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 retinoid
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