Dr. Sonia , many woman of all skin types are concerned  about age spots, and dark patches on their skin from sun damage.

Q- What is the first line of defense in preventing age spots and sun damage?

The most important line of defense is prevention through the daily use of broad spectrum sunscreen, wearing protective clothing, and avoiding peak sun exposure between 10am-4pm.

Q- Many people especially in the Bay Area lead very active outdoor lives. What would you recommend as an effective skin care routine to keep their skin looking  healthy and youthful?

The most basic and effective skin care routine involves application of sunscreen every single day (rain or shine!). I prefer SPF 30 or higher with micronized zinc or titanium dioxide for the best protection. In addition, an evening routine using a vitamin A cream such as retinol or retin A will help prevent future lines, wrinkles, and improve age spots and texture. Alpha hydroxy acids, which include glycolic acid also play a role in an antiaging regimen.

Q- At what age would you recommend starting a good skin care routine?

Teenage years are a great time to start instilling basic skin care including a cleanser, moisturizer, and sunscreen. This will instill healthy skin care habits in the future.

Q- Are certain skin types more prone to sun damage /and or age spots  than others and does heredity also play in role?

Absoultely–Fair skinned individuals, especially those with red-hair and blonde hair and light eye color, those who burn easily when outdoors, and ones with a family history of sun damage and skin cancers are more likely to get photodamage and are at increased risk of skin cancers.

Q- What is the difference between Melasma and age spots?

Age spots are focal lesions found on sun exposed areas, especially the face, neck, declotee, and hands due to cumulative sun exposure. The driver side or areas that have been previously sunburned tends to show the most amount of sun spots. Age spots are more common in fair skinned individuals. Melasma, also called the mask of pregnancy tends to occur due to pregnancy, oral contraceptive use, and/or sun exposure. Melasma is very common in ethnic skin.

Q- What are  some  of the most effective  treatments for  treating  Melasma, and age spots?

There are several options to treat melasma and age spots depending on the condition, skin type, and severity of the condition. In general combination treatments tend to be more effective when combined with sun avoidance and/or sun protection. Skin lighteners and brighteners containing hydroquinone, kojic acid, arbutin, vitamin C, niacinamide, tretinoin, and soy can help lighten these dark spots. In addition, superficial and deep chemical peels, microdermabrasion, and a variety of different lasers can target pigment producing cells and slough the melanin off the epidermal skin layer. My popular choices include skin resurfacing for fair skin and a skin lightening peel for ethnic skin.

Q- Once you have undergone a treatment (s) and your skin has improved, what is the maintenance  program you would recommend.

Maintenance and prevention are very important. Sun avoidance and sun protection cannot be overemphasized. I prefer my patients use SPF 30 with micronized zinc or titanium dioxide every single day. A combination of skin lightening and brightening agents are used for home care. Additionally, regular use of light chemical peels and microdermabrasion can be helpful for deeper exfoliation to prevent new dark spots and unevenness in skin color.

Sonia Badreshia-Bansal, MD, FAAD, is a Board Certified Dermatologist, practicing in Danville, CA. She is also a Fellow, American Academy of Dermatology and UCSF Clinical Instructor.  Dr Badreshia-Bansal regularly contributes to mainstream media and has been quoted in Allure, Real Simple, Prevention, Self, Family Circle, The Los Angeles Times, The Washington Times, and Rivaaj Indian Life and Style. You may also recognize her from the Dove’s “Next Real Woman” national ad campaign featured in the December 2007 issue of Self Magazine. “National Geographic, WebMD, AOL Health” in “Allure, Real Simple, Prevention, Self, Family Circle, The Los Angeles Times, The Washington Times, and Rivaaj Indian Life and Style.”

You can contact her at Elite MD, http://elitemdspa.com 925-735-SKIN