Dark spots or blemishes on your skin can be unattractive and make you feel self-conscious. The good news is that our medical team can assess your dark spots to work out what's causing them and, if appropriate, prescribe and deliver an effective treatment to your door.

We prescribe a cream that contains 3 active ingredients: hydroquinone, a retinoid and a steroid. We ship a 3 month supply at a time.

Hyperpigmentation is the technical term for when your skin darkens. Dark spots are often caused by excess melanin, which is the pigment that gives skin its color. The melanin can sometimes build up in patches and makes the skin appear darker than the skin around it. Many different things can cause the melanin to build up - prescription medicines, certain health conditions, skin conditions, excessive sun exposure, infections.

Sometimes dark spots can be caused by more serious conditions such as skin cancer. Therefore it's very important to be familiar with your own skin. Make sure you go for a yearly physical exam with your doctor or nurse practitioner in person, and tell them about any suspicious skin spots you have. If you notice spots or marks on your skin that are changing in number, size, or shape over time, you should also see a dermatologist for a more comprehensive skin exam.

You can use our service if you're between the ages of 18 and 70 and you have defined areas of dark spots on your skin. GoMDUSA doctors or nurse practitioners can help with dark spots related to specific conditions such as PIH (postinflammatory hyperpigmentation), melasma, and solar lentigines (age or liver spots).

We aren't able to help you if:

• You want to lighten your overall skin color, rather than lighten specific dark spots.
• Your dark spots are caused by something other than PIH (postinflammatory hyperpigmentation), melasma, or age or liver spots (solar lentigines).
• Your medical history suggests it's best for you to see a doctor or nurse practitioner in person - history of skin cancer, vitiligo, other skin conditions that are uncontrolled (active eczema, psoriasis) pregnant/breastfeeding

We prescribe a compounded cream that typically contains 3 active ingredients:

• Hydroquinone - works as a skin ‘bleaching agent' to lighten dark spots.
• Tretinoin - works by promoting skin cell turnover which allows for brighter skin cells to surface. Also helps the cream to work more effectively.
• Hydrocortisone - a steroid that reduces any irritation or inflammation that in patients with sensitive skin can be caused by tretinoin and hydroquinone.

A compounded cream is one that's customized for particular patients and made by a licensed pharmacist in a pharmacy that's licensed to do compounding. Although the FDA doesn't approve specific compounded medicines, compounding is tightly regulated and serves an important role in patient care.

You'll typically need to apply our cream for at least 3 months to start seeing benefits.

Let us know if the cream doesn't seem to be working. We'll likely check that you're applying it properly and then give you more advice based on what you tell us.

It's simple to use our service. Most people complete the process in 15 minutes:

1. Complete our simple dark spots health questionnaire
2. Upload photos of your face and any other areas of skin that have dark spots. Make sure you follow the instructions and provide close-ups if needed.
3. Create an account (make sure you do this to save your answers)
4. Make payment with a credit or debit card (we won't charge your card until after one of our medical team reviews everything)
5. If required in your state, we may need to do a short video or telephone consultation.
6. We'll prescribe and ship the appropriate cream. If instead we think you should see a doctor or nurse practitioner in person, we'll explain why.
7. Get your cream in the mail and start treating your dark spots!

We'll send you a secure message a month after your consultation to make you're doing ok and to see if you have any questions. If you want to speak to us sooner, you can message us anytime.

Yes we can. Your photos and answers to our health questions give our medical team the information we need.

If we think you need to see a doctor or nurse practitioner in person for a more detailed examination or a skin biopsy, we'll explain that to you and we won't charge you anything.

One option is not to treat dark spots. Typically they aren't caused by a condition that's life-threatening so you don't need to treat them from a medical perspective. That said, we still recommended you go for a yearly physical exam with your doctor or nurse practitioner in person, and tell them about any suspicious skin spots you have. If you notice spots or marks on your skin that are changing in number, size, or shape over time, you should also see a dermatologist for a more comprehensive skin exam.

To prevent your dark spots getting worse you can also focus on lifestyle changes such as wearing sunscreen (SPF 30 or higher) and wearing protective clothing to avoid exposing your skin to sunlight.

If you want to treat them then there are some over-the-counter treatments that aren't as strong as our prescription cream.

Avoid excessive exposure to sunlight, use sunscreen (SPF 30 or higher), and wear protective clothing. You should also avoid picking at acne lesions or scabs, as this can damage the skin further and create dark spots.