How can brown spots on the hands be eliminated?

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

• The vitamin C,

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

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

• The azelaic acid and the glycolic acid.

  Azelaic acid is a naturally derived active ingredient with depigmenting properties that are effective in fading brown spots on the hands. It also works by inhibiting tyrosinase enzyme activity and exhibits anti-inflammatory and antioxidant effects, enabling it to target various forms of hyperpigmentation, including post-inflammatory marks. Glycolic acid, for its part, is an AHA renowned for its exfoliating action, allowing it to remove melanin-rich 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 melanocytes produce melanin.

  A 24-week study was conducted involving 60 patients with melasma. Although the 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 applying a cream containing 20% azelaic acid twice daily. The second group used the cream alone. Evaluation was based on the MASI score (Melasma Area and Severity Index). While both groups showed improvement, the score reduction was significantly greater in patients receiving the combined glycolic and azelaic acid treatment.

• The arbutin acid (or alpha-arbutin).

  Often referred to 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 via 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.

  For 56 days, participants applied twice daily a cream containing 10% 3,4,5-trihydroxybenzoic acid glucoside (THBG) and 2% α-arbutin, alongside a once-daily SPF 50+ sunscreen. The protocol’s efficacy was assessed using a mexameter to measure melanin content and the MASI score. The results showed a significant reduction in skin pigmentation and in the MASI score, as well as no side effects.

• The licorice extract.

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

• The tranexamic acid.

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

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

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

As a first-line intervention, laser therapy is one of the most effective solutions for brown spots on the hands. Among the most commonly used techniques are Q-switched lasers, intense pulsed light (IPL), and non-ablative fractional lasers. These devices specifically target the melanin contained within 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 will gradually eliminate. One to three sessions, spaced several weeks apart, are generally sufficient to achieve a noticeable improvement. The procedure is quick and minimally invasive, but it may produce some transient side effects, such as redness or crust formation.

The results achieved with a laser are often highly satisfactory, but they require a thorough pre-treatment dermatological evaluation to rule out any suspicious lesion 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 years, treated in three monthly sessions. Follow-up was conducted at one and three months after the final session, with 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 is professional chemical peels. These procedures operate on the same principle as cosmetic exfoliating treatments but employ higher concentrations. Among the most commonly used active agents are glycolic acid, trichloroacetic acid (TCA), and lactic acid, either alone or in combination. The objective is to induce desquamation of the superficial layers of the epidermis containing melanin clusters, 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 preliminary evaluation by a healthcare professional is needed to validate the protocol and ensure it is appropriate for the individual situation.

Prevention is better than cure: to avoid brown spots on the hands, it is recommended to protect them daily with sunscreen.

• 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).