Summer is quickly fading, but unfortunately the damage that's been done to your skin won't fade unless you make a plan to address your summer skin sins. Every year, I reiterate that no amount of SPF protection can prevent sun damage if you're spending hours in the sun every day, but my patients still come in at the end of summer wondering why they're seeing brown pigmentation, dilated blood vessels, wrinkling, and rough scaly patches despite slathering on the sunscreen. The only--I repeat, the ONLY--way to prevent these signs of sun damage is to steer clear of the sun entirely. But if it's too late for that, let's talk about the options for treating the symptoms of sun worship, keeping in mind that these treatments are most effective when you wear sunscreen on a daily basis.
Brown discolorations on the face are usually a female problem and occur on the forehead, cheeks and upper lip. While sun exposure is the main culprit of this discoloration (called melasma) it can also be caused by pregnancy or hormonal changes. Eradicating melasma once and for all is tough because it tends to recur after treatment unless you're really fastidious about staying out of the sun. At home, the best treatment is using a topical lightening agent like Hydroquinone, which can be combined with retinol or glycolic acid to increase its penetration and efficacy. If you're looking for a gentler option, there are a host of new alternative lightening ingredients--often used in combination--including arbutin, kojic acid, licorice extract, soy extract, and even vitamin C. Remember, any of these ingredients need to be used consistently for at least a month in order to see results. In-office treatments for melasma include a series of light peels using glycolic acid, retinol, lactic acid, or trichloroacetic acid, as well as mild laser treatments like Q-switched Nd yag. Keep in mind that laser treatment works best on light skin.
Men and women can both develop brown spots on sun-exposed areas of the body--it's important to get a body exam by a dermatologist once a year to rule out skin cancer. The same at-home treatments can work on these spots, but dark ones usually need to be treated by a dermatologist. For spots on the body, lasers are the treatment of choice: Q-switched ruby, alexandrite and Nd-yag lasers are all great options. If you have numerous brown spots on the face, chest, or arms, these Q- switched lasers can be used in combination with Fraxel dual laser for maximum lightening benefits. The results of all these in-office treatments can be maintained at home with topical lightening agents.
Brown discoloration isn't the only effect of sun exposure--red discoloration caused by broken capillaries can appear on the chest, neck and face. Again, lasers work best for targeting both individual dilated vessels and diffuse redness. If you're not sure what's causing your discoloration, try pressing on the affected area. If it fades when you apply pressure, it's actually a vascular problem even if it appears to be brown. I've found that a few treatments of the V-beam laser or Excel-v laser work well for these issues.
Some physicians prefer to use intense pulsed light treatments such as the new Icon device, which uses a broad spectrum of light to target both red and brown discoloration on the face and body. Whether you choose laser or intense pulsed light treatments, your physician's experience is paramount--do your homework and make sure you go to a doctor with the necessary expertise.
I will address the treatment of lines and wrinkles and skin texture using cosmeceuticals, prescription creams and in-office devices in another post. Until then, enjoy the last summer days with plenty of sunscreen.
For more information tune into Dr. Brandt's radio show, Ask Dr. Brandt, on SiriusXM Stars Channel 107 at 1:00 PM EST on September 10th.