I have a few solar lentigos on my face. I have tried many things and it has only gotten darker. I tried 2 IPLs about 2 years ago. I tried a series of 6 chemical peels (superficial peels). I tried a Vi peel about a month ago. After the Vi peel, I felt my lentigos actually got darker after I peeled and have not faded since. I have also used retin-a. What can I do about these spots? TCA peel, nd:yag etc? I wear sunblock everyday and avoid the sun as much as I can, although I do live in Miami.
How Can I Get Rid of Stubborn Solar Lentigos?
Doctor Answers 13
Stubborn Solar Lentigos
If you have stubborn solar lentigos/sun spots then the best combination would be a combination of Fraxel Dual laser and Yag laser. I wish you had provided a photo of the sun spots of the face so that I would know your skin type. I don't like the IPL as much as the Fraxel for the type of stubborn sun damage that you are describing. Find a board certified dermatologist in your area with a lot of experience in lasers and cosmetics.
I recommend using a combination of bleaching cream (hydroquinone 4%) and tretinoin cream (vitamin A).
Q switched laser or Fraxel Dual both work for Sun Spots
Q switched lasers are excellent for getting rid of sun spots. I always tell my patients to expect some scabbing for about 5-10 days, and then the brown spots are replaced with fresh, youthful skin. This works really well for sun spots on the hands and arms. Fraxel Dual can also get rid of sun spots, but it may take a few more treatments and be a bit more expensive than the Q switched treatments. The benefits of doing the Fraxel Dual is that it also helps with tone and texture.
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Use Melaquin AM and Melaquin PM topical cream for sun spots
Solar lentigenes can be improved with Retin A, retinol, and a combination of Melaquin AM and Melaquin PM topical creams.
Treating Stubborn Solar Lentigos
Laser such as erbium or C02 fractional are excellent tools to treat sun spots. Consult with 3-4 experienced, reputable, and expert practitioners to explore your options.
Fraxel Dual For Solar Lentigos
Fraxel Dual is an excellent tool for treating sun spots. In case you are interested, it was demonstrated on the Rachel Ray show for the treatment of sun spots.
The way laser treatments work is by penetrating deeper layers of the skin to break up the pigment, which is then eliminated by the body. Fraxel Dual uses the 1550nm (and 1927nm as well, hence the name Dual) wavelength which can safely reach the lower layers of the skin where the pigment is.
In the past, cosmetic laser treatments were only safe for individuals with very fair skin. This is because they have less melanin. Having more pigment is risky, because it will absorb the laser energy, which then turns into heat energy.
The dermis in your skin will react to this overheating as though it were injured and produce scar tissue as it tries to heal itself. Fraxel Dual does not create this problem because melanin does not easily absorb the 1550 or the 1927nm.
Getting Rid of Solar Lentigos
I have the best results with Q-swithced laser. I use the Cutera Laser Genesis with great success. For patients who want a more conservative approach, the combination of Hydroquinone and Retin-A creams can be helpful. IPL has been effective in some patients, but is better for melasma treatment.
How to get rid of sunspots
One of the most effective ways to reverse sunspots due to the effects of chronic sun damage to your skin is by using a combination of two prescription strength medications: 4% hydroquinone and tretinoin cream. Prescription strength 4% hydroquinone is better than any OTC product for lightening dark spots in the skin. These dark spots are typically due to chronic sun damage so daily use of sunscreens is essential in your treatment. Combining prescription-only tretinoin cream with hydroquinone will make it even more effective. I recommend the Obagi Nu-Derm System which uses both tretinoin cream and hydroquinone to visibly lighten age spots as well as the fine lines and wrinkles that are due to chronic sun exposure.
Get them frozen
Bleaching creams and retinoids are excellent suggestions and I would use both for about eight weeks and stop the hydroquinone after that time, continuing the retinoid. Would use DAILY sunscreen even if going no further than mail box. If spots perist after lasers and peels, I would have them frozen.
Brown spot removal
Living in Miami makes removing age spots difficult. Are you wearing a hat? In your sunny climate no sunscreen is protective enough for you. A hat is the best investment you can make. Not only do you have to buy one, you actually have to put it on your head every time you go out in the sun. I would also try Hydroquinone cream (ask your doctor for a prescription) in conjunction with your Retin A. Finally, 2 IPLs are not enough. As the energy level is generally increased with more treatments, you usually need a series of 3 to 6 to make a difference. Make sure you are doing this in a doctor's office, by experienced staff.
Hope that helps!
Madeline Krauss, M.D.