15 Treatments for More Beautiful Skin

Lumpy thighs? An age-spotted chest? If a body concern might keep you covered up this summer, look at our list of the best solutions (from dermatologic procedures to drugstore remedies). Treatments for discoloration, acne, leg veins, and stretch marks can effect lasting changes in your skin, some more dramatic (sclerotherapy for veins) than others (lasers for stretch marks). The noninvasive treatments to minimize cellulite or tighten loose skin, however, are far less consistent (see The Cure for Cellulite). With that in mind, here are the facts about what various treatments can do and what they will cost (both in pain and cash). It's up to you to decide what's worth it.
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• Skin Laxity and Cellulite
  
• Visible Veins
  
• Discoloration
  
• Acne
  
• Stretch Marks
  

VelaShape:  
A machine that combines radio-frequency and infrared-light energy with suction and mechanical massage to stimulate collagen production and help metabolize the fatty deposits that cause dimpling. (It's similar in concept to SmoothShapes, but the added radio frequency can also offer a skin-firming effect.) Each treatment feels like an intense, slightly warm massage. Four to six weekly sessions can improve the appearance of cellulite for six  months, says Anne Chapas, MD,assistant clinical professor of dermatology at NYU School of Medicine, who also uses VelaShape to tighten skin on the hips, inner thighs, and abdomen. In a recent study, she treated the stomachs of ten postpartum women. Three months after four weekly treatments, an evaluation of five of the women showed four had an average reduction in abdominal circumference of 1.2 inches; one saw no change at all. 
Cost: $2,000 for four treatments


Thermage: 
Doctors also use Thermage to improve both skin laxity and cellulite. It uses radio-frequency energy to heat collagen below the skin's surface, causing it to contract so skin tightens over time. This spring the device will be available with a bigger handpiece so that large areas (like the stomach or thighs) can be covered more quickly than before. The treatment still heats the skin to the point of discomfort, though (even if you take a prescription-strength pain reliever). After one session, most patients notice improved tightness in the skin over the next three to six months—if you're an appropriate candidate. In a cruel twist, because Thermage works by heating collagen, you need to have enough collagen for it to act on. "It's most effective on skin with mild to moderate laxity," says Chapas. "If your skin is really sagging, Thermage will do very little, if anything, to improve it. That'swhywe usually don't use it on patients over 65." In one study, ten subjects ages 35 to 59 had their thighs treated with Thermage; six months later, about half had thighs that were 0.6 to 1.6 inches slimmer. Chapas has found that while Thermage can improve skin tightness for up to three years, cellulite results last only six to 12 months. 
Cost: $2,500 to $4,500


The Accent: 
Another radio-frequency device that can improve cellulite for several months, says David Goldberg, MD, director of laserresearch at the Mount Sinai School of Medicine. It requires multiple treatments but is much less uncomfortable than Thermage; you won't need any pain medication. Ninety percent of the women whose thighs were treated in one study maintained results after six months. (All 30 subjects underwent six sessions at two-week intervals.) The mean decrease in their upper thighs was 1.2 inches. 
Cost: $700 to $1,000 per treatment


Sunscreen: 
Unfortunately, no topical treatment will firm your skin or get rid of cellulite. Sunscreen, however, can help prevent the UV-induced collagen loss that will make skin look saggier and more dimpled, so wear it. Always. 
Cost: $32 for Anthelios 60 Melt-In Sunscreen Milk

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.

Next: How to get rid of discoloration

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

Next: The latest acne treatments

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 back

Next: How to hide stretch marks

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: $40