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Offline rm1961  
#1 Posted : Saturday, December 26, 2009 3:07:46 AM(UTC)
Rank: Member

Joined: 12/7/2009(UTC)
Posts: 375
Woman
Location: MA
I have sun damage on my chest from many years of outdoor swimming and am quite depressed about it. You can see a clear ring from where the neckline of my suit. It is tanned and red with sun spots. I have been sun avoidant for the last 1.5 years so it appears to be permanent. At this point (48 yrs old) I have sun damage on my face, neck, arms, back, legs - everywhere where a swimsuit was not. I also had a lot of beach time up until my earlier 40's and with Irish skin, this was not very smart. Sunscreen with 30 SPF gave me a false sense of security as I still got tanned despite using it.

I have researched IPL but read so many horror stories. I have used Retin A micro 0.4 on my face for the last 11 months and sometimes put it on my neck and chest but my chest does not tolerate it well. I can't tell if it is helping my face or not. My chest is all broken out from using it now.

Any suggestions and/or a trustworthy dermatologist recommendation?

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Offline DCNGA  
#2 Posted : Saturday, December 26, 2009 3:44:35 AM(UTC)
Rank: Advanced Member

Joined: 9/18/2008(UTC)
Posts: 7,198
Woman
Have you seen my peel pics of my chest? It's in the "P-Day" thread I started a couple of weeks ago.

I won't lie and say it's an 'easy' procedure, but it does a reasonably good job. If I could take another round of it, I would do it again and my discoloration would be 90% resolved, I would say. Since you are 10 years younger, it would likely be much easier on you and your skin will likely give good results.

I will be posting pics of my chest in a week or less. I still have a few areas that are healing. The neck and chest are harder to peel and cannot take a 35% solution of TCA like the face can. I had 20% TCA to my chest and neck and lemme say, OUCH!. I had more than one layer and my derm INSISTED I use a retinoid for 6 weeks (minimum) on the area before the peel. The itching on my chest was sincerely intense. If you look at my chest pics on the other thread you will see mine sounds like yours, plus 10 more years exposure than you. I never thought to put sunblock on my chest until about 3-4 years ago. So, USE SUNBLOOK!

I wrote yesterday on the other thread that it is 50% better now, but each day brings more fading, so I would say is probably 65% better and hopefully will continue to improve.

As for red areas, if they are broken caps only pulsed dye is going to help with that. If I can scratch up the nerve (I have an aversion to any type of laser/PDL type devices), I may have my chest done to get rid of the redness.

If you do a peel, go to a derm (IMO) and one who does them regularly and is well versed/comfortable with doing them.

Good luck and hope you find a solution that is suitable to you.
Offline rm1961  
#3 Posted : Saturday, December 26, 2009 8:28:43 AM(UTC)
Rank: Member

Joined: 12/7/2009(UTC)
Posts: 375
Woman
Location: MA
Thank you for the info, and yes I did look at the photos. yes, I use sunblock but up until recently I just used the Banana Boat SPF 30 or whatever was on sale, and then I read last year that a lot of the popular sunscreens aren't that great. Now I'm using Neutrogena Dry Touch SPF 85 (which is probably a lot of bull) and using strict sun avoidance. I have been doing pretty strict sun avoidance for the last 1.5 years and for a year or two before that I was careful and always wore SPF 30 but who knows if it really works in the water? But the damage is done...and I'm a performer so I often wear low cut dresses and my chest just looks awful. I use make up and that mineral type make up that you brush on.

My chest looks worse now as it is all broken out from the Retin A. So I put hydrocortisone cream on it - is that a bad idea or should I just let it be for a while and let the break out clear up? I noticed there is one "sore" like lesion that is very concerning...

Thank you.
Offline AnnieB  
#4 Posted : Saturday, December 26, 2009 8:50:17 AM(UTC)
Rank: Advanced Member

Joined: 7/23/2009(UTC)
Posts: 1,600
rm1961 wrote:
Thank you for the info, and yes I did look at the photos. yes, I use sunblock but up until recently I just used the Banana Boat SPF 30 or whatever was on sale, and then I read last year that a lot of the popular sunscreens aren't that great. Now I'm using Neutrogena Dry Touch SPF 85 (which is probably a lot of bull) and using strict sun avoidance. I have been doing pretty strict sun avoidance for the last 1.5 years and for a year or two before that I was careful and always wore SPF 30 but who knows if it really works in the water? But the damage is done...and I'm a performer so I often wear low cut dresses and my chest just looks awful. I use make up and that mineral type make up that you brush on.



Thank you.


True, many sunscreens are terrible. People read the SPF and assume they are all the same. Neutrogena Dry Touch is a wonderful line, however, anything over 50 SPF is doing nothing for you other than adding more pore clogging ingredients. I read a few months ago that the FDA is working on banning any sunscreen claiming to have over 50 SPF. It is misleading and people are assuming they can spend hours in the sun without reapplying, and they just can't.

I find that the Dry Touch works great at 30SPF for my face, and it is so "dry" that sometimes I don't remember if I put it on yet or not and I can't tell! However, if I use the 45 SPF, it does leave a bit of a "feel" to it. But, I use that if I am really going to be out in the sun like doing outdoor shopping or spending time in a park or something. Even with a hat, I increase the SPF.

If I were you I'd buy the 50 or even less, and just realize that if you go to the beach or something you need soemthing alltogether different (more water and sweat proof), but still at 50 or under. But, something you can reapply a lot.
Offline AnnieB  
#5 Posted : Saturday, December 26, 2009 9:07:22 AM(UTC)
Rank: Advanced Member

Joined: 7/23/2009(UTC)
Posts: 1,600
This isn't the actual article I read, but this sums it up regarding the SPF situation I was talking about.

http://www.medscape.com/viewarticle/703205

*edit*

Oddly, that link is requiring membership, although when I googled it took me to the article. So, here it is pasted.



For the first time, sunscreen manufacturers will be required to provide information on the amount of ultraviolet A (UVA) screening provided by their products. UVA rays do not cause sunburns, but they do contribute to skin cancer and sun-related skin aging.

The new regulation will also prohibit manufacturers from claiming sun protection factors (SPF) of more than 50+, so those very high SPF sunscreens that now line drugstore and grocery-store shelves may go away.

In an interview with WebMD, Rita Chappelle of the FDA confirmed that the agency hopes to finalize the label rules before the end of the year and that SPF claims will be capped at 50+.

But sunscreen companies will have a year to 18 months after the new rules are enacted to make the label changes or provide scientific evidence justifying a higher SPF rating.

Chappelle also confirmed that the terms “sunblock,” "waterproof,” “sweat-proof,” and “all-day protection” will no longer be allowed on sunscreen labels under the new regulations.

“No product can completely block out the rays from the sun and no product is completely waterproof,” Chappelle says. “And labels will have to advise consumers to limit their time in the sun, wear protective clothing, and reapply sunscreen at a minimum of every two hours, especially after swimming or perspiring."

Label Changes a Decade in the Making

It has been a decade since the FDA first proposed a standardized UVA rating system, but there was widespread disagreement about how to best evaluate the level of UVA protection that sunscreens provide.

“It took some time for the science to catch up,” Chappelle says.

Under the new regulations, sunscreens will be subjected to lab and human skin tests using a standardized sun simulator.

Almost two years ago, the FDA unveiled a proposed four-star rating system, with one star representing low UVA protection and four stars representing the highest UVA protection available in an over-the-counter product.

The stars would appear near the SPF rating on sunscreen labels.

Chappelle would not say if the proposed star system will be adopted in the finalized plan.

She says the agency received more than 3,000 comments about the proposed label changes and an “unprecedented” amount of scientific data from companies challenging those changes.

“Typically when we put out a proposed rule we get five or 10 submissions of scientific data,” she says. “We received over 100 on this and they all had to be analyzed.”

Sunscreen Companies Respond

Representatives of sunscreen manufacturers Neutrogena, Banana Boat, Hawaiian Tropic, and Coppertone all told WebMD they will comply with the FDA label changes.

But they also left the door open for challenging the SPF 50+ cap.

“The FDA has asked for data supporting high SPF products,” Coppertone spokeswoman Jennifer Samolewicz notes in a written statement. “Many manufacturers, including Coppertone, have submitted new data for review and are awaiting the FDA’s response.”

A spokeswoman for Energizer Personal Care, which makes Banana Boat and Hawaiian Tropic sunscreens, tells WebMD that the company will assess its options after seeing the final FDA label requirements.

Farah Ahmed, who is general council for the cosmetics industry group Personal Care Products Council, tells WebMD that although the group doesn’t object to capping SPF levels at 50+, it strongly disagrees with a proposal to prohibit sunscreens from claiming that they protect against skin cancer and premature skin aging.

“We are not saying that sunscreens alone prevent skin cancer and wrinkles,” she says. “What we are saying is that when used as an overall sun-safe regimen, sunscreens reduce the risk of certain types of skin cancer and photo damage.”

Sonya Lunder, who is a senior analyst for the environmental advocacy organization Environmental Working Group, says the FDA rule changes are long overdue and urgently needed.

“It’s kind of a Wild West environment out there now,” she tells WebMD “Companies can make all kinds of claims, and they are making them. Claims like ‘all-day protection’ and ‘complete-protection’ are proof that manufacturers are not following the (now voluntary) FDA guidelines.”
Offline DCNGA  
#6 Posted : Saturday, December 26, 2009 9:13:10 AM(UTC)
Rank: Advanced Member

Joined: 9/18/2008(UTC)
Posts: 7,198
Woman
Be careful with the cortisone, it can 'thin' the skin in those areas with too much use. I think the retinoids are bringing the sun damaged areas closer to the surface and that is why they are red and irritated looking.

I can start using it on my chest again a week from Monday and will see if it irritates those spots that are still a little brownish on my chest post-peel.
Offline MissJ  
#7 Posted : Saturday, December 26, 2009 1:03:07 PM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 23,708
You might need to 'cut' or mix the retin a with some kind of soothing emmolient. You know, 'Renova' is just that; retin a mixed with some kind of soothing cream so it does not irritate too much. Plan on using that stuff for 6 months to a year just to PREP for a future TCA peel to the exposed body areas.

I'm waiting for someone to come out with a line of TURTLE NECK bathing suits.
Offline rm1961  
#8 Posted : Saturday, December 26, 2009 1:10:10 PM(UTC)
Rank: Member

Joined: 12/7/2009(UTC)
Posts: 375
Woman
Location: MA
Thanks MissJ - I recently had my PCP renew both my Retin A and Renova prescriptions...I never actually filled the Renova prescription so once I'm ready to drop the $375 it will take the buy the two tubes (gheesh, what a country....the price of this stuff is OUTRAGEOUS) then maybe I'll try it on my chest. But it is SO broken out right now, I have never seen anything like this and it's a darn good thing I don't have a performance for another 2.5 weeks. It WILL clear up by then if I just leave it alone, right?

I bought a bathing suit at TJ Maxx for $7.00 at the end of the summer, Nike Tribal prints or something like that. It zips in the back and covers the entire back and comes up pretty high in the front, but is not a turtleneck. I wish I had worn this for years but sadly I did not...
Offline MissJ  
#9 Posted : Saturday, December 26, 2009 1:31:34 PM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 23,708
You can get generic retin a on AllDayChemist (overseas discount prescription drug order place) for maybe $25 or so and then mix that with emollient cream.
Offline Anna  
#10 Posted : Sunday, December 27, 2009 10:04:21 AM(UTC)
Rank: Member

Joined: 11/21/2009(UTC)
Posts: 543
Why would you need renova and retin a both? MissJ's idea is good, I've ordered from alldaychemist before and they are legit. If you do end up mixing it I'd recommend mixing a little on your fingertips everytime you use it instead of all at once to keep it as bacteria free as possible.

Offline rm1961  
#11 Posted : Monday, December 28, 2009 8:59:05 AM(UTC)
Rank: Member

Joined: 12/7/2009(UTC)
Posts: 375
Woman
Location: MA
Thanks Miss J and Anna -

So AlldayChemist is legit? I don't know but I'm afraid to order this stuff online...but the brick and mortar pharmacy price is really ridiculous.

Since Renova has the built in emollient and is less strong than Retin A, I thought it might be better for the chest since the Retin A made it break out.

I use the Retin A on my face and neck and haven't had any problems. I doubt it is going to help the poikiloderma on my neck though, I have read that nothing much really helps that. I have also considered asking a derm about TriLuma....

I keep reading about AHA's and BHA's and Vitamin C....is this all prescription stuff or are there products that you can buy over the counter that are good?

So even with using retinoids on the chest for a year, a peel would still be needed? So depressing....

Is IPL generally frowned upon as being dangerous? I have seen on line before and after photos that seem too good to be true. The horror stories have kept me from seriously considering IPL but most of the stuff I've read says it can really work wonders with age spots, etc on the chest area.
Offline MissJ  
#12 Posted : Monday, December 28, 2009 9:53:18 AM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 23,708
Lots of people order stuff from All Day Chemist (it's in India).

Glycolic acid creams and vitamin C serums can be purchased over the counter.

Retin A can be 'cut' with an emollient of your choice by mixing both in your hands.

Retinoids and other acids are used to prep one for a peel later down the line.

Age spots or "liver spots" ALSO respond to directly freezing them off with cyrogen spray; (liquid nitrogen directly on EACH spot).

Many derms now a days prefer to use a laser because they feel there is more patient 'demand' for that because the demand is generated by the laser industry. So, it's hard to find an 'old timer' type derm to freeze the brown spots off which is a simpler process and less expensive but the 'money is in the lasers' for them so they do that.

For IPL, try to find a doctor who will do a TEST SPOT on an area so you can see how you will respond before doing the whole thing with the laser.

The OBAGI program is pricey and is often the 'default' to do when a person does not know how to orchestrate all of the many creams and when to put them on and how much of them because they instruct you on the application protocol. Unless you know stuff like:

What concentration of retin A, when to put on the hydroquinone to help fade brown spots, how much vitamin C serum and alpha hydroxys and when to apply ect the obagi program puts all that info together FOR YOU and that's one reason it's pricey.
Offline DCNGA  
#13 Posted : Monday, December 28, 2009 9:55:36 AM(UTC)
Rank: Advanced Member

Joined: 9/18/2008(UTC)
Posts: 7,198
Woman
You have to ask yourself, "Is it worth the risk?" Everything in PS, even peels and lasers, are a question of whether or not the risk to you (your own personal feelings risk vs benefit) is worth it. For me, it's not worth it. For those for whom it turned out life-altering bad, it was not worth it. But, for those whom it worked well, I guess it was worth it.

Now ask yourself, what risk am I willing to take? If there's only 1 chance in 1000 that something might go horribly wrong, is it worth that risk? Or, if the risk is only 1 in 1000 that something might go just a bit wrong, is it worth that risk to you?

Only you can answer these questions based on the amount of risk you are willing to take.

I will say that of the ladies I've corresponded with over the years all say they wish that had that moment back where they were trying to decide whether or not the risk was worth it. For every single one of them, they wish they had not taken the risk.
Offline rm1961  
#14 Posted : Friday, January 01, 2010 11:15:33 AM(UTC)
Rank: Member

Joined: 12/7/2009(UTC)
Posts: 375
Woman
Location: MA
MissJ wrote:
Lots of people order stuff from All Day Chemist (it's in India).

Glycolic acid creams and vitamin C serums can be purchased over the counter.

Retin A can be 'cut' with an emollient of your choice by mixing both in your hands.

Retinoids and other acids are used to prep one for a peel later down the line.

Age spots or "liver spots" ALSO respond to directly freezing them off with cyrogen spray; (liquid nitrogen directly on EACH spot).

Many derms now a days prefer to use a laser because they feel there is more patient 'demand' for that because the demand is generated by the laser industry. So, it's hard to find an 'old timer' type derm to freeze the brown spots off which is a simpler process and less expensive but the 'money is in the lasers' for them so they do that.

For IPL, try to find a doctor who will do a TEST SPOT on an area so you can see how you will respond before doing the whole thing with the laser.

The OBAGI program is pricey and is often the 'default' to do when a person does not know how to orchestrate all of the many creams and when to put them on and how much of them because they instruct you on the application protocol. Unless you know stuff like:

What concentration of retin A, when to put on the hydroquinone to help fade brown spots, how much vitamin C serum and alpha hydroxys and when to apply ect the obagi program puts all that info together FOR YOU and that's one reason it's pricey.


Thank you. Can you suggest specific brand names I might look for in the glycolic acid creams and vitamin C serums?

I have had age/liver spots frozen off by a derm I saw last year. I was impressed as I had been to two derms at Mass General and neither one even suggested this, and then I visited a dermatologist in the suburbs who promptly got rid of four very ugly raised keratoses I had, two on my back, one on my chest and one on my stomach with the liquid nitrogen. I was SO happy with the results of this. But I think she will only use the spray on these raised, crusty brown spots and not on flat brown spots.

Thanks for the information on Obagi. I know it is quite expensive. I was told by the derm at MGH that bleaching with hydroquinone does not work.

I'm still afraid of IPL. I'm hoping in a few years they will improve light therapy so it is less risky. I'm quite convinced my swimmer's tan is permanent and the only thing I can do is strict sun avoidance and use the retinoids on my face and chest and hope for the best. I'm sure I will have more keratoses appear with my Irish skin (and with the experience of my sister who is 57 and has had WAY less sun exposure than I have) so I will go back to the derm to have them frozen off.

Thanks again.

Offline 4beauty  
#15 Posted : Monday, January 18, 2010 4:15:54 PM(UTC)
Rank: Newbie

Joined: 7/4/2008(UTC)
Posts: 77
Location: Boston
I've had quite a few IPL treatments--for me they worked wonders--but my facial complexion and skin tone is ideal for it, I believe--I have brown hair, blue eyes, and fair skin that never ever tans, but only burns--which means I have little pigment in my face, which means those sun spots were easy for the light laser to target. At least that's why I think it worked.

Since those treatments, I have been an absolute zealot about suncreen--so that my face has gotten progressively 'whiter' over the years. I've read on some boards about how the damage returns, but it didn't with me, and I wonder if it was because of the sunscreen. I often go out in the midday sun, btw, and never wear a hat. So I don't really do sun avoidance.

Add me to the legion of fans who have used Alldaychemist with perfectly satisfactory results. Got the hydroquinone, the retin-a, and the lumigran last-growing stuff rom them. All good, all at good prices . .
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