Age 37: Tanning bed damage, how much can I realistically repair the damage and what should I do?

Don't waste time beating yourself up for past tanning behavior. The important thing now is to focus on repairing existing sun damage and prioritizing your skin health moving forward. Laser treatments can be very effective at healing sun damage, including fading pigmented spots. I suggest scheduling an in-person consultation for a full evaluation, which should include recommendations about the optimum treatment or combination of treatments for your specific needs. Good luck!

Thanks for your question. Many of my patients (myself included!) are recovered tanning bed users. It is very hard to fully answer your question without seeing pictures, or better yet, you in person. Consider reposting for a more helpful answer. In particular, your background skin type can greatly affect the modalities that will be best for you.
Certainly, start your zinc or titanium containing sunscreen now and use it every day. To repair past injury, IPL / BBL and a variety of laser energies (I use Halo and other forms of erbium resurfacing) for the majority of my treatments) can remove sun / brown spots, grow more collagen, help fine lines and crepiness and more aggressive lasers can even help with deep wrinkles and sagging.