From sun spots to freckles and splotches, the sun’s damaging rays can and do leave a footprint. We asked two RealSelf.com Contributing Dermatologists—Sejal Shah, M.D., of New York City, and Joel Schlessinger, M.D., of Omaha Nebraska—to break down the most effective treatments for hyperpigmentation.
BY GRACE GOLD
What is it? Laser and IPL are similar technologies that treat everything from sun damage to unwanted hair growth and broken blood vessels with the use of energy, light, and heat. While laser delivers a stronger direct beam to skin, IPL is a series of lighter pulses.
Who is it for? Both laser and IPL have a lot of flexibility, from treating just a single pesky spot or two, to larger surface areas, like a full face of sunspots, says Shah. There are a variety of lasers available, so a broad range of skin types can be treated. Intense Pulsed Light (IPL), Fraxel, and CO2 are all popular options for treating sun damaged skin.
Effectiveness: Expect up to 90 percent or higher improvement, or potentially even complete clearance in some cases.
How long does it last: While CO2 is an aggressive laser, lower-grade lasers and IPL typically require a series of treatments for full results—and then additional treatments are usually required to maintain results. An aggressive laser may last more than 12 months, while lower-grade lasers typically need maintenance every six to 12 months, says Shah.
Average cost: This can vary widely based on the system being used, areas treated, and location you live. The average range for an IPL treatment is $400 to $600 for a full face treatment, lasers like Fraxel or Pico Genesis range anywhere from $800 to $1200 per treatment, and CO2 laser starts at $3,000 to $4,000.
What is it? A chemical peel consists of an application of an acid solution that removes damaged outer layers of skin. Acids that are commonly used include alpha hydroxy acids like glycolic and lactic, trichloroacetic acid (TCA), or the very aggressive phenol.
Who is this best for? Similar to laser treatments, peels can treat individual spots or a face full of sun spots and pigmentation issues. A range of peel options are available for virtually every skin type and tone.
Effectiveness: Results vary based on a number of factors like how many peels you get done, but similarly to laser therapy, you can achieve greater than 90 percent improvement and potentially even complete clearance, says Shah. It’s important to note that the type of peels that typically result in full clearance may not be appropriate in darker skin types due to risks of discoloration, adds Shah.
How long does it last: A series of lighter to moderate peels are often recommended, and deeper peels are also available for more dramatic results with more recovery time. Like laser, you typically need maintenance peels down the road—Shah recommends every three to 12 months for her patients, depending on how aggressive the peel is.
Average cost: Varies widely based on type of peel used, though the average cost of a chemical peel is $700. A more superficial peel can be significantly less, and a deeper peel can be significantly more.
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What is it? Cryotherapy uses the extreme cold of liquid nitrogen to pinpoint and freeze off skin tissue, and can be used to treat benign conditions like sun spots or even pre-cancerous or cancerous cells.
Who is it best for? If you’ve got a single dark lesion (or a few), cryotherapy can work like a charm. This isn’t an option for anyone who wants large surface area treated. Shah also finds it best for individuals with lighter complexions, as there’s a risk of permanent discoloration in darker complexions.
Effectiveness: This can potentially achieve complete, easy clearance—however, Shah says she notices the percentage of individuals who have complete clearance with cryotherapy is lower than with lasers, IPL or chemical peels.
How long does it last: If it’s gone, it’s adios!
Average cost: Will vary based on how many lesions being treated, though Shah says an average session in her office is about $300.
What is it? If you’re good about being consistent with your skin-care routine, wear sunscreen religiously every day, and avoid extended time in direct sun, you can see results with an aggressive regimen, says Schlessinger. Other popular options include retinol and hydroquinone-containing formulas. While ingredients like retinol and alpha hydroxy acids (AHAs) brighten skin by speeding up cell turnover and exfoliating the damaged surface layer, hydroquinone blocks the process in skin that leads to discoloration and is known as a lightening agent.
Who is it best for? Anyone!
Effectiveness: This all comes down to you, says Schlessinger. If you use the products consistently and practice both sun smarts and sun avoidance behaviors, you can see “excellent” results—anywhere from partial to complete clearance.
How long does it last: Skin care will have to be an ongoing treatment and will essentially need to be continued any time sun exposure is present. (Hello, every day?) Hyperpigmentation can come right back if you lapse on your routine, don’t wear sunscreen, or sunbathe.
Average cost: Products on the market can vary from drugstore to department store and specialty dermatologist levels. The Obagi NuDerm system that Schlessinger recommends to his patients is about $400 for the full set.