A multiple approach plan is likely the best.

Bojana,

To help improve your skin, it is best to start with prevention with SPF sun block and moisturizers for your skin. The next step is to start with good skin hygiene and a maintenance program. This could include Retin-A and possibly Hydroquinone. The next step would be intervention with chemical peels or laser. However, your plan has to be individualized to your skin, so it is hard to give specifics without examining you.

I hope this is helpful.

David Shafer, MD

At Home treatments for sundamage; 1- Zinc oxide sunblock - I like EltaMD for prevention. 2- Hydroquinone 4% lotion or creams as a bleaching agent for the skin. 3-Retin-a for dispersion of melanin granules, thus reduces the chance of further sunspot formation. Doctors office treatments; 1- Alpha Hydroxy acid peels - (lactic, glycolic, acetic, salicylic) are better light peels with minimal downtime (lunch hour peels) and modest melanin dispersion. 2- Jessner Peels - a great intermediary peel - 3-4 day downtime without a mess, just peeling. Better at bleaching the skin then AHA. 3- TCA Peels - different percentage peels have a different amount of bleaching effect. The stronger the concentration, the longer the downtime and the better the effect. 4- Phenol peels have big permanent bleaching effect with mazing wrinkle reduction. Patients are too white afterwards. Hope this helps.

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