Please see the first post on contour, if that’s more your issue.  This post addresses sun damage, and crepey skin primarily.

Let’s do an analysis first though.  Please go find your mirror and put on a tank top.  Let’s look honestly at what we have.  First we need to decide, is this a problem with fat that’s under the skin and over the muscle?  Is this really just mostly loose skin?  Or, are the skin and fat pretty good, but our bicep and tricep muscles need exercise?

Look also at your forearms and hands, is the skin quality pretty good?  Maybe you have precancerous spots (actininc keratoses) or skin cancers that need to be treated first.  Have you had your skin exam with your dermatologist or primary care doc in the past year?  Please make sure you see your dermatologist if there’s any question in your mind about a skin cancer!!

What to do about the quality (brown spots, fine wrinkles, etc) of the skin on the arms:

1.  Start with Topicals.

You can’t correct everything this way, but you can get a good start.  And… will help you prevent more damage in the future as you are spending time and money on fixing this.

  • Every time you are outside, you need either long sleeves, or a high zinc sunscreen (10-20% zinc).  Zinc is the only sunscreen ingredient that blocks most of the UVA.
  • Exfoliate once or twice a week.  You can do this with a scrub or with glycolic lotion (10-20%).  Use in the morning under your sunscreen.  Gets rid of dead skin, and helps other treatments penetrate better.
  • At least 2-3 nights a week, add in a retinol (OTC) or tretinoin (prescription) cream.  You can dilute it with moistuizer 1:1 to make it go farther.

2.  Build collagen

  • Use your topicals.  They will help.
  • Sculptra can be used at a body dilution (FDA off-label) on the forearm skin.  Experts only please.  The upper arm can build skin collagen using RF deep microneedling like Profound and Infini.  Experts only and off-label.
  • Collagen peptide supplements are not recommended.  They are made from cow hide, and are essentially a protein supplement.  Better is a high quality whey based protein supplement if you think you need one (like Biogen’s).
  • Radiesse.  Some very advanced practitioners are using a body dilution Radiesse (FDA off-label).  Experts only please!

3. Consider Lasers & Devices

  • Fraxel Dual works well on arm skin because one wavelength helps with brown (1927 nm) and the other (1550nm) helps with texture.
  • IPLs work very well on the hands, but not on the arms. They don’t tend to be as effective for brown here, and often leave “striping.”   Vbeams don’t work for brown pigment.
  • Thermage, Exilis, Peleve, Ultherapy, etc. are minimally effective on the arms.  You will get mild tightening usually, but it’s not dramatic.
  • Co2 laser (fractionated) could also be an option, if one of your goals is to also reduce your skin cancer risk.

If you have a lot of loose skin, plastic surgery may still be your best option.

Hope this helps,

Dr. Brandith Irwin





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