What treatment or combined treatments would you suggest for fine lines, wrinkles and pigmentation due to sun damage? (photo)

I've looked at microneedling w/PRP, Ultherapy & botox/fillers, but I'm not sure what might be the best path to take for my particular issues. I had Botox around the eye & browline about 4 months ago. Also, I would like to know typical treatments required to get a good result plus maintenance intervals.

Doctor Answers 9

Best Combination To Treat Wrinkles and Sun Damage

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Great question! You have perfect skin to respond to a combination of modalities to work together for best results. A lot depends on your downtime tolerance. If you are looking for absolute optimal results to start, that is without a doubt a combination of botox followed by deep full field resurfacing with PDO threads followed with fillers. From there your maintenance would be BBL, Botox, Microneedling with PRP and occasional Halo. If that's too much downtime, then you could still get very nice changes with a combination of Botox, followed with BBL, Halo, PDO threads followed by fillers and then the same maintenance plan. Be sure to seek out someone who is very comfortable with skin rejuvenation using a combination of modalities.


Incline Village Physician

Skin Rejuvenation Laser Options

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To improve the quality of your skin: reduce pigmentation, reduce fine lines and wrinkles and fine veins, a combination of intense pulsed light (ICON MaxG)and fractional nonablative laser with the (ICON 1540) would be a great option. The "three for me" treatment uses both of these light based treatments to address your skin issues.  The deeper wrinkles may respond better to fillers, but fillers do not address pigment issues and other sun damage.

Gary Nackman, MD, FACS
Clifton Vascular Surgeon
5.0 out of 5 stars 3 reviews

Microneedling w/PRP, Radiesse, Juvederm, Kybella, IPL, Zo 3 Step Stimulation Peel, Microblading,Skinbetter Science

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Microneedling with PRP would be an excellent treatment to help brighten, induce collagen production, tighten and improve your overall skin tone and texture. I would recommend  a series of treatments (3) 4-6 weeks apart to start, then repeat microneedling treatments every 3 months. There are several procedures you can include such as chemical peels, laser treatments...that will help you improve and maintain.

Adding some filler under the eyes would help fill in the hollowed area, then adding filler to the cheeks to give you that youthful lift back, then filler to the marionettes/lips and nasolabial fold would look beautiful.

Kybella under the chin, microblade your eyebrows and do not forget your skin care regime to use at home to help stimulate, maintain and protect your skin (Skinbetter Science is one of our favorites).

Best to you,



Treatment of Fine Lines, Wrinkles & Pigmentation due to Sun Damage

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Basic skin care consists of a cleanser, an alpha hydroxy, a pH balancer and a good UVA sun block. Notice there is NO moisturizer, something that causes the skin to stop making its own moisture and increases the incidence of wrinkles. The pH balancer can be upgraded to one that is also an antioxidant, like Vitamin C Serum. These do not take care of wrinkles and pigmentation, however. For these, you need, tretinoin to stimulate collagen to correct the wrinkles and hydroquinone to correct the pigmentary abnormalities. In my experience, the best way to combine these is with the Obagi Nu-Derm System that doubles or triples the effects of these individual reagents. (See plasticsurgerytoday.com/beautifulskinlaserresurfacinghighlandsnorthcarolina/obagi-nu-derm/)

Robert T. Buchanan, MD
Highlands Plastic Surgeon

What treatment or combined treatments would you suggest for fine lines, wrinkles and pigmentation due to sun damage?

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Hello Jmannie,

There are lots of treatments out there for various conditions.  Each does something a little different so a customized plan really depends on your areas of concern.  You wrote that fine lines and wrinkles as well as pigmentation issues from sun damage bother you the most.  

For fine lines those can frequently be improved with topical products like Retin-a or retinol.  It takes several weeks to  see a result, but they are great medications.  If you don't get the result you want then you can proceed with light based therapy.  This can include IPL/BBL on the more gentle side to lasers on the more aggressive side.  These help with fine lines, wrinkles, and pigmentation issues from sun damage.  Other treatments for sun damaged skin include chemical peels and other topical products.  If the fine lines you see are more from a moving muscle as opposed to sun damage, then a neurmodulator like Botox or Dysport would be of benefit.  

This is just a small sample of available treatments.  I would recommend you consult with a facial plastic surgeon to learn what is best for you.

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Full facial rejuvenation and Skin Tightening with lasers, microneedling/prp, RF, Sculptra, Kybella, Ultherapy, fillers, botox

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You have a few options. I find that a combination of fillers, botox for fine lines and volume, Cosmelan, lasers, rf treatments and microneedling/prp for texture and tone with sculptra for collagen building, salt facials and skin care help with skin rejuvenation. Kybella, Ultherapy and/or ThermiRF treatments (Venus Legacy) would be non-invasive options that would do well in combination for skin tightening and provide lift. Please see a cosmetic dermatologist for a long term treatment plan.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Procedures to help Facial Sun Damge

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Dear Jmannie, 

It appears from your photos that you have signs of sun damage on your face resulting in lines, wrinkles and sun spots.

There are 3 ways to help this. First though, its important to wear sun protection daily to prevent further sun damage. 

Medical Skin care products using Retin-A and Hydroquinones can help to improve your skin.

BBL light treatments can also help restore your skin to better health and appearance. 

My RESET for Sun Damage procedure is the most dramatic way to help aged skin but has 2 weeks of recover involved. 

I'll leave some links below.

I hope this was helpful.

Adam Scheiner, MD
Tampa Oculoplastic Surgeon
4.4 out of 5 stars 39 reviews

You are on the right track

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My recommendation if you are willing to go the distance, would be to start with a Vampire Facelift or a few Vampire Facials. After the first treatment wait a week, have your provider do a little botox, then a small amount of filler around the coners of the mouth to prevent the frowning while relaxed look. The vampire facelift series will get rid of the fine lines and the pigmentation issues, and the botox will relax those lines until they fade away, then look into a good NovaThreads provider to pull the chin/jowl area tight. After all that all you need to do is a vampire facial once/twice per year and a little botox whenever you need it. 

Keep us updated! Thanks!

Jennifer Guthrie, MD
West Palm Beach Physician

Skin Rejuvenation

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While other treatments can be considered, a laser treatment such as Halo would be effective to address the sun damage. Consult with an experienced and expert board certified plastic surgeon who can outline your options. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

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.