Undoing the damage from too much sun

Freckles. Sunspots. Hyperpigmentation. Call it what you want, but after a certain age, those brown patches of skin are no longer cute. In fact, a 2006 study by Procter & Gamble found that uneven skin tone alone can raise a person's perceived age by up to 20 years.

Even if you're doing everything right to prevent further damage -- slathering yourself daily with sunblock, wearing a hat, avoiding the sun between 10 a.m. and 2 p.m. -- there's still the matter of those lost years. You know, the ones you spent slick with baby oil, baking at the beach or on a blacktop driveway. That damage is done. Or is it?

Fine lines and wrinkles have long been the target of anti-aging regimens, but now a number of treatments designed to reduce the appearance of age spots are available. While they can help, no solution is permanent if you don't keep up your guard.

"Whether you treat visible sun damage with in- office procedures or topical products, the spots will reappear without daily use of sunscreen rated SPF 30 or higher," says Dr. Jaime Davis of Uptown Dermatology in Minneapolis.

Here's a quick rundown of ways to fight sun damage. Which one you choose depends on your skin type, your budget and your patience.

How it works: Lightening products (such as Clinique Even Better Clinical Dark Spot Corrector and SkinCeuticals Pigment Regulator) inhibit melanin production and fade mild spots using natural ingredients such as kojic acid, licorice extract, mulberry, vitamin C, soy and L-arbutin.

Benefits: Inexpensive, gentle, natural alternative to hydroquinone. Requires no prescription.

Cost: $10 and up.

Where to get it: Drugstores and departments stores.

How it works: This topical formula contains three ingredients that work together: hydroquinone to lighten, tretinoin (a form of vitamin A) to speed the exfoliation of spots and an anti-inflammatory cortisone to soothe any redness or irritation that may be caused by the other two ingredients.

Benefits: Easy to apply, painless, less expensive than lasers and peels.

Drawbacks: Usually doesn't eliminate pigmentation completely. Hydroquinone has been banned in some countries because of its potential cancer risk.

Where to get it: Available by prescription only.

How it works: A professional-strength solution of glycolic acid, alpha hydroxy acid, trichloroacetic acid, lactic acid (or a combination thereof) is applied to the skin. The solution dissolves the damaged, pigmented spots to reveal smoother, brighter skin. The strength and depth of a chemical peel varies by the type of acid used and how it's applied.

Benefits: Especially effective when used in conjunction with other treatments, such as intense pulsed light (see below).

Drawbacks: Skin may feel hot or prickly during the peel, and will continue to visibly slough off for a week or more.

Cost: $200 and up.

How it works: During this 30-minute treatment, short pulses of noninvasive laser light are flashed onto affected areas of the skin, breaking up and destroying the melanin. Spots began to fade several days later, and in some cases peel off.

Benefits: Minimal pain (the sensation is often described as a rubber band snapping), no downtime, works on both brown and red pigmentation, such as broken blood vessels.

Drawbacks: Often requires multiple sessions; pigment looks worse before it gets better.

Cost: About $300 a session for a full face, less for individual spots.

Where to get it: Dermatologist offices and some skin clinics.