AHAs (Alpha-Hydroxy Acids)

• AHAs are derived from fruit acids and/or sugarcane. Some AHAs that are commonly used in age spot-removal creams, lotions and serums include L-alpha hydroxy acid, glycolic acid, lactic acid, malic acid. Sometimes, the AHAs on the ingredient list might simply read "citric acid" or "sugarcane extract." AHAs work by loosening old skin cells that dull the skin's texture, for as you age, your skin cell turnover rate decreases. The higher the percentage a product contains of AHAs, the deeper it penetrates. To find which percentage is right for you, start with a maximum of 10 percent. For higher than 20 percent, go to a dermatologist. Unlike manual exfoliation with a grainy scrub, most people--even those with sensitive skin--can tolerate AHAs and see results without irritation. These are best for light-to-medium spots. In addition to lightening the spot by refining skin tone, added benefits include the smoothing of fine lines and clearing out your pores.
  
  

Copper Peptides

• Copper peptides are to be used in conjunction with the exfoliating treatment of AHAs. While AHAs fade and remove traces of your age spot, it's these peptides that help nourish and rebuild those younger, now-exposed skin cells. They also prevent scarring and reduce irritation. Since some copper peptides products are blue in color, most users prefer to apply them in the evening--an hour or so before bedtime--to allow the cream, lotion or serum to work itself into the skin.
  
  

Topical Vitamin A

• For darker, more stubborn spots, try a topical vitamin A cream such as Retin-A. You will need to see your dermatologist for this, and she will prescribe a particular cream with a given concentration. The weakest is 0.025 percent; the highest is 0.1 percent. With topical vitamin A, you should only apply to the spot because the skin will peel, and the spot should fade away in a few months. It is important to tell your doctor what other products you are using; he might want you to use the peptides along with the topical vitamin A. Because the topical vitamin A is so potent, your skin becomes much more sensitive--especially to sun exposure. Make sure you protect your skin with sunscreen (see "Considerations.")
  
  

Hydroquinone

• A topical skin-lightening agent, hydroquinone inhibits the skin's production of melanin, which gives skin its color. As with topical vitamin A, you will need to see a dermatologist. Women who are pregnant or people with liver or kidney disease should not use hydroquinone. U.S. studies have linked its long-term use with leukemia, liver damage and thyroid disorders. Be sure to tell your doctor your health history and ask her about the risks.
  
  

Considerations

• More than likely, you'll find that a product containing more than one of these ingredients can be effective when formulated properly. However, it is also best to ask a dermatologist if you plan to use more than one at a time; for example, you might use a cleanser with hydroquinone and a serum with AHAs and peptides. Above all, it is best to go to a dermatologist at least once a year to check for for any unusually shaped spots and keep track of the growth of spots, as extensive sun damage has been linked to an increased risk of skin cancer.
  
  Also keep in mind that your effort to treat and remove age spots will be in vain unless you protect your skin from further damage. This not only applies to topical vitamin A, but all age spot removers. Always wear a sunscreen (or a lotion or moisturizer that contains it) with a minimum of SPF 15. This goes for the winter and cloudy days as well. Age spots occur over repeated, long-term exposure to the sun, so even a few minutes in the sun each day add up over time.