Like the bumper stickers that say "I'd rather be sailing," the brown spots that show up on our faces declare our love for the outdoors--just not in the way we want. Depending on the frequency of sunburns suffered in youth, it can take 5 to 10 years for brown spots to appear in someone with very fair skin and 20 to 30 years in someone with a darker complexion. Sun damage also rears its ugly head in the form of broken blood vessels, thin skin, a yellowish cast, wrinkles, and scaly little precancerous bumps, says Bruce E. Katz, M.D., the director of the Cosmetic Surgery & Laser Clinic at Mount Sinai School of Medicine in New York City and the owner of that city's Juva MediSpa.

The many marks of sun damage explain the surfeit of skin-brightening treatments offered at spas, from sessions with laserlike devices that may nip skin cancer in the bud to pampering facials laced with seriously strong medicine. In the past ten years, the technology has developed to the point where brown spots or broken blood vessels can be removed with very little downtime, says Dr. Katz, adding that traditional tools like electric needles and curettes (for scraping) "are fading into the past." Even that old standby liquid nitrogen, which is still used to freeze off the occasional precancer, is being left on the shelf when it comes to brown spots. "We get a much better result with a laser, which doesn't leave a white mark in its wake the way liquid nitrogen did," he says.

Here are three of the newest ways that spas are helping refresh complexions that have had too much sun. They run the gamut from instant gratification (well, after a week's worth of redness) to downright leisurely (using an at-home regimen of cosmeceuticals prescribed with the help of a digital camera that reveals sun damage beneath the skin). Your choice depends on how quickly you want to see results (read: your tolerance for discomfort, as the fastest effects come from the least comfortable treatments), but all hold out the promise of fading almost everything.

Seeing the Light

If someone said you could get rid of brown spots, blotchy pigmentation, and scaly precancers called actinic keratoses in one fell swoop, you might be tempted to say, Sign me up. And you can--but there are downsides. According to Dr. Katz, Photo-Dynamic Therapy, or PDT, is a treatment that accomplishes in one session what photofacials take three or four to do (i.e., zap brown and red sun damage), while also reducing keratoses, pimples, and facial hair. What's not to love? We'll get to that.

Some doctors are calling PDT the wave of the future for its ability to treat keratoses that are not yet visible to the naked eye. Usually performed by a nurse in a medical spa, PDT involves the application of a clear solution called Levulan (the trade name of aminolevulinic acid), a chemical that, when activated by certain wavelengths of light, is readily absorbed by abnormally fast-growing cells and obliterates them. (Fast-growing cells include not only the precancerous kind but also harmless ones in some oil glands and hair follicles, which explains why Levulan lessens the glands' and follicles' output.)

Next come flashes of intense pulsed light (IPL) at a painlessly low setting, just enough to activate the Levulan. About 20 minutes later, after your face has been "beeped" and flashed all over with the three-inch hand piece, you go home with detailed instructions and dire warnings to avoid the sun for 24 hours. (You even have to sign a consent form saying you'll stay out of the sun.) That's because the Levulan, though washed off, remains active and can cause a serious burn if exposed to light. Friday afternoons are a popular appointment time for those who work outside the home, so they can hide inside on Saturday.

Hide is the operative word, since your skin will be red and swollen. As for pain, reactions vary. I'm pale-skinned, and I spent the day icing my face with a bag of frozen peas, but a friend who has a darker olive complexion didn't have any pain from her PDT. The redness diminishes daily, the top layer of skin flakes away (that is, if you don't try to peel it off, as I stupidly did), and within a week you'll see a diminishment of brown spots, broken capillaries, fine lines, pore size, and--oh yes!--those keratoses, for which this treatment is sometimes covered by insurance.

Now the only problem is, the glow on my face doesn't jibe with the leathery look of my arms and chest. Just wait, says Mitchel P. Goldman, M.D., the medical director of La Jolla Spa MD. "I predict that in my lifetime, we'll invent an IPL device large enough to cover the whole body, and we'll apply Levulan all over and zap the precancers away," he says. In the meantime, the treatment is on the verge of becoming mainstream. "Some experts think an occasional Levulan PDT treatment may reduce the incidence of skin cancers in general," says Norman Leaf, M.D., an assistant clinical professor of plastic surgery at the University of California-Los Angeles and the director of Leaf & Rusher Skincare Medical Clinic in Beverly Hills.