The four steps to beautiful skin;
1- Good Sunblock - Always use a zinc oxide based sunblock. It has broader UVA and UVB coverage than anything else. It works immediatley upon application, not the case with avobenzone based products. It does not have estrogen mimetic effects like avobenzone based products. It won't make free radicals like avobenzone based products. Get the idea - Zinc is good! But it goes on too thick - wrong! In my practice we sell EltaMD sunblock that has 8 different products designed for any lifestyle or skintype.
2-Retin-A- The BEST skin care product - exfoliates, thickens the dermis, reduces the loss of elastin, improves acne, reduces skin cancer, and most importantly - Disperses Melanin granules, in other words it diminishes brown spots.
3- Hydroquinone - skin bleach that temporarily bleaches the skin to improve the sunspots.
4- Lasers and intense pulsed light treatments - Used as a last resort. They work too well sometimes. The loss of melanin sometimes results in Ivory white spots on the skin - this is worse than the alternative. The treatments are also far more expensive than the treatments described above.
Robert M. Freund, MD, FACS
New York, NY



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