Summer’s long gone, but it may have left our skin with a few lasting souvenirs: Brown spots. Visible blood vessels. A complexion that appears more saggy or wrinkled than before. Perhaps dry, pink, or discolored spots that are precancers (called actinic keratosis) or even skin cancer. The good news is, you can reverse signs of sun damage -- and this is the perfect time to do it (one reason dermatologists love fall and winter!). Here are some derm-recommended strategies that can help.
Protect from the sun. You’re probably aware that sunscreen guards against new damage. But you might be surprised to learn that protecting against ultraviolet (UV) light gives the skin an opportunity to heal and actively reverse old damage (much like “smoker’s lung” can improve significantly a few years after quitting cigarettes). Ultraviolet B (UVB) rays are out in force mostly during summer, but ultraviolet A (UVA) light reaches our skin year-round, gradually damaging and aging our skin whenever we step outside. That’s why dermatologists like me are always harping about wearing a broad-spectrum, SPF 30+ sunscreen all year long.
Support your skin with an antioxidant serum. Vitamin C, vitamin E, green tea, and resveratrol are antioxidants that can help skin cells repair their DNA and fend off free radical damage from sunshine, pollution, and the body’s metabolism. Before I even reach for my first cup of morning coffee, I make sure I’ve layered one on under my daily sunscreen.
Consider a supplement. Antioxidant supplements can help keep skin healthy, too. The B vitamin called nicotinamide has been shown in human studies to lower the risk of skin precancers and nonmelanoma skin cancers. The fern extract Polypodium leucotomos has been shown to reduce the risk of sunburn and make the skin a bit more resilient to UV damage. Though these supplements may offer bonus protection, it’s important to note that dermatologists do not consider them a substitute for sunscreen, hats, clothing, sunglasses, and shady spots. Talk to your doctor before you start any new supplement.
Dab on a vitamin A cream. Creams, gels, and serums derived from vitamin A (retinoids) have been proven to reverse signs of sun damage and age, including fine lines, wrinkles, spots, and sagging. They can gradually thicken and strengthen fragile or crepey skin and help with pores and blemishes, too. Sounds too good to be true, right? It would be, if not for the irritation, redness, and dryness that retinoids can cause -- especially if you overdo it with a formula that’s too strong, or if you apply one too liberally or too often. The best way to start is with a gentle, over-the-counter retinol cream applied sparingly, at bedtime, under moisturizer.
Dabble in acid. Over-the-counter creams, masks, and serums containing alpha hydroxy acids (such as glycolic acid) or beta hydroxy acids (such as salicylic acid) can improve the skin’s tone, smoothness, and texture while reducing breakouts and pores. Chemical peels done in an office (I recommend a well-trained aesthetician or board-certified dermatologist) more powerfully smooth and brighten the complexion, fade spots, correct blemishes and scars, ease dark patches called melasma, and reduce fine lines. I recently had a medium-depth peel in my office, and my face flaked like a snake for a few days (which was oddly satisfying!). Afterward, my skin emerged much smoother, brighter, and more even than before. Recovery times vary depending on the depth and type of the peel, but skin typically heals within a week or two. (Sensitive skin types may want to avoid peels and acids due to the risk of irritation.)
Explore light therapies. Your dermatologist may offer a blue light treatment called photodynamic therapy, a medical procedure that targets sun-damaged skin cells to prevent and treat precancers (actinic keratosis). Cosmetic lasers and lights can improve the appearance of sun-damaged skin, too. Choosing among them can feel a bit like walking into a shoe warehouse with a blank check on Black Friday, which is why it’s ideal to have a board-certified dermatologist guide you through the options. If you’re fair-skinned, intense pulsed light (IPL), also known as broad band light (BBL), is a time-tested therapy that can reliably improve the appearance of sun damage by fading tan spots and visible blood vessels. If you have richly pigmented skin, a laser with a long wavelength (1064 nanometers) is a safe way to rejuvenate the complexion and reverse signs of sun damage.
Discuss medicated creams with your dermatologist. For anyone with a history of skin precancers (actinic keratosis) or skin cancers, prescription creams or gels may help to undo sun damage in a powerful way. Ingenol mebutate gel (Picato, derived from the milkweed plant), 5-fluorouracil cream (Efudex), and diclofenac gel (Solaraze, an anti-inflammatory) target and remove rapidly dividing precancerous cells when applied to the skin. Imiquimod cream (Aldara) harnesses the body’s immune system to help remove precancerous cells. These medicines can cause redness, irritation, and other side effects, so you should only use them under the guidance of a dermatologist.
Get zapped. If you’ve ever been to a dermatologist, you might be familiar with one of my favorite tools: liquid nitrogen. It’s that super-cold, nontoxic spray that derms use hundreds of times a day to quickly freeze off warts, precancers, age spots (seborrheic keratoses), skin tags, and more. Yes, the treatment stings for several seconds, and you may feel itchy and irritated afterward. You’ll probably remain pink and scabby for a couple of weeks while you heal. But once you do? As I often say to my patients, “your skin will be smooth like a baby.”