Which treatment is more effective for removing sun spots? Chemical Peel or Microneedling?

Question

I am want to correct sun damage on my face. I'm 64 yrs. old. I use retinol daily at night. I used to get a Trinity treatment annually & that took care of sun damage spots on my face, as well as skin tightening. It worked well but was very painful. I'm interested in non-surgical only. What is more effective to remove sun damage now? Chemical Peels or Microneedling? My doc uses the Skin Pen for Microneedling. I haven't tried either yet. Will wait for your advice. Thanks. :-)

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Thank you for your question, both the Chemical Peel and M+N will give you some improvement with sun spots. However, a combination approach will give the most improvement long term with lasers (Fraxel, Tattoo lasers, Excel V, Pulsed Dye) and microneedling/prp. It may take a few treatments to get improvement and will need life-long treatments to maintain. See an expert. Best, Dr. Emer

R. Stewart Collins, MD · Answer

Hi! Thank you for your question! I think that either peels or laser treatments would be your best option to address sunspots/hyperpigmentation. While microneedling is an amazing treatment for a variety of other concerns, it’s not the most effective when trying to impact pigment. It’s also important to factor in your individual skin type and lifestyle, which can most easily be done with an in-person consultation. Please see a Board Certified Plastic Surgeon to review different options for both peels and laser treatments, and you may find that a combination approach will yield the best results. Thanks!

Johnson C. Lee, MD · Answer

In the short-term, hyperpigmented areas of the face and neck such as sunspots are best treated by keeping the areas out of the sun and protected when outside. They may fade on their own or can be treated with energy-based treatments such as laser and intense-pulsed light (IPL photofacial). Another option which can be used synergistically is topical "bleaching" creams such as hydroquinone, however care must be given to apply the cream only to areas that are darker to avoid lightening normal skin. Maintenance skin care such as chemical peels and topical creams should be used to maintain beautiful and youthful skin in the long-term. Microneedling is not as effective since it does not penetrate into the deepest layer containing the pigment cells. I prefer to use microneedling for textural issues rather than color issues. It is important to wear sunblock and to protect your skin whenever outside. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Aurora DeJuliis, MD · Answer

It depends on the type of sun spots, your overall skin condition and health. That is why it is very important to get an assessment from an experienced physician. I think in your age group I would have a deep chemical peel first. Reassess your face 6 weeks after and decide if you are a candidate for microneedling or a series of IPL.

Laura Riehm, MD · Answer

Thank you for your question.  You can get similar effects of microdermabrasion from doing a scrub at home.  You hyperpigmentation is much deeper.  Chemical peels will probably yield limited results.  The trauma from microneedling can actually cause more damage.  Hyperpigmentation is something we see and treat every day in our practice.  Depending on your skin type, you may be a candidate for a series of IPL treatments.  It should only be done on Skin Types I-III with no sun exposure.  Summer is probably not the best time to start IPL treatments.  We have been very successful using the PicoSure laser with the FOCUS and / or Flat Lenses with a series of treatments.  FOCUS lens treatments have the extra benefit of reducing fine lines and wrinkles.  Unlike the other treatments mentioned below, the PicoSure as almost no downtime.  This is one of our go to treatments for patients older than 40 and worried about the signs of aging.  This laser is safe for all skin types.  Start with sunscreen every day!  Once you have treated your hyperpigmentation to your satisfaction, you will probably need a follow treatment every 6 to 12 months depending your level of re-pigmentation.  Best of luck.

Anita Saluja, MD · Answer

For sun spots, my favorite treatment is laser resurfacing or IPL (intense pulsed light photo facials). IPL photo facials also stimulate collagen and help with redness.  An alternate choice would be a series of 3 to 4 professional medium depth peels such as Apeele or Vi peel. Microneedling is better for texture of skin and less effective in sun spots so this would not be my first choice. I strongly urge an at home skin regimen such as Obagi Nu-derm system for optimal results. I recommend learning more about IPL photo facials, laser, and peels. Best to you.

Which treatment is more effective for removing sun spots? Chemical Peel or Microneedling?

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