With age, the collagen that supports the skin breaks down, and areas that were once taut (knees, upper arms, stomach) start to look a little…baggy. Collagen loss also makes cellulite more apparent because the skin becomes thinner and less able to conceal the puckers created by the superficial fat and connective tissue just below its surface.
VelaShape:
Thermage:
The Accent:
Sunscreen: You can thank your parents and your progesterone for the road map of blue squiggles winding around your calves and over your thighs. Though no one knows exactly what causes them, visible veins are probably influenced by genetics and hormones. Standing or sitting for long periods, pregnancy, and obesity may also exacerbate blood pooling in the legs, which can cause some veins to swell and rise toward the surface of the skin.
Sclerotherapy: The best option for eradicating leg veins is sclerotherapy. A solution containing glycerin, saline, or Sotradecol (a sodium sulfate compound) is injected into individual veins to irritate and collapse them. Each injection site stings for about five minutes; many doctors recommend that patients wear compression stockings for several days after the procedure to maximize results. Two or three treatments are usually necessary, and the veins will look worse before they get better (you should count on about a month before you see results). Be forewarned: You won't be vein-free forever; after a couple of years, new ones will probably form. Cost: $300 to $500 per treatment
Self-Tanner:If your veins don't bother you enough to consider needles (or dropping several hundred dollars), try a self-tanner. One coat will deepen your skin tone enough to make leg veins less noticeable. Or try a leg bronzer, which will camouflage veins—and wash off at the end of the day. Cost: $10 for L'Oréal Paris Sublime Bronze Luminous Bronzer Self-Tanning Lotion.The sun has the same effect on your body that it does on your face, stimulating melanin production so skin becomes mottled with clusters of pigment. The right treatment can wipe the slate clean—and if you get serious about sunscreen, those dark patches won't come back.
Q-Switched Ruby Laser: Isolated brown spots on your chest, hands, arms, or legs can be eradicated with a Q-switched ruby laser, which emits a red light that vaporizes (with only a slight sting) concentrated areas of pigment. "You'll get a scab that fades away over a couple of weeks and leaves clear skin behind," says Roy Geronemus, MD, clinical professor of dermatology at NYU Medical Center. One to three treatments are necessary, depending on the number of spots to be treated. Cost: $300 to $700 per treatment
Fractionated CO2 Lasers: If you have more diffuse freckling or a lot of dark spots, targeted zapping isn't a practical option. The new fractionated CO2 lasers (common brand names include the Fraxel Re:pair and TotalFX) are a good option for treating larger areas of hyperpigmentation. These lasers split powerful CO2 energy into tiny pixels that resurface discolored skin without the extensive downtime (and potential scarring) of the old CO2 technology. "One treatment is all it takes to undo years of sun damage. You can expect an 80 to 90 percent reduction in discoloration," says Chapas, who has been using the Fraxel Re:pair on patients' arms and chests for the past six months. The treatment stings, so doctors administer an injectable pain reliever and apply a topical anesthetic to the area being treated. Expect four to seven days of recovery; skin will be red, rough, and peeling. Cost: $3,500 to $5,000 per treatment
Photodynamic Therapy (PDT: Sun damage that includes actinic keratoses (scaly patches that can be precursors to cancer) is best treated with photodynamic therapy (PDT). The chest or hands (or both) are painted with a photosensitizing chemical that's activated with light; the reaction that follows (it feels like a mild sunburn) removes both precancerous cells and visible discoloration. Skin is red, swollen, and a little sore for up to four days; after a week, it will be clearer, brighter, and much more even toned. One or two sessions usually suffice. Cost: $500 and up
Hydroquinone or Prescription Retinoids: If this all sounds a little too invasive, you might prefer a topical solution. It will take longer to get results, and they won't be as dramatic, but you will notice a difference. Your dermatologist can prescribe a cream that contains 4 percent hydroquinone, which inhibits melanin production and can fade blotches in three to six months. (Over-the-counter creams contain only 2 percent hydroquinone and usually take more than six months to lighten subtle discoloration.) Prescription retinoids (like Retin-A or Renova) speed up cell turnover, which sloughs away dark patches. "You should already be using a retinoid on your face at night," says Ranella Hirsch, MD, assistant clinical professor of dermatology at Boston University School of Medicine. "I tell patients to also blend a pea-size drop over their chest and a drop on the backs of their hands." You'll notice a more even skin tone in two to four months. Cost: About $50 for prescription hydroquinone; $5 for Ambi Fade Cream (with 2 percent hydroquinone); about $40 for a prescription retinoidAs temperatures rise, the oil glands produce more pore-clogging sebum, and sweat stimulates bacteria growth on the surface of the skin. The result can be breakouts on the chest, back, or butt.
Cleanser: The right cleanser is often enough to clear up body breakouts. Look for one that contains benzoyl peroxide, an antibacterial that can be very drying on the face but is usually well tolerated from the neck down. (Dermatologists recommend PanOxyl Foaming Acne Wash, which has 10 percent benzoyl peroxide.) Leave the cleanser on for a few minutes in the shower. With daily use, you should notice improvement after about a month. Cost: $10 for PanOxyl
Isolaz: If the topical approach doesn't solve the problem, consider an Isolaz treatment, which combines intense pulsed light (to kill acne-causing bacteria) with suction (to clean out pores). The skin-vacuuming sensation is slightly uncomfortable but doesn't require pain medicine. Most patients need to have three to four sessions, scheduled four weeks apart, but see noticeable improvement after one treatment. Results last about three months, even longer when combined with topical treatments. Cost: $500 for one treatment of the chest and backWhen rapid weight gain overstretches the skin (most often during puberty and pregnancy), collagen and elastin fibers tear, creating these annoying—and, unfortunately, intractable—scars. But though you'll never get rid of stretch marks completely, there are a few treatments that can permanently improve their appearance.
Pulsed-Dye Laser: When stretch marks are new and still red (it can take months to years before they become white), a pulsed-dye laser can fade them. Most women require two to six treatments (spaced four to six weeks apart). Results vary significantly, says Patricia Farris, MD, clinical assistant professor of dermatology at Tulane University: Some see a 25 percent improvement, others closer to 75 percent. The treatment feels like a light rubber-band snap and leaves a bruise that lasts about a week. Cost: $300 to $750 per treatment
Fractional Nonablative Laser: Once stretch marks are white, a fractional nonablative laser (like Fraxel Re:store or Harmony Pixel) is the most effective treatment, says Chapas. It feels like electric zaps on the skin, and calls for prescription-strength ibuprofen and topical anesthetic. Four or five treatments, every six to eight weeks, can improve the texture of stretch marks by 50 percent, at most. Cost: $500 to $750 per treatment
Prescription Retinoids: Though many creams are touted as stretch mark solutions, a prescription retinoid is the only one that creates any appreciable improvement in stretch marks—and it's most effective in the early stages. In one study, when applied daily to red stretch marks for six months, a retinoid improved their appearance by about 14 percent. (You can't use retinoids while pregnant or breastfeeding, though.) For white stretch marks, a retinoid won't restore color but can help even out texture. Cost: $40From the May 2009 issue of O, The Oprah Magazine
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