“The sun’s UV rays can cause uneven pigmentation, brown spots, broken blood vessels, and white spots,” explains Debra Jaliman, MD, a board-certified dermatologist and author of Skin Rules: Trade Secrets from a Top New York Dermatologist. “It can also break down the collagen and elastic tissue leading to wrinkles and sagging of the skin.” While a full reversal of sun damage isn’t always feasible, there are a handful of treatments and products that can partially turn back the clock and curb future damage. At the forefront of your “must apply” list is an SPF 30+, which should be worn everyday. It’s also good practice to cleanse and moisturize daily. Prioritize products formulated with ingredients that have scientific backing, such as peptides, ceramides, niacinamide, and vitamin C. If your skin isn’t too sensitive, you can also work in an exfoliating product once or twice a week. In-office treatments range from very mild peels that use gentle enzymes, all the way to very intense acid peels (such as a TCA peel) that require downtime. Though stronger peels can create the most noticeable results, not everyone is a candidate. Your provider can walk you through the best options based on your complexion and specific goals. While professional chemical peels are typically stronger (pH of around 2.0), you can opt for the lower strength stuff at home with AHAs and BHAs, lactic acid, and mandelic acid. Also known as “lunchtime peels” (since they involve little to no downtime), these superficial peels penetrate minimally and exfoliate gently to assist with mild skin problems like minor discoloration and rough texture. “Prescription [tretinoin] is the only thing that has been formally studied to show reversal of some of the textural changes of the skin, like wrinkles,” explains Orit Markowitz, MD, a board-certified dermatologist and skin cancer specialist. Over time, Dr. Markowitz says that consistent application of tretinoin helps thicken the dermis and increase elastin, which makes skin appear less wrinkled, rough, and dull. “For basic freckles and sun spots, I like the Pico laser technology,” says Dr. Markowitz. “This is a photo acoustic, rapid pulsing laser. There’s no heat or thermal damage on the skin and therefore no downtime with very great results.” You’ll need three or four Pico laser treatments, usually spaced about two to four weeks apart, to see optimal results. Fraxel lasers, which use fractionated light, target brown spots and fine lines. They require about four treatments spaced one month apart, and generally include about five days of downtime each. “It’s about an hour-long procedure done in the office,” Dr. Jaliman adds. “You are first numbed for an hour with numbing cream. Then the laser takes 15 minutes. Then you ice for another 15 minutes.” “Here you apply a chemical called aminolevulinic acid, [which] tends to bind to cells that are probably growing at a more rapid rate. [This is] usually a sign of cancer or precancerous damage,” says Dr. Markowitz. The chemical sits for 16 minutes and 40 seconds (yes, it’s that precise!) while the skin is exposed to blue, or sometimes red, light. Dr. Markowitz explains that the cells growing too quickly will light up, crust over, and the skin will appear almost like it has a sunburn. “Then, after a week, things begin to nicely fade away. You won’t see optimal results until three to four weeks after treatment.”
