112: How To Deal With Hyperpigmentation w/ Dr. Anthony Youn

Hyperpigmentation (e.g. sun spots) is very common. It can be caused by hormonal changes (like melasma during pregnancy), or sun damage. My guest will be talking about how to prevent sun spots, and how to try and reduce existing sun spots.   

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

My guest today, Anthony Youn, M.D. F.A.C.S, is known as America's Holistic Beauty Doc. He is a nationally-recognized, board-certified plastic surgeon.

Recognized as a leader in his field, Dr. Youn is the author of the best-selling books The Age Fix: A Leading Plastic Surgeon Reveals How To Really Look Ten Years Younger and In Stitches: A Memoir.

His public television special, The Age Fix with Dr. Anthony Youn, has been viewed by millions. Dr. Youn also hosts the popular podcast, The Holistic Plastic Surgery Show.

His new book, Playing God: The Evolution of a Modern Surgeon, details his humorous, heartwarming, and often harrowing journey to become a leading plastic surgeon. He is an Assistant Professor of Surgery at Oakland University / William Beaumont School of Medicine.

Join us as we discuss how to deal with hyperpigmentation.

Have you taken steps to prevent or reduce sun-related hyperpigmentation? Let me know in the comments!

In this episode:

  • What exactly is hyperpigmentation of the skin?
  • Is there something you can do to, number one, reduce the ones that you have, and then stop the development or progression of other sun spots?
  • Different options that help with hyperpigmentation.


“Sun-related spots, freckles, age spots, sun spots, liver spots: Technically they're many, many names for the same thing.” [3:55]

“Sun spots are caused by ultraviolet radiation, by ultraviolet exposure to your skin. You are more likely to get sun spots in areas where your skin is exposed.” [5:37]


Find Dr. Youn online

Jennifer's appearance on Dr. Youn's podcast, The Holistic Plastic Surgery Show – Episode 136: The Healthy Skin Diet

Healthy Skin Show episode 033: Tackling Scars And How To Support Sensitive Skin w/ Dr. Anthony Youn

Playing God: The Evolution of a Modern Surgeon

Youn Beauty Brightening Cream

Follow Dr. Youn on Instagram | Facebook

112: How To Deal With Hyperpigmentation w/ Dr. Anthony Youn FULL TRANSCRIPT

Jennifer: Hi everyone. Welcome back. I've got a great returning guest for you today. You may remember that Dr. Tony Youn joined us a number of months ago and I really appreciated him being on the show because what he does is a lot of different from all of my other guests, and I had all these questions, believe it or not, from listeners about hyperpigmentation that are not what I deal with but Dr. Youn does. So I figured it would be great to have him back to talk about this and give you guys some straight answers.

Jennifer: If you don't know him, he is known as America's holistic beauty doc. Dr. Anthony Youn is a board certified plastic surgeon, best-selling author, and television personality. He's one of the nation's foremost expert on turning back the clock without surgery. His recent public television special, The Age Fix with Dr. Anthony Youn, has been viewed by millions. He's the author of the best-selling book, The Age Fix, and the host of the popular podcast, The Holistic Plastic Surgery Show, which I was on.

Jennifer: Dr. Youn is a frequent guest of the Rachael Ray show, the Dr. Oz show, I've actually seen him on a ton of press including different places like Harper's Bazaar, U.S. News & World Report, Town & Country, I feel like you've been on CNN before, and he's got a really great website, dryoun.com and he has actually been named one of the nation's best top plastic surgeons. And the reason that I have him on for all of you listening going, “Wait, why are you having a plastic surgeon on?” Dr. Youn has a very different approach. He really appreciates a holistic full body look at how things are so that he can support you, whatever your needs are, to get and reach your goals.

Jennifer: And I really appreciate that about him. What he's doing is different. I went in skeptical and as I talked with him more and more I realized that he's doing something that other people aren't, so that's why I think he's a great person for you to learn from, to follow. I learned a ton from him and I'm really honored to have him back. Thank you Dr. Youn for joining us.

Dr. Youn: Thank you so much, Jen. You could have cut that down in half and it still would be really nice, but thank you so much.

Jennifer: I really appreciate what you do and that's the hard part here. So full disclosure, I'm about 40 and I start noticing that I'm getting age spots, and I also get all of these readers that have written me asking about hyperpigmentation, melasma, weird patches that they don't know what to do with. “What nutrient can I take? What supplement?” And I'm like, “I don't really know the answer to that question,” and so I reached out to you and you're like, “Yeah, let's talk about that.”

Jennifer: So can you tell us a little bit, what exactly is hyperpigmentation of the skin?

Dr. Youn: So I think simply put it's spots, and we all have different types of spots. Sometimes we talk about them as very cute like, “Oh cute, that person has freckles.” Other times we give them names like age spots or liver spots, but they come in a couple of different kinds and I guess I would probably very simply separate into three different bins.

Dr. Youn: The first bin are the spots that you are typically born with, that you can develop sometimes as you get older that you really can't do much with, and those are moles. So we have moles, we have birthmarks, those aren't necessarily age related issues as they are more genetics and that type of thing. So we take moles out of the equation other than if you've got a mole, it's getting bigger, you've got weird colors in it, it's changing shape, then you've got to look out for the potential risk of skin cancer.

Dr. Youn: But taking moles out of the equation, when you've got other types of pigment that you dislike there are two other groups you can group it in. There are the sun-related spots, freckles, age spots, sun spots, liver spots, technically they're many, many names for the same thing.

Jennifer: They're all the same thing.

Dr. Youn: The same thing. It's melanin that has gone haywire from, typically, sun damage. And then the other group is melasma. Okay, melasma's more of a patchy pigmentation and that patchy pigmentation can be related often with pregnancy and other hormonal changes in the body.

Dr. Youn: Melasma's a really hard thing to treat, okay? Melasma's one of the questions I get all the time on my Facebook group, on Instagram, on YouTube, and nobody has a really good answer for it. Age spots, however, or sun spots, or liver spots, or whatever you want to call them, there we do have answers though for.

Jennifer: Okay, so let's talk about that because I feel like you start getting them… Well, I could be wrong but I tend to find that you get them around the face, like I have one on the side of my eye, and then I noticed on my parents and actually on myself I start to get them on the back of my hands and whatnot. So where are the most common spots that you tend to see them and should I have been probably using more sunscreen earlier in life? Or am I doomed with these things continuing to develop?

Dr. Youn: So basically sun spots… We'll just call them sun spots, okay?

Jennifer: Fair enough.

Dr. Youn: Because they're age spots, liver spots. The only reason they call them liver spots, it has nothing to do with the liver, it's just that they're brown like the color of liver and that's why they call it liver spots. But basically sun spots are caused by ultraviolet radiation, by ultraviolet exposure to your skin. You are more likely to get sun spots in areas where your skin is exposed and so that's why if you compare the skin of your face to the skin of your chest to the skin of your butt, you don't get age spots on your but. Unless you're a nudist you're not going to have age spots on your butt because they're due to the sun, okay?

Dr. Youn: Whereas sometimes you don't get many age spots as much on the face because a lot of women may wear let's say mineral make up or sunscreen, but then you start seeing it on the hands and on the chest where they may not apply it as much. And people who drive a lot, often you'll see more spots on the left hand and the left side of the face because that's getting exposed to the sun.

Dr. Youn: Now interestingly enough some people say, “I'm driving a car, I've got the window. Why do I need to put sunscreen on?” Well, actually the windows of your car will block the ultraviolet rays that are UVB rays that will cause you a sunburn. You don't get sunburns if you're sitting in your car driving but they don't block the UVA rays which can cause premature aging and sun damage, and result in spots.

Dr. Youn: So those are some of the most common areas, the hands, the chest, the left side of the face typically more than the right if you're driving a lot. I guess if you're a passenger a ton it could be the right side of the face. And where you don't see it are the areas that are covered, the genitals, the butt.

Jennifer: So what's interesting is that as you're saying this and you're comparing the difference between UVA versus UVB. So this may not necessarily have to do with how burned you've gotten, it more has to do with that specific band of light that doesn't necessarily cause burning, so that would be why a car scenario would still-

Dr. Youn: Yeah, but most of the time when you've got a lot of sun, the chances are you've exposed yourself to both UVA and UVB rays. The only time where you haven't that I can think of just offhand is in a car, but most of the time you're out sunning yourself, you're out exercising, you're doing work outside, you're going to be exposed to both. I suppose one situation is if you're wearing a non-broad spectrum sunblock where it only blocks, let's say, UVB rays, then I suppose that's the case but there are so few of those anymore. Most sunblocks and sunscreens are broad spectrum.

Jennifer: So what do you do then? Is this something that I'm just stuck with or any of the listeners are stuck with for life? They just keep progressing or is there something you can do to, number one, reduce them, the ones that you have and then stop the development or progression of other sun spots?

Dr. Youn: So prevention obviously is the first thing, and that's wearing sunscreen, and so wearing sunscreen is going to help, obviously, prevent it. The bad thing about these types of sun spots is that you can't get rid of them unless you actively do something. If you aren't doing something to actively get rid of your spots they're just going to get worse and worse and worse and continue to build up.

Dr. Youn: And I do believe, although I don't know that it's scientifically proven, I do believe that sun damage you may get earlier in life may present later in your skin. I see that in my patients all the time but I don't know of any study that's necessarily shown that that's the case.

Dr. Youn: So how do you treat sunspots? This is what your audience wants to know. There are a number of ways to treat it. The chemical-free way to treat it is to use a treatment called IPL, Intense Pulse Light. Another name for that is the photo facial, and this is similar to a laser, technically it's not a laser but very similar, where you use a light with a certain type of wavelength to target the dark pigment in that spot. And so you zap the skin with it, the spot will typically turn darker after as little as a few minutes to a few days, and then after about a week a lot of the spots will actually slough off. They will fall off.

Jennifer: Oh wow.

Dr. Youn: Now we usually recommend four to five treatments for maximal effect. The treatment is not painful. It may feel a little bit like somebody's pinching your skin but it's not something that you need pain pills or numbing medicine or anything like that for it and it does work really well. It's no downtime other than your skin looking a little darker once again as those spots are sloughing off. That's a really nice way for those people who say, “Look, I don't want to put creams on my skin. I don't want to deal with that. I want to get rid of it quickly.” Then doing IPL is a reasonable option.

Dr. Youn: It's not cheap. In my office I think we charge $300 for a full face IPL session. I think if I remember right, and I don't look at the numbers that much for cost, but I think we have a buy four get one free. I think if it's $300, you buy four it's $1200 and you get five treatments. And that's usually enough to really, really reduce that pigment. So that's really a great way.

Dr. Youn: There are other ways to get rid of pigment like chemical peels, more aggressive laser treatments, but those typically have downtime to them and so the easiest, best way to get rid of spots chemical-free would be IPL.

Jennifer: And what about those vitamin C serums? Do those work on these spots or is that not applicable in this case?

Dr. Youn: Yeah, so there are a lot of topicals that can claim to reduce spots and the most effective one is controversial, Hydroquinone. Hydroquinone basically is an ingredient in certain skin lightening creams. You can get it over the counter strength which is 2%. Prescription strength is 4% and some compound pharmacies even will do 6% or more. If you look at pure efficacy, effectiveness for creams, Hydroquinone is most effective to reduce the activity of melanin. By far most effective.

Dr. Youn: The problem with Hydroquinone though is it has been shown to cause cancer in laboratory rats in very high percentages, in high concentrations. It is banned, at least prescription strength is banned in Europe but is still used in the United States. So you've got to be very careful with it, it really is something where… We actually have used it in my practice for the last 15 years selectively.

Dr. Youn: There are other negatives with it in that if you use it for longer than approximately six months you can get tolerance to it, you can get rebound hyperpigmentation if you use it for too long and then you go off of it, and then if you have really dark skin, especially if you're of African ancestry there is something called Ochronosis which is a pigmentation type of a disorder. It's a patchy disorder that some people get when they're using Hydroquinone.

Dr. Youn: So I only really recommend it under the care of a physician, dermatologist, or plastic surgeon. Only use it for six months at a time and that's if you really have got bad, bad spots, okay? That's the most effective but something that, once again, exercise caution.

Jennifer: So we're in the car, we've got our sunscreen which is blocking both UVA and UVB light, even outside we're wearing sunscreen and a hat, do you feel like that does a decent job in preventing the onset of new age spots?

Dr. Youn: In general, yes, but if you want to do more… You mentioned vitamin C earlier. When you're looking at these types of creams, Hydroquinone is one that is a powerful skin lightener. But once again there's issues with toxicity so what else can you do? I have one in my skincare line called Youn Beauty brightening cream, very simple. Not a real fancy name, and what that is is there are a number of other ingredients out there that you can look for for brightening creams that are safe, that you can use in the long term that can help suppress the pigment as well from developing.

Dr. Youn: So the one that I have in mine is called kojic acid. From what I can tell looking at the literature on the studies, kojic acid is probably the number two most effective skin lightening ingredient out there. It's very well tolerated and like I said, a lot of skin creams have them. That's a main component in my cream as well.

Dr. Youn: Other ones that you can look for that are very safe, niacinamide is another one that's used in a lot of over the counter topical brightening creams and spot reduction creams. Also very safe for long term use and pretty inexpensive. And the other thing, if you want to go real natural, is licorice extract. My product, the brightening cream has licorice extract and kojic acid in it.

Dr. Youn: Some people will literally take licorice extract from a health food store, put it in a dropper and then put that on their spots. The problem with that, it's so much easier to take a cream that's made for your skin, that you put on your skin and it blends in and it absorbs into your skin versus taking drops of [inaudible 00:14:54] six weeks for that to work, for you to start seeing those changes.

Dr. Youn: It can take much longer if you're doing something less aggressive like niacinamide or licorice extract. Now one way that you can supercharge it if you're going the cream route is you can get your skin exfoliating, okay? The creams will suppress the melanin in the skin but the creams aren't going to actually get rid of the melanin, okay? So there's a difference there. The melanin's still going to be there. The creams will suppress it and then what happens is that our skin gradually turns over, exfoliates itself, and eventually those spots will come to the surface and they will slough off, you will get rid of them, and because you've suppressed the melanin you're not going to have new spots come up.

Dr. Youn: So it makes sense that if you get your skin turning over more quickly that you could get rid of those spots quicker than if you just applied the skin lightening ingredient. What I recommend in general for those people who want to be more aggressive, is you can combine then a skin lightening cream like our Youn Beauty brightener or the other ones out there with something that exfoliates your skin. You can do it very simply by using, let's say, a Clarisonic type of ultrasonic brush, you could do it using a manual scrub, or my preference would be to combine that with a Retinol cream. Retinol will actually exfoliate your skin. Also Retinol itself is a very mild skin lightener too on the same wavelength as vitamin C.

Dr. Youn: Vitamin C is a great antioxidant. It's great for your skin, it helps with the building blocks, Collagen in the skin. Vitamin C is a very mild skin lightener. I wouldn't just use that to lighten my skin because it's not powerful enough but hey, if you combine the vitamin C with a brightener, with kojic acid or niacinamide, and hey, if you even add something like Retinol, now you're hitting that pigment in many, many different ways.

Jennifer: And with the Retinol creams, my recollection is you have to be careful of sun exposure with that because it is easier for you to burn. Is that correct?

Dr. Youn: That is true, yeah. And it depends, too, on how aggressive it is. Most of that is based off of prescription strength Tretinoin or Retin-A. Most people, to get that you've got to get through a doctor's office. It's pretty darn aggressive so most people I don't really necessarily recommend going with that route. If you've got real thick, oily skin then that may be a better option for you but otherwise go with an over the counter Retinol moisturizer because you know your skin's going to have a better chance of tolerating it and you're still going to get a lot of those anti-aging exfoliating benefits, and even the pigment reduction too.

Jennifer: Yeah, absolutely. Before we wrap up, I just want to say to everybody who's listening, Dr. Youn has a new book out and the reason that I just wanted to share this is my dad's a surgeon and so I felt like when he told me about the book there was just something that interested me so much in it, because the life of a surgeon is very different even from a regular doctor. His book is called Playing God: The Evolution of a Modern Surgeon which is available now.

Jennifer: Dr. Youn, could you just tell us briefly, what would someone find in it? It's an interesting title, Playing God. And a lot of times we'll say doctors are playing god, what is the book about?

Dr. Youn: The book basically is a journey of how does somebody go from being a clueless new doctor trained by old fashioned surgeons who believe that they are God's gift to the world to becoming what is essentially a holistic modern surgeon of today, a surgeon who doesn't think that he or she is God but relies on God or a higher power to help him or her to help their patients.

Dr. Youn: So there's a lot of stories here that are uplifting. There are some that are quite shocking because I am a plastic surgeon and not all of my patients are really nice and kind and genuine people, but it's how do you get to that point where you really become that modern holistic surgeon of today.

Dr. Youn: We've had a lot of great reviews of it and I'm really excited about it because it really has, I think, resonated with so many people in getting into the psyche of physicians and today's wild west of medicine.

Jennifer: That is so true. There is a lot of wild west and one of the things that struck me about you, and I think that's why I wanted to let people know how highly I think of you, is because you are one of the most humble surgeons I've ever met, and I've met a lot. My dad has been in the world of ophthalmic surgery for a long, long time. He's in his seventies and so I've met a lot of surgeons, and you were very different from most surgeons.

Dr. Youn: Oh, thank you.

Jennifer: I know that your faith is very important to you and you really do care deeply about your patients, and that's why I'm so grateful that you're always willing to come back and share what you know here. I think for anybody who has an interest in understanding this aspect of not just Dr. Youn but other physicians that are out there, this is a great book to check out and we'll put a link to that in the show notes along with Dr. Youn's website.

Jennifer: He's got a great Instagram account as well so you should follow him there. He's always showing different procedures and tips and all sorts of things. I always learn a lot from him and of course, we'll make sure to connect you guys with all of the ways that you can get in touch with Dr. Youn. He's also got a bunch of great free guides as well in case you're interested in knowing more about antiaging and whatnot. He is the person to go to.

Jennifer: Dr. Youn, thank you so much for being here. I really appreciate it.

Dr. Youn: No, you're great. Thank you so much Jen, it was so much fun and I have to have you back on my show as well.

Jennifer: Absolutely. All right, have a great afternoon.

Dr. Youn: Thank you.

“Sun-related spots, freckles, age spots, sun spots, liver spots: Technically they're many, many names for the same thing.” [3:55]