Dr. Lott on Dr. Peter Gott

I admit it. I regularly read his advice column in the Lincoln Journal Star. I read it at first so I would know what my patients were referring to. I became a fan when I understood, compared to so much “medical advice” on the internet, Dr. Gott’s information is balanced, comprehensive and well researched. He is also willing to keep an open mind to stories of alternative approaches to treatments that have helped some and most importantly do no harm. History supports many of Grandma’s treatments in spite of the lack of double blind, independent studies done at several facilities with a large subject number.

What motivated this blog was the article entitled “Battling Age Spots”. Dr. Gott aptly described these gifts from the birthday fairy and what we can do about them.

First and foremost is sun protection with clothes, hats and sunscreens plus staying out of the sun from 10 to 4. (“Only mad dogs and Englishmen go out in the noon day sun”). There are over the counter bleaching creams which are half the strength of the prescription ones. These help but require regular use for months. I personally like “cryotherapy” or freezing them if there aren’t too many. They generally scab over and peel off in 7-10 days. We have a much improved chemical peel for brown especially for a lot of diffuse color. The skin peels after about 3-4 days and is more like the fine scaling of a sun burn.

The laser is particularly effective for generalized discoloration but costs more than the chemical peel. Nothing is consistently effective for Melasma (hormonal based brown discoloration). I am also seeing improvement after the fractionated CO2 laser treatments. This definitely has more downtime (4 days) because it is actual pinpoint wounding of the skin. This technique is being called Ablative Fractional Resurfacing (AFR) and is the current popular treatment for fine lines, wrinkles, sun damaged skin and acne scars.

The most important bottom line is to be sure the brown spots are from age and aren’t cancerous. When in doubt, the best is to have a skin exam at your friendly dermatology office.

Dr. Ann