Best Treatment for Sunspots (Cryotherapy, Laser Resurfacing, Chemical Peels, Etc.)?

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi JJJ.  None of the treatments you mentioned for sun spots is the best.  Chemical peels will make your skin feel nice, but unless they are very deep (phenol peel) then you will not be able to permanently remove sun damage.

Cryotherapy is good for things like warts, but we would not use it for sun spots.  Because sun spots are flat, you end up having a lot of collateral damage if you go deep enough with cryotherapy to remove them permanently.  It can be done, but the risk is that you may have an atrophic scar (a depression in the skin).  

Laser resurfacing is for textural changes in the skin like wrinkles and acne scars and is not ideal for sun spots.  

You should consider either q-switched lasers (ideal) or IPL treatments (less ideal).  The reason we suggest q-switched lasers is because they can get rid of sun damage permanently and easily with very little risk.  IPL does not always remove the spots permanently and has more risk associated with it.  

Check the link below for pictures of our work with the q-switched laser.  Good luck.

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.