People who reside in Brisbane, Gold Coast and the Sunshine Coast have an increased risk of sun damage compared to living in Sydney or Melbourne. The high UV index in the North can give rise to age spots, sun spots, brown spots, wrinkles, droopy eyelids and solar keratosis. Some form of sun damage such as rough, dry spots are pre-cancerous and should be treated. Laser treatment is the preferred method as down time is short and the outcomes are excellent.
- Sun damage can present in many ways including brown liver spots, premature wrinkling, droopy and wrinkled eyelids, as well as rough dry red and scaly areas on the forehead, nose, cheeks and temples
- Some form of sun damage such as solar keratosis, actinic keratosis and sun spots are precancerous and should be treated
- Other forms of sun damage can be classed as cosmetic (brown spots and dots that have no potential to be cancerous), wrinkles, and lines
- See your dermatologist for regular skin check ups if you are concerned about any lesion that could be a cancer
- Treatment of background sun damage will enable a Specialist to pick up any cancers at an earlier stage
- Treatments I perform include PDT, and various laser treatments
- Laser therapy treats all aspects of sun damage including pigmentation, wrinkles, and skin laxity and has largely replaced PDT and creams
As a laser and cosmetic dermatologist , I split sun damage into 2 subtypes.
Cosmetic sun damage. This means you can elect to have nothing done, and treatment is based upon improving your skin age and to freshen up dull skin, improve skin texture, tone and volume. Sun damage can manifest in many ways including – premature wrinkles, age spots, upper lip lines, droop eyelids, forehead wrinkles, loss of skin volume and altered skin texture.
Medical sun damage. This means you should consider treatment and close follow up by a medical or Moh’s surgeon who does regular skin checks. This type of sun damage produces red, rough and persistent areas of solar keratosis, a pre- cancerous lesion. Some brown spots may also be pre- cancerous (HMF, or melanoma in situ). I treat both cosmetic and medical sun damage with laser. (NOTE- laser or PDT is not the only way to treat medical sun damage, however it is my preferred option as I achieve better results with less downtime compared to creams such as Efudix.)
Sun damage can be pre-cancerous. A skin check with your local dermatologist can reveal if these lesions need to be treated or not. Solar keratosis present as scaly, stingy, rough, dry and persistent areas on the nose, cheeks, forehead, nose, upper lip, and temples. The use of creams, PDT or laser can reduce the amount of sun spots. Treating sun damage can also remove pigmentation and this enables your Dermatologist to find skin cancer at an earlier stage.
The answer is yes, if sun damage is medical sun damage, namely sun spots or solar keratosis. The treatment of wrinkles and the majority of brown spots will not reduce the skin cancer rate. Sun damage removal also allows for earlier detection of skin cancer.
One typical Fraxel laser treatment- complete recovery is within 6 days.
Creams for sun damage include Efudix, Aldara, Picato, and Solaraze. These need to be used for 4-60 days, depending on the cream and severity of sun damage. Cream management can be supervised by your GP, skin cancer doctor or your dermatologist.
Laser for sun damage is by far the best treatment- depending on what is requested I use either high density 1927 Fraxel or full face laser surgery. Laser addresses all aspects of sun damage, treating both wrinkles, pre cancerous lesions as well as improving skin texture and skin tone.
PDT or photodynamic therapy. Sun spots treatment with PDT is an excellent method for the treatment of red, scaly solar keratosis and IEC or squamous cell cancer insitu.
Treatment is over within 3 hours, with most patients needing only one session. Your skin heals within 5-7 days of PDT. This treatment is covered under DVA (Department of Veteran Affairs) or if you have International health insurance.
Sun Spots Treatment
The only 2 methods I use to treat sun damage skin is PDT and or laser treatment.
If you have skin cover under DVA (Department of Veteran Affairs), then PDT is the treatment of choice because this treatment is 100% covered.
Laser treatment of sun damage skin has advantages of Photodynamic Therapy as it also treats the cosmetic aspects of sun damage as well as the pre-cancerous aspects.
Patients in the early 20s-40s will have ‘spots and dots’, and Fraxel laser is my preferred option. This laser will also improve skin texture, and fine lines. Suns spots treatment with Fraxel in this age group can help reduce the incidence of certain forms of skin cancer.
Patients in their late 40s-70+s will have more age spots, but droopy eyelids, wrinkles, and skin laxity, in addition to possible pre- cancerous lesions. In this age group, I like using fully ablative lasers, including Erbium and CO2 combined. This gives amazing results, turning back time by 15-20 years. The downside of this laser is the recovery period. Sun spots treatment with this form of laser resurfacing will give dramatic results – improving skin texture and skin tone.
7-8 days with PDT
5-7 days with Fraxel 1927 High Density laser
10 days with fully ablative Erbium and CO2 combination laser
Fraxel laser is associated with the quickest recovery time, whilst fully ablative laser resurfacing is associated with a downtime that is proportional to the amount/ level of wrinkling and sun damage. The greater the downtime, the better the results.
Recovery from Fraxel is fast- this is what your skin looks like 48 hours after laser.
My studies on sun damage and Fraxel laser commenced in 2012, and has now achieved World Wide recognition as one of the best treatments for solar keratosis with clearance rates approaching 95% at 12 months. This treatment is more effective than PDT, with a quicker recovery time than any other sun spot treatment.
Centers in the United States, and NSW, Victoria and South Australia are using my High Density Fraxel method. Multicenter studies are now conducted with more scientific papers on this method coming out next year. Stay tuned.
Yes, fine wrinkles and age spots will improve with Fraxel laser, however if you desire marked wrinkle reduction (especially around the eyes) and tighter, more toned skin, fully ablative Erbium and CO2 laser is the treatment of choice.
Sun Spots Treatments
Creams such as Efudix, Aldara, and Picato can be prescribed by your skin cancer doctor, GP or a general dermatologist.
|Fraxel 1927||5-7 days||From $990- 1290||Cost; may need two procedures if severe sun damage||One off treatment, very quick recovery time – less than 7 d.||Helps with skin rejuvenation|
|Efudix||21-28 days||$160+ including follow up||Downtime, follow up visit mid treatment||Cost effective, works very well||*Best option if downtime is not an issue and tolerable skin type|
|PDT –photodynamic therapy||7-8 days||$2500- $3500Face and scalp||Cost||Short downtime, very effective, one off application||Good treatment for smaller areas of sun-damage. Eg upper lip|
|Picato||5-7 days||$150 for 5 cm by 5 cm||Cost; variable levels of inflammation.||Shorter downtime||Variable inflammation; needs physician monitoring.|
|Aldara||4-8 weeks||$300-$700 including follow ups||Long treatment regime||–||Limited use|
Fraxel laser ranges from $1290 – $1690 * High density Fraxel blended to neck areas
PDT Full face ranges between $1990-$2500
Full face CO2 and Erbium ranges between $4500-$5500 * Medicare rebate applies in some cases
NOTE- Erbium and CO2 laser resurfacing inclusive of anaesthetic and laser operating theatre fees.
Sun spots treatments with Fraxel laser can give amazing results
Some sun damage treatments are covered under Medicare- these include the treatment of sunspots with laser therapy. Medicare cover is minimal as you will only receive a reimbursement of 8%.
White and Gold Card DVA patients get 100% coverage for PDT.
Private Health insurance gives between $50-$110 back for PDT, depending on the health fund.
Sun Spots Treatments
The Department of Veteran Affairs covers top line sun damage treatments such as PDT for solar keratosis of the face, and precancerous squamous cell cancers anywhere on body or face. Additionally they cover laser resurfacing for sundamage lips, and broken blood vessels. Ensure you have either a Gold Card or White Card covering SKIN.
Top cover BUPA International (Note – Not BUPA Australia), covers PDT to precancerous and skin cancer.
By Dr Davin Lim
Laser and Cosmetic Dermatologist
The vast array of sun spot treatments can make things confusing for patients. As a laser and aesthetic dermatologist, I place priority on the cosmetic aspects of sun damage- wrinkling, lines, droopy eyelids, crows feet, sun spots, age spots, and age warts. My aim is to turn back time, and reverse the years of sun damage. The upside is that laser or PDT also treats pre-cancerous cells, reducing the chances of certain forms of skin cancer.
Fraxel high density laser has revolutionised how sun spots treatments are managed. Gone are the days of cream application associated with 4 weeks of redness, scabs, and itching. With Fraxel the skin completely heals within 5 days of treatment. Sun spots, age spots and pre cancerous cells are all addressed with Fraxel. The upside is fresher, younger skin with improved skin texture.