What is the best treatment for years of sun damage on arms? (photo)

Hello, thank you for your question. Our cosmetic nurse reviewed your case and states treating sun-damaged skin involves a combination of prevention, at-home care, and professional treatments depending on the severity of the damage. The first and most important step is prevention—daily use of a broad-spectrum sunscreen with SPF 30 or higher is essential, even on cloudy days. Wearing protective clothing, such as hats and sunglasses, and avoiding peak sun hours between 10 a.m. and 4 p.m. can also help prevent further damage. For mild sun damage, including dullness, dryness, and uneven tone, at-home treatments can be very effective. Ingredients like retinoids or retinol promote cell turnover and help smooth texture and fade discoloration. Vitamin C serums can brighten the skin and repair oxidative stress, while niacinamide helps reduce redness and even out skin tone. Gentle exfoliants like AHAs (e.g., glycolic or lactic acid) remove dead skin cells and improve radiance, while BHAs (e.g., salicylic acid) are useful if you're acne-prone. Hydrating moisturizers with ingredients like hyaluronic acid and ceramides can also help restore the skin barrier.

For more moderate to severe sun damage, such as deep wrinkles, dark spots, and rough texture, professional treatments may be necessary. Chemical peels, laser therapies like fractional lasers or IPL (intense pulsed light), microneedling, and microdermabrasion can all improve tone, texture, and pigmentation with noticeable results. In some cases, prescription-strength retinoids such as tretinoin may be recommended for more aggressive skin repair. Supporting your skin from the inside out with a healthy, antioxidant-rich diet and staying well hydrated also contributes to long-term skin health. Overall, the best approach depends on your skin type and the extent of the damage, but a consistent skincare routine combined with preventive habits can significantly improve the appearance and health of sun-damaged skin.

Thank you for sharing your concerns and photo. Based on the visible signs of chronic sun damage — including hyperpigmentation, lentigines (sun spots), and overall skin texture changes — here are some treatment options that can help improve your skin’s appearance and health:

Topical Treatments:
Prescription Retinoids (e.g., Tretinoin): Promote skin cell turnover, reduce pigmentation, and improve texture.

Hydroquinone or Other Brightening Agents (e.g., Azelaic Acid, Vitamin C, Kojic Acid): Target dark spots and uneven pigmentation.

Topical 5-Fluorouracil (5-FU): In cases of actinic keratoses (pre-cancerous spots), this may be prescribed to remove damaged skin cells.

In-Office Dermatologic Procedures:
Chemical Peels: Improve skin tone and reduce hyperpigmentation.

Laser Therapy (e.g., IPL or Fraxel): Targets pigmentation and sun damage at deeper levels.

Cryotherapy: Used to remove individual sun spots or precancerous lesions.

Photodynamic Therapy (PDT): Can treat sun-damaged skin with signs of actinic keratosis.

Supportive Care:
Daily Broad-Spectrum Sunscreen (SPF 50+): Essential to prevent further sun damage and protect your skin during treatment.

Moisturizers with Antioxidants: Help repair the skin barrier and combat oxidative stress from UV exposure.

It's important to stay consistent with sun protection and skincare, as sun damage accumulates over time. A combination of treatments often yields the best results.

Instead of a more aggressive lasers with longer downtimes, you may want to consider PicoSure PRO. PicoSure PRO effectively diminishes hyperpigmentation, dark spots, uneven skin tone and texture, as well as fine lines. It delivers the laser energy in picoseconds, a trillionth of a second, to target the pigmented lesions reducing injury surrounding skin tissue making it for all skin types and tones. Based on your photo, you may be a good candidate for PicoSure PRO!

You will likely have the best results from a combination of treatments. Begin by visiting an aesthetician for a skin analysis. IPL treatments will address current hyperpigmentation. Products can also be recommended to optimize your results. Daily sunscreen use will help protect against further damage.

We recommend Photos Genesis Skin Therapy, Intense Pulsed Light (IPL) for areas of hyperpigmentation from sun damage. The light is selectively absorbed by the pigmented spots. The rapid heating of these cells causes the therapeutic effect. We recommend 2-4 treatments 4-6 weeks apart.

Hi Webchez! I took a look at your photo and I can see how the hyperpigmentations, dark spots, increased skin laxity, and dryness could be a concern for you. Majority of my patients are concerned about hyperpigmentation so they visit me and we usually do a customized treatment for each patient bc there are many factors we need to consider before starting a treatment since every person is different. First of all, I would like to recommend you to apply body moisturizer to enhance your skin barrier every night after a shower (with a mild body wash / mild soap) do not rub too hard on your skin when washing. Also you need to wear sunscreen and UV protection clothing (sometimes my patients have a hard time getting those kind of clothes so they are recommended to use a UV skin patch you use on your face). Now for the treatments we could do would be laser treatments using 1064 , 755, 532 wavelengths / injections - skin boosters PN, PDRN, PRP and so on / needle RF treatments / IV treatments / medication / topicals and so on. There are actually many ways to address the issue but we need to thoroughly examine all of the hyperpigmentations on your skin bc they are different and react differently to all these treatment modalities. So I suggest you go to a physician and get a physical examination done in person so that we can choose the right treatment method for you. Hope this helped. Good luck !

Hello there, thank you for submitting this question with a photo, best treatment for hyperpigmentation would be series of IPL Laser treatment.

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. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin Winnetka and Chicago. For years of sun damage on your arms, several effective treatments can help improve the appearance of your skin. Topical retinoids can promote cell turnover and improve skin texture, while products containing vitamin C or hyaluronic acid can brighten and hydrate the skin. Chemical peels, which remove the outer layer of damaged skin, can also be beneficial, especially those formulated with glycolic or salicylic acid. Laser treatments, such as fractional laser or intense pulsed light (IPL), target pigmentation and stimulate collagen production, leading to more even skin tone and texture. Additionally, regular use of broad-spectrum sunscreen is essential to protect your skin from further damage and prevent new spots from forming. I hope this helps and best of luck!