regulating hyperpigmentation. It significantly reduces the amount of endothelin-1, a mediator involved in melanogenesis and which is released by keratinocytes after UV exposure. Moreover, liquorice extract inhibits phospholipase A2 (PLA2) activity, an enzyme released by epidermal keratinocytes following UV exposure or during inflammation that stimulates tyrosinase activity and thus melanin production. To date, however, the depigmenting effects of liquorice extract have only been demonstrated in vitro.

• The tranexamic acid.

  Tranexamic acid is a synthetic derivative of lysine, an amino acid present in the skin. This active ingredient combats hyperpigmentation by blocking the interaction between keratinocytes and melanocytes and by competitively inhibiting the active site of tyrosinase, thus preventing its activity and, consequently, melanin synthesis.

  Multiple studies have demonstrated the benefits of tranexamic acid for brown spots. A recent study assessed the efficacy of a serum and a cream formulated with 3% tranexamic acid to reduce hyperpigmentation in 22 individuals aged 45 to 67. After eight weeks of daily application, a significant 13% reduction in the colourimetric intensity of the spots and a 6% decrease in their size were observed. Furthermore, 77% of participants reported a visible reduction in their spots.

Although certain active cosmetic ingredients can lighten brown spots, their effect remains gradual and limited: in cases of pronounced hyperpigmentation, only aesthetic medicine can deliver rapid and visible results.

As a first-line intervention, laser treatment represents one of the most effective solutions for brown spots on the hands. Among the most commonly used techniques are Q-switched lasers, IPL (intense pulsed light) devices and non-ablative fractional lasers. These devices specifically target the melanin contained in the spots : the light energy emitted by the laser is absorbed by the pigment clusters, causing them to fragment into smaller particles that the body gradually eliminates. One to three sessions, spaced several weeks apart, are generally sufficient to achieve a noticeable improvement. The procedure is rapid and minimally invasive but may cause some transient side effects, such as redness or crusting.

Results obtained with a laser are often highly satisfactory but require a thorough preliminary dermatological assessment to exclude any suspicious lesions and to tailor the protocol to the patient’s phototype.

A recent study evaluated the efficacy of intense pulsed light on brown spots on the backs of the hands in 15 participants aged 40 to 73, treated in three monthly sessions. A follow-up assessment was conducted at one and three months after the final session, using image analyses via the VISIA system, a digital imaging platform used in dermatology and aesthetic medicine. The results, presented in the table below, show a significant reduction in the number of brown spots, their intensity and their contrast.

Another aesthetic medicine option: professional chemical peels. These rely on the same principle as cosmetic exfoliating treatments but employ higher concentrations. Among the most utilised active agents are glycolic acid, trichloroacetic acid (TCA) and lactic acid, used alone or in combination. The aim is to induce the desquamation of the superficial layers of the epidermis containing melanin deposits, while stimulating the production of more uniform cells. Depending on the depth of the peel, several days of social downtime may be necessary. Multiple sessions are often required, and once again a prior assessment by a healthcare professional is essential to validate the protocol and ensure it is appropriate for the individual’s circumstances.

Prevention is better than cure: to prevent brown spots on the hands, it is advisable to apply sunscreen daily.

• GAO J. & al. The use of botanical extracts as topical skin-lightening agents for the improvement of skin pigmentation disorders. Journal of Investigative Dermatology Symposium Proceedings (2008).

• SARKAR R. & al. Cosmeceuticals for hyperpigmentation: What is available? Journal of Cutaneous and Aesthetic Surgery (2013).

• DUA R. & al. Combination of glycolic acid peel and topical 20% azelaic acid cream in melasma patients: Efficacy and improvement in quality of life. Journal of Cosmetic Dermatology (2016).

• SHAH P. & al. Efficacy and safety of topical trihydroxybenzoic acid glucoside and alpha-arbutin containing formulation along with a sunscreen in facial hyperpigmentation. International Journal of Research in Dermatology (2022).

• KENKEL J. & al. The efficacy of intense pulsed light as a treatment for benign pigmented lesions on the dorsal hand. Dermatologic Surgery (2022).

• KARIM M., DIEP D. & al. Chemical peels for the management of melasma and hyperpigmentation. Dermatological Reviews (2023).

• ATTA B. & al. A comparative study of two topical treatments for photoaging of the hands. Plastic and Reconstructive Surgery (2024).

• LAURENT A. & al. Pilot clinical safety and efficacy evaluation of a topical 3% tranexamic acid cream and serum protocol for managing facial hyperpigmentation in caucasian patients. Cosmetics (2024).