Removal of age spots/sun spots on hands, arms and legs? (Photo)

Question

I am 51 with fair skin blue eyes. Although I haven't tanned for about 15 years, I spent plenty of my youth tanning, including sun beds for a while. What is the most cost effective procedure to remove these horrible spots? I have tried some at home tca peels, which improve appearance for a week or so. But then skin went back to what it looked like before. tried IPL on hands a few years ago. It did nothing. I also once tried hydroquinone I bought online, a huge tub, that didn't do anything either

Hooman Khorasani, MD · Answer

First thing to start is that you are using a daily sun screen with SPF 30+ that has broad band coverage.  IPL is a good option to repeat especially if you had good results in the past.  However other options include Clear+Brilliant and Fraxel Dual.  The Clear+Brilliant laser has minimal downtime and great results.  The laser has two hand pieces one for texture/pore size and one for color (pigmented spots)-Permea handpiece.   Fraxel Dual has a bit more associated effects with redness for 3-5 days.  Another issue is the cost of the procedure is bit more than Clear+Brilliant.  For another treatment plan we suggest four to six treatments depending on your response at a month a part.  Make sure to discuss these options with a board certified Dermatologist that has cosmetic training or uses these lasers on a regular frequency

Ronald Downs, MD, FACS · Answer

I recommend our Pico Laser treatment, this is great for age spots and gives you very little downtime.

Andrew T. Lyos, MD, FACS · Answer

Hello and thank you for your question and photos.  The lasers that are available to treat this type of sun damage/exposure will show significant improvement if used properly. I would recommend consulting with a board certified professional who has had success in treating age spots/sun damage, it is as important in finding the right provider as it is having the proper laser.  We offer a combination of laser treatment and then also may follow up with some filler in the hands to better accentuate the youthful appearance post laser. Also, based on the consultation, the plan may be to follow with a Melanage Peel, which will enhance the lightening and brightening of your skin..  Your fair skin and blue eyes should even allow for a better response to the lasers! We always recommend our Skin Medica line and sunscreen to assure the best outcome while the progressive treatment is in session. There are many great options available to you! I hope this information helps you and best of luck!

J. Roberto Ramirez Gavidia, MD, FACS · Answer

Hi Cat0107! I have a great solution for you. You are totally right when you say that you are paying for the sun that you got in you younger years. Age spot start deeper in you skin and they will continue to show up unless you stop the process. It very important that you remember that you remember two important things: 1.- That you will get improvement but you won't really get rid of them. 2.- That treatment requires multiple session.  The technology has improve and now we count with BBL (broad band light) that is a significant improvement in terms of safety and efficacy. I also like to add a laser nano peel to make the result even better. 
Hope you found this useful, 
Dr. RG

Raffy Karamanoukian, MD, FACS · Answer

I would use a combination of Kareskin Brightening Kit with Melarase creams, Clear and Brilliant laser, and IPL Limelight for your age spots. Best, Dr. KaramanoukianLos Angeles

Kenneth Hughes, MD · Answer

You mention that you tried an intense pulsed light (IPL) system a few years ago and found no improvement.  Would recommend that you give IPL Lumecca a try on pigmented or vascular lesions.  Lumecca has demonstrated effectiveness in treating brown pigment spots, facial redness and broken capillaries after several treatments.  Consult with a board certified plastic surgeon in your area to discuss these options.Kenneth B. Hughes, M.D., board certified plastic surgeonLos Angeles, CA

John Troccoli, MD, FAAD · Answer

For individual larger freckles/age spots, I would recommend a q-switched laser with either 532, 694, or 755 wavelengths.  The age spots will turn from brown to purple and you will experience some fine scabbing and crusting which resolves in 7 - 10 days, sometimes as long as 2 weeks on the legs. Usually 1-2 treatments are required.
For diffuse smaller sunspots/freckles, the Fraxel Restore 1927 works very well.  Patients like the fact that it doesn't cause a purplish discoloration immediately after the treatment.  Instead, the areas become slightly red and swollen for 2 days, then the areas turn a bronzish/tannish color and lightly peel and flake away for another 3 days.  By days 5-7, the skin is fully recovered.  Typically at least 3 treatments are required.
It is absolutely essential to keep the treated areas away from sunlight for at least 2 weeks after either laser treatment.
Of course, minimizing sun exposure in general and applying sunscreen is always good advice for preventing new age spots.  Having your age spots evaluated by a Dermatologist is always a good idea before beginning any laser treatment to be certain that they are benign.

Glenn Murray, MBBS · Answer

Hello,
Thanks for your question.
You should have a skin check by a doctor to check for skin cancers. 
IPL supervised by an experienced doctor is advisable and fractional laser or Picosure for the more resistant spots is a good approach. 
TCA self peels and online purchases is asking for trouble and is ill advised.
Please note, medical advice is given as general advice only and is not a substitute for a full consultation and examination.
Wishing you all the best,Dr Murray from Absolute Cosmetic Medicine

Tracy Evans, MD, FAAD · Answer

We have found that Fraxel is the most effective treatment for freckled skin/age spots. You would need at least 5-7 treatments to get back to clear skin. Not only will it even out the skin tone, it is also FDA approved to treat pre-cancerous lesions. Most people with fair skin and blue eyes develop pre-cancerous lesions by age 50 and beyond. For the health and beauty of your skin, consider getting a series of Fraxel treatments. They usually last about 2-5 years before you need a maintenance treatment. You would also need to plan for about 7-14 days of "molting" skin after the procedure.

Stephen E. Small, DO · Answer

I recommend  a laser treatment given all of the treatments you have tried. There are too many different types of lasers to list them all but laser with  a  755, 785 or even a 532 wavelength treats brown spots well.  Typically, the areas darken after treatment and flake or scab over 1-2 weeks.  You will see the full results of a treatment in about 8 weeks and often 1-3 treatments are necessary for the best results. 
A good IPL can often give   nice result for brown spots as well.

Removal of age spots/sun spots on hands, arms and legs? (Photo)

Answers (14)

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