As i get older, my age spots get darker. I know it's not a treatment that's covered by insurance, but I'd like to know about how much to set aside for this.
How Much Can I Expect to Spend Treating my Age Spots?
Doctor Answers 2
Start with topicals. This is the foundation of any regimen to clear and prevent pigmentary problems of the skin. Without this, all the money in the world and every treatment mankind has devised are for naught: the pigment will recur.
1. The basis of such topical treatment is to find a good sunscreen. I don't really care so much what kind, but find one that you like; that feels good on the skin and blends in well. A sunscreen that sits in a draw is doing nobody any good. Physical sunscreens are less irritating and better for sensitive skin. They work by deflecting the rays off the skin. Zinc might be better than titanium. Zinc has a long history in skin care ( Calamine Lotion, Unna boots); is an antioxidant, and is even good for acne. Among my personal favorites are Vanicream, Blue Lizard Australian Suncream Lotion, Kiss My Face Face Factor (titanium), Neutragena Healthy Defense Daily Moisturizer, Cetophil UVA/UVB Defense (titanium), and Badger SPF 30.
Chemical sunscreens work by abosrbing the rays; the rays bounce photons around and lose their velocity and get absorbed by the sunscreen. There are a number of good chemical sunscreens but they lack some of the better qualities of the physical sunscreen. Among the best in my opinion are Neutragena Ultra-Sheer Dry Touch, Oil of Olay Body Age Transform,and Aveeno Continuous Care Protection. The Neutragena and Aveeno products have helioplex technology which is really a new chemical which was added for stablilization. Anthelios by LaRoche-Posay has the first new sunscreen chemical in years called Mexoryl in their Anthelios SX sunscreen. Recently, some quarters have begun to worry about some of the possible carcinogenic aspects of sunscreen and their possible estrogenic potential.
If you want some good anti-aging ingredients thrown in try Aveeno ultra-calming cream with feverfew and RevaleSkin Day cream.
2. Use a Retinoi at night. The reason that your dermatologist tells you to use your Retinoid at night is not so much that it causes a sunburn ( if it does it usually is mild and more to do with the thinning of the stratum corneum, the dead skin layer, than an actual burn0 but because sunlight inactivates the Retinoid. Any of the big three are good: Differin, Tazarac, or Retin A (or Atralin or Avita). Retinols as found in Roc Retinol is another good choice, milder but not quite as effective.
Retinoids work by causing the epidermal cells to move out quicker and giving the pigment less of a chance to take hold.
3. A Bleaching Agent.
The standard is hydroquinone. The prescription editions are fairly expensive, even the generics. A few years ago I was enrolling patients in a post-marketing study for Galderma's Tri-luma. Subjects were entitled to two tubes of the stuff along with Cetaphil cleanser. The product had already been out for a few years. I was looking for my 10th enrollee. A lady came in with melasma. Ah hah! Upon reading the informed consent she shook her head no. I told her fine I will write you a prescription. Generic please. I wrote for generic but told her Medicare did not cover it. The next day she called back all upset that the generic cost $60. I told her too bad it does not come cheaper than generic.
Hydroquinone worksby blocking tyrosinase, the enzyme that helps form pigment. When combined with Retin A, and a weak steroid it is marketed under the trade name of Tri-Luma as mentioned above. Epiquin gel, Lustra AF, Aclero, and Solaquin Forte are other good prescription hydroquinones.
It has a cousin called arbutin, derived from cranberry or blueberry leaves, which breaks down to form hydroquinone and may be nearly as strong but milder. Kojic acid is is a substance produced by fungi and bacteria, popular in Japanese skin lightening products. Neo-strata makes a very good product containing alpha-hydroxy acids, Kojic acid and 2% hydroquinone. In my opinion it is one of the best OTC products.
Oil of Olay adds Glucosamine in its Definity product and this is excellent.
There are a number of other botanical ingredients in skin lighteners including licorice (also an antioxidant); Pomegranate (another antioxidant), Pycnogenol (another antioxidant), corainder seed oil, and CoffeeBerry (the subripe fruit of the Coffea arabica tree...whose product I drink every day).
Physical modalities which will help, but will obviously cost more since they entail a series of office visits, and teh procedures are usually not cheap. These would include chemical peels. These do not have to be too deep. Alpha hydroxy acid peels with glycolic acid would be the best since they not only are stronger but the alpha-hydroxy acids have a skin lightening quality by themselves as I mentioned.
Similiarly microdermabrasions help as they exfoliate the skin and take the pigment with them. This is usually a series of three or four.
Photofacials, using an IPL device, targets the pigment and can produce a very nice result. We charged $400 for 6, when I did them, but now my aesthetician charges more..and I have no idea how much that is. Sorry. Call around.
Finally, laser would be the most expensive of these procedures. The Q-switched Nd Yag, and Alexandrite lasers are used most frequently.
Oh yeah, if you are going in for something else, you can have the dermatologist gently freeze the sun spots on the back of your hands ( lentigines). Most of us don't charge anything at all for the procedure.
How much to treat age spots.
There are many options but clearly the mainstay of treatment is prevention with use of sunblock. This is the most cost effective method.
- Over the counter bleaching agents may help and include a variety of agents such as kojic acid, glutathione, Vitamin C, azelaic acid, alpha hydroxy acids, tretinoin, arbutin, etc.
- However the most commonly used agent is hydroquinone which is available over the counter in 2% preparations and as a prescription in 4-7% concentrations. Typcially it is combined with Retin-A and a steroid to calm the inflammatory effects.
- Phenol peels, and TCA peels may produce skin lightening.
- Laser treatments may also produce lightening of darkened skin and spots.
Depending on how severe and your method of treatment, costs can vary from $100 to several thousand dollars.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.