Dark spots? Wrinkles? Dermatologists say they’ve got new and improved weapons against sun damage

Like most Floridians, you’re probably overexposed to ultraviolet (UV) rays — and the result can be sun damage.

Dark spots, freckles, hyperpigmentation and wrinkles appear, and they tend to be most noticeable on places like your face, hands, neck and upper chest. But local dermatologists say there are advanced treatments available now, including improved topical creams, lasers and procedures such as microdermabrasion and chemical peels to help eliminate marks and remove blemished, damaged layers of skin.

“The technology has gotten much better to repair the damage in a way that is more comfortable with less downtime,” said Dr. Chere Lucas Anthony of Rendon Center Dermatology and Aesthetic Medicine in Boca Raton.

Lucas Anthony is among the South Florida dermatologists who shared the options available today.

TOPICAL PRODUCTS

If at-home treatment is the approach you’re taking, options include lotions and serums accessible over the counter and by prescription. This is the least expensive route, but it may take longer and cause some irritation.

Retin-A, also known generically as Tretinoin, is typically the go-to topical cream. It works by spurring skin turnover, dermatologists say, and is particularly good for lightening brown spots and making skin smoother. It comes in three strengths and requires a prescription.

“It will make your skin dry and flaky at first,” said Aventura plastic surgeon Adam Rubinstein.”That’s the normal reaction as the skin goes through shedding. The old skin is flaking and trying to push new healthy skin up from the base.”

It’s not for everyone, though.

“It is not a great option for people who get lots of sun exposure, which is what got you here in the first place,” Rubinstein said. “If you use Retin-A, try to prevent or limit your sun exposure. Your skin will feel warmer in the sun, more sensitive to sun exposure.”

Even with regular use, it can take several weeks or even months before you see an improvement.

Retinol, a milder form of Retin-A, is where innovation is happening. More skin-care lines are offering products that have retinol in combination with other ingredients to make them effective but less irritating. Retinol is designed to even out pigmentation, help fade brown spots, make the skin smoother and lessen fine lines and wrinkles.

“There are a lot of great retinol products on the market now,” said Dr. Marianna Blyumin-Karasik of Davie’s Precision Skin Institute, who sells her own version called Stamina Intention Moisturizer. “They do the same thing as Retin-A , but in a more gentle way.”

LASERS

In recent years, South Florida dermatologists and plastic surgeons have upgraded their lasers with new models designed for better, faster results. Instead of a 45-minute treatment, some do the job in 10 to 15 minutes and repair damage more significantly than topical creams, experts say.

“The lasers use new types of technology and are getting better and better,” said the Rendon Center’s Lucas Anthony.

These newer lasers aim to zap away sun spots as well as those tiny broken blood vessels around the nose and middle of the face. People often don’t realize those visible red lines or spots result from the sun breaking down the collagen that supports the vessels, causing them to crack and creating visible redness.

Depending on the extent of the sun damage, and the location, most people require multiple sessions with a laser. Insurance likely will not cover these treatments.

Fractional laser technology delivers precise microbeams of laser light into the lower layers of skin. The treatment usually lasts three to five years and works for fine lines and wrinkles caused by the sun, experts say.

Clear + Brilliant.  Dermatologists say this is a gentle laser that works for most skin types, using fractional technology to smooth fine lines and rough textures. It also may lighten dark spots.

“We typically do three or more treatments,” Rubinstein said. “However, most people notice a difference after just one. Anywhere you want to polish surface of skin it can work.”

A single treatment can cost anywhere from $500 to $750,

Cold-fiber laser technology uses extremely fast, precise, multilevel micro pulses to remove damaged epidermal cells with minimal pain, helping to reduce fine lines and wrinkles and get rid of brown spots.

UltraClear Laser. Blymin-Karasik says she has gotten great results with the UltraClear Laser that uses cold-fiber technology. Launched in 2022, it has four different modes of intensity to treat multiple skin layers without damaging the top layer.

“It’s a newer device and lets us do shorter treatments with similar results to the older versions,” Blyumin-Karasik said. A full face treatment takes 15 minutes.

A single treatment averages $800. Dermatologists typically recommend three treatments.

Pico laser technology uses laser beams in ultra-short bursts known as picoseconds (one trillionth of a second). Because of the speed of these energy pulses, this is considered one of the most gentle laser treatments in use. Dermatologists say it works well for freckles, dark patches and discoloration.

PicoSure, PicoPlus and PicoWay. There are three types of pico lasers in use in South Florida.

Older laser treatments were known to damage dark skin because heat on pigment-prone skin could worsen dark spots. Because pico laser treatment uses energy instead of heat, it can be used safely on darker skin tones.

A single treatment can cost $400 to $500. Dermatologists generally recommend four treatments.

Carbon dioxide laser resurfacing uses targeted beams (or pulses) of light to remove the top layer of skin. It is considered a more aggressive option for more drastic results. This is the most painful of the laser treatments, but it targets deep wrinkles and lines and uneven skin tones.

A CO2 laser takes 30 minutes to 2 hours, depending on the issue being addressed and the area of skin undergoing treatment.

“This is the big gun,” Rubinstein said. “It is going to give you a deeper, bigger change.”

Rubinstein said he is using a new generation of this laser that is more precise in how it removes, or burns off, the thin top layer of skin.

Recovery takes longer than with other lasers, typically a week or more of downtime.

A single treatment can cost as much as $2,000 to $3,000 for the full face.

PROCEDURES

IPL Photo Rejuvenation. This in-office treatment uses light energy to the skin to stimulate the production of collagen and elastin. Celebrity Kim Kardashian brought this treatment into the limelight when she documented her experience with it on social media. Also known as photo facials, these tackle brown spots, redness/visible blood vessels, texture, pores and fine lines, experts say.

At Rendon in Boca Raton, Lucas Anthony says she uses the BBL Hero for phototherapy treatments.  She said the device works well on patients with brown and red spots from the sun.

“Patients usually need a couple of treatments a month and then they are good for a long time,” she said.

The average cost is $650 to $950 for the body and $450 for the face.

For more mild skin damage, a dermatologist may recommend an in-office procedure such as microdermabrasion or a chemical peel. This treatment uses a chemical solution to remove the outer layer of old skin. The new skin that replaces it is usually smoother, less wrinkled in appearance.

Lucas Anthony said chemical peels have advanced and newer options vary in their ingredients, depth of penetration and recovery time.

“Some of them can be done with almost no downtime,” she said. “Similar to a laser, we are buffing off sun-damaged cells and causing new collagen to form.”

These peels aren’t for deep facial lines and more severe wrinkles, so she suggests doing an evaluation with your dermatologist to see what’s best for you. Chemical peels can cost $300 to $1,000 per session.

Microdermabrasion is another option dermatologists use, sanding the skin with a special device to try to smooth away dark spots. The procedure, which is meant to improve overall skin tone and texture, can be done in combination with chemical peels. It costs between $75 and $300 per session.

Protection

While sun protection helps to prevent skin damage, it becomes even more important during the healing period after a treatment, when skin is extra sensitive.

Dermatologists suggest looking for sunscreens that offer broad-spectrum protection, SPF 30 or higher, and water resistance.

Lucas Anthony says sun damage rarely is beyond repair.

“You should be able to significantly reduce the look of sun damage,” she said. “You may not get rid of all, but you can make some strides.”

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Sun Sentinel health reporter Cindy Goodman can be reached at [email protected] or Twitter @cindykgoodman