Dear Paula, 

I am a 34- year-old former sun worshipper. Overall, my complexion is quite good with no wrinkles and only  mild rosacea that I keep under control using your Skin Recovery Toner, 2% BHA Liquid, RESIST Barrier Repair Moisturizer and of course sunscreen every day.  

Due to my days of sun worshiping dark brown spots have started to crop up.  What is the best laser treatment available to rid my face of these spots?  Will a product like Retin-A or even a chemical peel diminish these spots? I've tried over-the-counter skin lightening creams but they don't seem to do much.  

Niki, via email  


Dear Niki,

First, I am thrilled that you’re no longer a sun worshipper! Stopping this unhealthy activity and starting to use sunscreen daily is the best thing anyone can do to keep their skin young (and I mean really young), radiant, and naturally hydrated.

As you’ve seen, the damage from years of tanning and unprotected sun exposure often doesn’t begin to show up until we’re in our late 20s or early 30s. Discolorations and an uneven skin tone are hallmarks of early sun damage (and there is even more lurking underneath), but there is much you can do to improve and possibly even eliminate the brown spots and prevent them from recurring. Here’s what I strongly suggest you consider:

• Make sure your daily sunscreen is rated SPF 15 or greater (when discolorations are present, greater is better) and contains titanium dioxide and/or zinc oxide for broad spectrum protection.
• Retin-A (tretinoin) is an excellent option but what would be even better is Tri-Luma. This prescription-only product combines tretinoin with 4% hydroquinone to help fade brown spots while discouraging wrinkles and loss of firmness. Hydroquinone is the only topical skin lightening ingredient with years of proven results.
• Facial peels using alpha hydroxy acids (AHA), beta hydroxy acid (BHA), or trichloroacetic acid (TCA) are worth considering though please note that these don’t do a tremendous amount to fade brown skin discolorations. Which one to have done is something to discuss with your dermatologist.
• Laser or light-emitting treatments are a must and in fact you should consider these instead of a peel. Begin with a series of Intense Pulsed Light (IPL) treatments from a reputable cosmetic dermatologist in your area and you will be amazed at the results.
• If your discolorations don’t respond favorably to IPL, your next step is to discuss laser treatments with your dermatologist. Examples would be the Q-switched laser or, for potentially greater benefits, fractionated laser (Fraxel) treatments. 

Keep in mind with in order to have a successful outcome you MUST be diligent (almost neurotic) about sun protection and, whenever possible, sun avoidance. There’s no sense in spending time and money to improve brown spots from sun damage if you’re going to be careless in the sun. For times when you’ll be in the sun for extended periods, remember to seek other protective measures beyond sunscreen. Those include wearing sunglasses, broad-brimmed hat (there are lots of attractive options), and protective clothing.