Sun damaged skin with resulting in freckles and dark spots can appear at any age.
This includes situations such as younger people who’ve experience a lot of sun exposure
or indoor tanning, as well as older people with accumulated sun damage which becomes
more visible in later years.
Treating sun damaged skin in the past involved aggressive treatments accompanied by long
downtime.
Modern technologies allow me to help my patients get comparable results, but without the prolonged
healing process.
I’m Dr Amiya Prasad.
I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculofacial Plastic & Reconstructive
Surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years.
I have been treating sun damaged skin since I started my practice.
I started first using deep chemical peels and fully ablative CO2 laser.
As medical technology evolved, I adapted the use of less aggressive fractional lasers such
as CO2 and Erbium lasers.
In addition, I routinely use nonablative lasers which leave the top layers of skin intact
resulting in tupically no downtime.
I also synergistically use regenerative medicine technology like PRP or platelet-rich plasma
to further improve the skin at the same time.
Types of sun damaged skin ranges from different concentrations of melanin and pigment.
Light to dark discolorations that manifest as small spots are commonly described as freckles
or solar dyschromias.
Larger, more defined spots are commonly described as dark spots or brown spots, which we call
in our field solar lentigos.
These freckles and brown spots occur between the top and bottom layer of the skin, called
the dermal-epidermal junction.
To treat dark spots and freckles in the past involved removing, or ablating the top layer
skin.
This was first done with chemical peels, also known as TCA peels, which stands for trichloroacetic
acid, which required significant recovery for the top layer of skin to regenerate.
Chemical peels also tended to treat unaffected areas of the face, so treatment wasn’t localized
to small areas.
This meant that more surface area of the face was involved in the healing process.
While TCA peels are effective, they did require patients to take time off work while their
facial skin was still peeling for several days after treatment.
Skin treatment evolved into the first fully ablative CO2 lasers in the mid 1990s.
CO2 lasers also removed the top layer of skin, and required significant downtime.
Lasers were also effective but patients were exposed to a lot of heat energy, and doctors
and practitioners had to manage the effects of high levels of heat on the skin.
Fully ablative CO2 lasers also involved removal of the top layer of skin, with heating of
the lower layer of the skin, the dermis.
A lot of healing time was needed.
Patients could be out for weeks while waiting for a skin layers to come back and cover up
the skin which was intensely red.
The laser technology I use in my practice every to treat solar dyschromias and lentigos
are treated without the need for prolonged downtime.
I discuss with my patients during consultation what the specific aspects of the skin my patients
want to see improve.
I also discuss the amount of recovery needed for the issues they are concerned about.
For example, if they want to address fine lines, an option we can use are fractional
lasers.
There is a dual benefit to fractional lasers.
One is the removal of irregular top layers of skin which is the epidermis and the other
is energy delivery for collagen remodeling in the lower layer of the skin, the dermis.
Unlike fully ablative laser treatment, fractional lasers allow surface areas to be left intact
which results in faster healing.
If the main concern is about dark spots and freckles, I usually use a Q Switch laser.
The laser can go through the top layer of skin leaving it intact while breaking up the
pigment caused by sun damage.
The approach to treatment is typically to have patients come in monthly so the pigmentation
progressively diminished without any disruption in the patient’s schedule.
I explain to my patients that the pigmentation caused by the sun is comparable to a tattoo
even though a tattoo is placed in the deeper part of the skin.
The laser energy is absorbed by the pigment and broken up into smaller particles which
are metabolized by the body.
Like all laser treatments, skin type and skin color are very important factors in the type
of laser used and the energy settings.
Generally speaking, lighter skin can take a higher energy setting, while darker skin
needs a lower setting.
As I stated earlier, I routinely employ the use of regenerative medicine technology such
as platelet rich plasma and hyaluronic acid to help the skin quality.
It’s actually a routine for us to perform Q switch laser treatment, which we refer to
as laser toning with PRP and hyaluronic acid delivered to the dermis called skin boosting.
In fact, PRP has been documented in the medical literature to be beneficial in treating hyperpigmentation
which further makes this combination an effective strategy.
Treating pigmentation and other skin issues caused by sun damage no longer requires the
long downtime of chemical peels and aggressive lasers.
As mentioned earlier, since the top layer of skin is intact with the Q Switch laser,
healing time is minimal to none even when combined with skin boosting.
This means your skin quality and areas of pigmentation can be treated conveniently without
interruption in your daily routine.
I recommend using other products such as sunblock to protect the skin from sun exposure which
can cause more brown discolorations to appear.
I hope you found this information helpful...thank you for your question.