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The exfoliant will lift dead skin cells, and over time it may fade the dark areas around your mouth. You can use a chemical or a physical exfoliant. Chemical exfoliants can be better for treating dark areas because they do not stimulate the skin like a physical exfoliant, which can exacerbate the problem. You can find chemical exfoliants and facial scrubs in drugstores, grocery stores, and bath-and-body stores. Read reviews of a product before you buy it. Some scrubs may be sold to treat acne and other skin conditions; these scrubs often use acids and chemicals to deep-clean your skin. You can find moisturizing, skin-brightening pigment products in drugstores and beauty-product stores. Find a cream that contains Vitamin C, kojic acid (extracted from certain fungi species), arbutin (taken from the bearberry plant), azelaic acid (found in wheat, barley, and rye), licorice extract, niacinamide, or grapeseed extract: these ingredients help to block the enzyme tyrosinase, which your skin cells need to produce melanin. Spread a thin layer of the cream around your mouth. Follow the instructions, and don't use these skin-lightening products for more than three weeks. Kojic acid is a popular treatment, but it can irritate sensitive skin. Be careful. If you have celiac disease or are gluten intolerant, avoid using azelaic acid, which comes from wheat. If your spots won't go away, your dermatologist may prescribe a drug-based cream like hydroquinone. Hydroquinone limits your pigment-making cells and slows your skin's production of tyrosinase. Dark spots tend to vanish quickly with lower pigment production. Animal studies have linked hydroquinone with cancer, but those animals were fed and injected with the drug. Most human treatments stop at topical application, and no research suggests toxicity in humans. Many dermatologists deny the cancer link. Most patients show the first signs of skin lightening within a few days, and most of the effects act within six weeks. After the treatment, you can switch to an over-the-counter cream to keep up the brighter pigment. Lasers like Fraxel tend to be the most lasting and effective way to treat discolorations that are close to the surface of the skin. However, laser pigment work is not always permanent. The effect will depend upon your genetics, your UV exposure, and your skincare habits. Lasers also tend to be more expensive than other treatments. Your dermatologist may suggest these peels to reach and treat damaged cells deep within your skin. Bear in mind that these treatments are not permanent. Depending on your genetic predisposition to dark spotsand how much UV exposure you getyour spots may return as soon as a few weeks or as late as a few years. Stay out of the sun, wear sunscreen when you do go outdoors, and treat your dark spots early to make sure that your treatment lasts longer.
Exfoliate daily with a mild facial exfoliant. Use an over-the-counter skin-brightening cream. Consider using a prescription cream. Try a laser treatment. Try a glycolic or salicylic acid peel.