Hydroquinone: A topical ingredient that inhibits the pigment-forming enzyme tyrosinase, to lighten discoloration. A 2 percent concentration is available over-the-counter; doctors can prescribe 4 percent, for more dramatic lightening.
Chemical peels: An acid solution is painted on the face to lift away the upper layers of skin, improving texture and discoloration. A basic, light peel most commonly uses glycolic or salicylic acid and causes mild, temporary redness. Four to six monthly treatments are generally recommended.
Microdermabrasion: Tiny aluminum oxide crystals are sprayed against the skin to buff away dead cells, improving texture and removing surface pigmentation. Skin may be pink for a few hours afterward. A series of four to six treatments is usually suggested.
Botox: A purified injectable form of botulinum toxin that blocks the nerve impulses that cause muscle activity — and the resulting expression lines. After it's injected (you feel a pinch), lines disappear in about a week; results last three to four months. (Many dermatologists now also use Dysport, a newer FDA-approved botulinum toxin comparable to Botox in effectiveness and longevity.)
Hyaluronic acid fillers (Restylane, Perlane, Juvéderm): Synthetic sugars injected into the skin to plump lines and restore lost volume in the face. Restylane and Juvéderm are now mixed with anesthetic lidocaine, so injections cause minimal discomfort. Results are noticeable immediately and last about six months. You may have slight swelling for a day or two; bruising is also possible.
Radiesse: A filler made up of calcium-based beads that can recontour the cheeks and jawline. You see results right away, and they last up to a year. You may have slight swelling for a day or two; bruising is possible.
Fat transfer: Fat harvested from one part of the body (usually the butt or thighs) is used to recontour the face. Results generally last about six months to two years. You may experience a couple of days of swelling and bruising.
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