From topical treatments that lighten to in-office lasers that ablate the upper layer of skin, there are a myriad of options to limit the look of sun-damaged skin. Topicals are almost always the first recommendation to address sun damage, and are often coupled with more aggressive treatments.
If you have freckles and minimal sunspots, erase them with Intense Pulsed Light (IPL): Although the least intense type of sun damage—they can be dark and large in quantity—freckles tend to surface on the skin as early as childhood. “After the summer months are over, many patients come in trying to get rid of their spots and we offer them Intense Pulsed Light (IPL) treatments. In my opinion, it’s the best tool to get rid of both red and brown pigmentation,” says Brooklyn, NY, dermatologist Tatiana Khrom, MD. “IPL is one of my favorites because it does a great job of normalizing color, so you can really get those light and dark brown spots. The more you do this, the more collagen that forms, so your skin looks healthier and smoother. IPL is a great treatment for someone who isn’t ready for a fractional laser just yet,” says Delray Beach, FL, dermatologist Janet Allenby, MD.
If you have severe age spots, erase them with hydroquinone or kojic acid and laser resurfacing: Ranging in color from brown to almost black and in size from something bigger than a freckle to as big as a coin, age spots (also known as liver spots and sunspots) are a direct result of excessive sun exposure that has prompted an overproduction of melanin. When it’s an isolated brown spot that isn’t too dark, hydroquinone or kojic acid, used with Retin-A, can help reduce discoloration. “It’s the more aggressive procedures, like lasers, that really work to resurface the skin. The principle is that the body recognizes a wound (created by the laser) and heals it with new collagen and new skin. Erbium and fractionated CO2 lasers remove the outer layer of skin to reveal healthy new skin as the skin heals,” says Lafayette, LA, plastic surgeon Darrell L. Henderson, MD.
If you have skin that is uneven in texture, erase it with regular at-home exfoliation and chemical peels: “The sun sucks the life right out of your skin,” says Dr. Henderson. “After skin is damaged, it looks older than it should and more leathery in texture. It’s not smooth or youthful-looking because there is a lack of healthy collagen and elastin, making the skin look rough, dull and weathered.” Regular exfoliation with alphahydroxy acids (AHAs) like salicylic, lactic and glycolic acids can help—you’ll see the most improvement when they are used in tandem with a prescription-strength retinoid to further smooth the skin. “In those cases where skin is really mottled looking, I’ll suggest a series of chemical peels. We’re doing them a lot more than in years past because what we have to offer patients today works so well to improve the texture of skin,” says Dr. Allenby. Chemical peels physically exfoliate the top layer of skin and repair some of the damage with specific ingredients, namely acids.
If you have lines and wrinkles, erase them with fillers and injectables: Lines and wrinkles that are the result of a breakdown of collagen and elastin from the sun need to be addressed with fillers that plump them up from the inside out. For areas that have been affected by extreme collagen loss, collagen-stimulating fillers like Sculptra Aesthetic and Radiesse, as well as hyaluronic acid fillers like Juvéderm Voluma XC, can be injected. “Sun damage can cause facial features to become flat and lose their definition. Injecting these areas with either hyaluronic acid fillers or collagen-stimulating fillers restores some of the fullness to skin and can fill in wrinkles. But, these treatments don’t eliminate or reverse sun damage, but rather merely hide it,” says Dr. Henderson.
If you have red broken blood vessels, erase them with two to three treatments of pulsed-dye laser: Small and thin, blood vessels can easily break from anything like stress, pregnancy, being too aggressive on skin and even the sun. But the problem comes when skin tries to repair them and can’t. Cumulative sun damage prevents skin from regenerating these damaged vessels properly and so the redness lingers. “Broken vessels respond well to vascular lasers or IPL,” says Hunt Valley, MD, dermatologist Karen L. Beasley, MD. The laser works to take the redness out because the wavelength of the machine targets the hemoglobin in blood, which is what gives skin that redness. “The vessel almost bursts or is reabsorbed by the body over time and the broken capillary goes away,” says New York dermatologist Whitney Bowe, MD.