I have sun damage on my face & all over. Lots of time in the sun & Tanning beds over the last 20 years. I was a Tan Mom. Addicted & now my skin is ruined. My derm is considered one of the best in Atlanta but he will not address my cosmetic concerns. Seems he is busy with skin cancer & Mohs. I went out on my own and tried dermabrasion & Skin Classic Treatment but not much improvement. I need an ATLANTA derm or PS willing to help with my severe sun damage. Under eyes fat pads are also a problem.
Where do I start to treat all this sun damage? Atlanta dermatologist or Plastic Surgeon? Anyone with recommendations? (photo)
Doctor Answers 8
Treat skin damage
Your best result will be with a plastic surgeon specializing in cosmetic treatments of the skin and well as surgery. I am one of them but certainly not the only one.
He or she can help with your eye bags as well.
Please do not treat yourself.
Treatment takes time but I have had patients with dreadful skins that with a step-wise approach of skin care, peels and laser got fabulous skins, even after years of tanning. Do not despair. Just find a surgeon who works with the skin.
Recommendations For The Treatment Of Sun Damaged Skin
This is a difficult problem to manage without a detailed examination but I will give it my best shot. True hyperpigmentation secondary to excessive solar damage is usually located on the temporal and cheek skin. It usually seems more pronounced in summer months because of a tanning of these effected areas. My method of choice is to first drastically reduce the pigment with 2 to 3 IPL (BBL) light treatments. Without using the intense light treatment first and relying strictly on the use of a topical lightening cream would take an extremely long time to notice a result. My recommendation would be as follows:
- Intense pulsed light (IPL, BBL) laser treatment. Will much more effectively reach the deeper skin layers and more effectively lighten the pigmented areas.
- After the above is done, then go to a topical skin bleaching cream (4%Hydroquinone) for maintenance and to help avoid a recurrence of the hyperpigmentation.
- Use sun-block because excessive solar exposure will worsen the problem and make the efforts in step 1 and 2 much less effective.
- For long term control (after 4 months) you can go to a 2% hydroquinone for long term maintenance.
Treatment of Sun Damage
Without a full examination, it is hard to determine exactly what you need. However, it appears that she have significant pigmentary abnormalities on your face as your main problem. Almost certainly, you will also have some dullness and thinning of the dermis (the support layer of the skin). I have been treating problems like this for over 25 years, and have found only one thing that really does improve the skin and rejuvenate it. That thing is the Obagi Nu-Derm skin care system. The system removes the dead cells, returning the luster to the skin, corrects the pigmentary abnormalities, thickens the dermis to prevent crinkles and wrinkles and protects the skin from further sun damage. There are many dermatologists and plastic surgeons in Atlanta using the Obagi system. Go to Obagi.com to find one near you. To improve your chances of really rejuvenating your skin, make sure the physician actually sees you. Being slightly North of Atlanta, I have found that many of the aestheticians there starting patient's on Obagi do not start them on the entire system or arrange for adequate follow-up. The latter is important since the Obagi system is a medical treatment for sun damage. That, however, is how it works so much better than other options which contain no FDA approved drugs. Though there are lasers etc. approved for treating sun damage, none of them treat the entire spectrum of damage like the Obagi system.
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Treating sun damaged skin
Chronic sun damage affects the structure of the skin, including rapid breakdown of collagen and development of brown sun spots, or solar lentigo. Volumizing and tightening the skin can be performed with laser and radiofrequency devices and to a lesser degree with topical creams.
I advocate maintenance and prevention for healthy skin care. I assess and listen to patients about their skin concerns and we find a regimen that works with their lifestyle-whether aggressive or progressive, and keep open discussion about tailoring any new changes, whether under eye dark circles, loss of volume in the face, double chin, hair growth, etc.
Some derms are pure medical derm. Some aren't . I was trained across cosmetic, pediatric, surgical and medical dermatology. It makes a difference to help patients with all concerns.
Treatment of Sun Damage - where to start
Clients with the following conditions should be referred to a medical aesthetician:
- Hyperpigmentation and irregular pigmentation, age spots
- Acne and its complications – e.g. scarring, hyperpigmentation, and large pores
- Rhytides (Wrinkles) treatment
- Patients with medical conditions such as Diabetes, Exzema, history of cold sore, shingles, psoriasis, rosacea, or steroid use
- Scar Management
- Previous chemical peel or laser treatment
- Severe sun damage (actinic changes of the skin)
- Plateau of results by conventional spa services requiring more aggressive medical based protocols
- Patients with a history of Skin Cancer or pre-cancers ( e.g. Actinic Keratosis, pigmented sores, or scaling lesions)
Medical procedures and use of medical equipment which must take place by physician protocol and/or oversight:
- Depth of Treatment as solo procedure with a non medical machine based on a more thorough treatment determined by number of passes or time per area; any procedure which requires recovery time because of redness (erythema).
- Medical Grade Machine, e.g., limited distribution to medical professionals, options for increased power settings, or medication delivery systems.
- Treatment of Patients with Medical Problems Acne, Roseacea, scars, stretch marks, non-uniform pigmentation (dyschromias), history of skin cancer, herpes, diabetes, hepatitis, HIV, previous laser or chemical peel prescription, etc.
- Non-medical grade microdermabrasion coupled with other treatments, e.g., glycolic, TCA, lactic acid or Jessner Peel, 4% hydroquinone, Oxymist, Dermaplaning, Micro Peel, Cryotherapy, etc.
- Chemical exfoliation (peels) within the scope of a cosmetologist’s license and affecting non-living tissue only, including Blue Peel, TCA peels and medical grade glycolic peels.
- Dermaplaning living tissue only per protocol.
- Laser treatments such Permanent Laser Hair reduction, IPL (photofacial) laser, vascular lasers (for broken capillaries or veins and red spots), color and scar improvement, and lasers for facial resurfacing.
- All injectibles such as Jeuvederm, Restylane, Sculptra, Radiesse, Voluma, Botox, lipoinjection (fat transfer). Surgical procedures.
Sun damage and hyperpigmentation with Retinoid Repair Cream
IPL or photo facial treatments for pigment and sun damaged to the face
Photo skin rejuvenation for sun damage and aging
Thank you for your question and the photos.
For definitive recommendations, you will need a full consultation in person. One option to consider is Broad Band Light therapy. It is good at reversing the signs of aging and sun damage, rejuvenating skin to a more youthful appearance.
See two or more board certified physicians for a complete evaluation before proceeding with treatments.
I hope this helps.