The Best Cosmetic Procedures To Correct Sun Damage

Labor Day has come and gone, which means the unofficial end of summer is upon us. And whether your warm-weather plans included beach days, farmer’s market jaunts, camping trips, or outdoor runs, there is little doubt you’ve soaked up a bit of sun. And while lathering up with a broad-spectrum sunscreen is a necessary first line of defense, most people don’t apply enough and/or forget to reapply throughout the day. The result? DNA-altering damage that persists well after the sun goes down.

A 2015 Yale University study found that sunlight can continue to affect the skin whether you’re back inside or not. UV rays from the sun or tanning beds can damage the DNA in melanocytes (the cells that make the melanin that gives skin its color), and that danger lingers for hours after exposure. The damage is a major cause of skin cancer (i.e. the most common form of cancer in the U.S.), and it can also cause an overproduction of melanin that leads to dark spots and hyperpigmentation.

Even more alarming? The visible sun damage that begins to manifest as said dark spots in your thirties and forties may be the byproduct of childhood fun in the sun. “Sun damage occurs very early on, and we know now through research, that you could have had a sunburn as a child and years later it could show up as a melanoma,” says Philadelphia-based plastic surgeon Jason Bloom, MD, who recommends daily sunscreen application and a yearly skin check with a dermatologist as precautions.

During a skin cancer screening, a dermatologist will look for any new spots or changes to existing ones, but you can be vigilant at home, too. “Pay attention to a mole that’s getting bigger, or darker or changing, or itchy, or bleeding,” says Dr. Bloom, for the abnormalities could be warning signs.

While first establishing that hyperpigmentation is benign is paramount, cosmetic concerns related to sunspots may endure. The 2018 Survey on Dermatologic Procedures from the American Society for Dermatologic Surgery (ASDS) found that sun damage treatments were up 63 percent in the last two years alone.

Jonathan Cabin, MD, a facial plastic and reconstructive surgeon in Arlington, VA, says that the visible damage caused by UV rays presents as “areas of hyperpigmentation or sunspots that are typically shades of brown and red.” But that’s not all. Dr. Cabin says that “poor skin quality” in the form of “thin or inelastic skin” and “wrinkling” is also common.

So, what are the best ways to restore even skin tone and texture? Here, a guide to the best in-office and at-home treatments to improve the appearance of sun damage.

In-Office Procedures

Often times, the most effective treatment protocol for sun damage is a multi-modal one. Below are some of the professional procedures that address visible signs of photoaging.

Chemical Peels

Used to treat everything from acne to wrinkles, chemical peels work by employing a blend of acids to chemically exfoliate the skin. The entire process is relatively simple and can be customized for more tailored results.

During the treatment, your provider will determine the solution strength best suited for your skin type and concern. Formulas range from relatively mild alpha- and beta-hydroxy acid cocktails to deeper trichloroacetic and carbolic acids. Patients may experience tingling and/or burning sensations during the treatment.

While a strong peel may only require one session (but months of downtime), milder versions often call for multiple visits, and professional sessions cost anywhere from $300 to $3,000 depending on the strength. In the days following the peel, dead skin cells will begin to flake off, leaving behind a smoother and brighter complexion.

The tried-and-true treatment is great for improving skin tone for patients of all ages, but Dr. Bloom is particularly fond of the preventative benefits of peeling. “I encourage my millennial patients to start early on getting glycolic, fruit, and salicylic peels,” says. Dr. Bloom. “It helps maintain a healthy visage and takes off any signs of early sun damage and aging.”

Microneedling with Platelet-Rich Plasma (PRP)

Commonly known as the ‘vampire facelift,’ this ever-popular treatment option can correct sun damage — in addition to all its other anti-aging benefits. “With one or more treatments, we can make fine lines and wrinkles fade,” says Dr. Bloom. “The result is glowing, healthy, and even skin.”

A standard microneedling session involves the practitioner rolling a handheld device covered in fine needles over the surface of the skin to create micro-punctures. While that process alone stimulates collagen production and improves skin health, the addition of platelet-rich plasma (a.k.a. PRP) only improves the results.

The two-part microneedling with PRP procedure first involves a medical professional drawing five to 15 milliliters of blood from the patient (Dr. Bloom says the collection is done in the office) that is put into a centrifuge to isolate the platelets that will form the PRP solution. After microneedling the affected area, the practitioner will massage the PRP blend into the skin so that it can penetrate the micro-wounds created by the dermaroller.

The treatment lasts about 30 to 45 minutes, and a bit of redness or swelling may persist for a few days. Sessions cost around $750 each.

Lasers

Laser skin resurfacing is one of the most effective corrective procedures available, but, since the laser market runs deep, it can be confusing to know where to start. While consulting with a board certified dermatologist or plastic surgeon will ensure that you get the right treatment for your skin type and the severity of your concern, Sejal Shah, MD, of Manhattan’s SmarterSkin Dermatology, says CO2, Fraxel, and picosecond lasers are among the most popular for targeting the “wrinkles, textural changes, and pigmentation” caused by UV damage.

• CO2 Lasers: A popular laser for skin resurfacing, carbon dioxide lasers are used to tackle deep wrinkles, age spots, and enlarged pores caused by sun exposure. The latest generation of the technology uses either short pulsed light energy or continuous light beams to remove thin layers of skin with minimal impact to the surrounding tissue. While recovery can take several weeks, the results can last several years. “A single treatment cost $3,500, but I do recommend maintenance with a lighter laser,” says Dr. Shah.

• Erbium Lasers: Safer for darker skin tones than their CO2 counterparts, erbium lasers can treat superficial to moderately deep lines and wrinkles on the face, hands, neck, and chest. “A non-ablative fractionated 2940 nm erbium laser is a powerful device for skin rejuvenation, fine lines, wrinkles, and acne scars,” says Samer Jaber, MD, of Washington Square Dermatology in NYC. Post-procedure downtime usually lasts no longer than a week with minimal swelling and/or bruising possible.

• Fraxel Lasers: With the ability to address everything from hyperpigmentation and wrinkles to acne scars all over the body, the energy from a Fraxel laser creates microscopic beams of energy that target only a fraction (hence, the name) of skin at a time. “I usually recommend three to five sessions, and then yearly maintenance,” says Dr. Shah. Each treatment costs an average of $1,000 with up to a week of downtime.

• Picosecond Lasers: While this laser type is most commonly associated with tattoo removal thanks to its ability to shatter pigment in all skin types, it can also be used to target specific dark spots on the skin. Picosecond lasers release energy in short nanosecond bursts without cooling the skin's surface, so the energy reaches multiple layers of skin. “I usually recommend three to six sessions,” says Dr. Shah, who adds that each can cost about $750. The quick visits last 15 to 20 minutes, and it can take up to a week for the treated brown spots to flake off.

Ultherapy

If you are looking for a procedure that can address skin laxity — not just tone and texture — Ultherapy is a popular non-invasive option for lifting and tightening loose skin without downtime. “Ultrasound energy heats the deep layers of the skin, creating micro-injuries to the same layer that is lifted during a facelift,” explains Dr. Jaber. “As the skin heals, new collagen is produced creating a lift.”

In addition to providing a firming effect on parts of the face (think: brow and chin) and neck, Ultherapy can also improve the appearance of lines and wrinkles on the décolletage. The procedure takes anywhere from 30 to 90 minutes depending on the treatment area, and the cost starts at around $1,000. It can take up to six months for the full effects to become visible, and patients may opt for maintenance treatments every one to two years.

At-Home Care

Not every sun damage treatment requires a trip to the dermatologist or plastic surgeon. A good skincare regimen not only complements whatever professional procedures you have opted to have done but also helps to prevent future damage. Oh, and it all starts with — you guessed it — sunscreen.

“I can’t stress enough how important sunscreen is for everyday use,” says Dr. Bloom, who recommends applying a broad-spectrum formulaSPF 30 or higher to all visible skin (think: shoulders, legs, hands, tops of feet) — not just the face.

And there’s a lot more where that came from. Topical antioxidants in the form of vitamins C and E are known for their brightening effect, in addition to providing a much-needed line of defense against free radical damage. A vitamin A derivative like retinol is also great for treating visible signs of aging like hyperpigmentation, lines, and wrinkles, and keeping skin hydrated is also a must. “I encourage the use of topical antioxidants, moisturizers, and retinoids,” says Dr. Shah, to address skin tone and texture.