By Leslie Crawford

In my sunny youth, I had nearly flawless skin. A sprinkling of faint freckles was all that sullied my fair complexion. But then something happened; something called 40. While the slide into middle age doesn’t happen overnight, it nevertheless felt like a brutal jolt when I took a bold look (no squinting allowed) in the mirror one recent morning. I saw brown spots, too large and dark to be freckles, on my face and hands. Weird little chunks of rubbery skin sprouting under my arms. And, to top it all off, a big screaming pimple on my chin.

I’d braced myself for the wrinkles that come with age but not for the other skin spoilers. Clearly, DNA coding and decades of sun exposure had finally caught up with me. Rather than accept my fate gracefully, I resolved, right there in my bathroom, to fight back.

Vain? Perhaps, but why not? The truth is we no longer have to live with many of the most common blotches and blights of age, thanks to many new dermatological advances, conventional and alternative alike. Everything from skin tags to sun spots can be removed by using minimally invasive methods. The advantage of alternative options is that some can actually prevent such problems from recurring. They’re also a lot cheaper.

So I’m tackling my blemishes one at a time, some with the help of a dermatologist and others on my own. As the following guide suggests, it isn’t all that hard to knock a few years off your beloved birthday suit if you’ve got the inclination, the time and, in a few cases, the money.

Here’s how to get started.

Age Spots

• What they are: Age spots are brown marks that range from the size of a pea to a quarter. “Our parents’ generation called them liver spots because they’re the color of cooked liver,” says San Francisco dermatologist Kathleen M. Welsh. They appear most commonly on the face, back of the hands, forearms, shoulders, and chest, and come in two basic varieties. The most common are solar lentigos, which are smooth like freckles. The second type, keratoses, are rough spots that can resemble warts; since these can be precancerous, you should get them checked by a dermatologist as soon as you notice them.

• What causes them: Years of sun exposure that darkens the skin’s pigment.

• How to prevent them: Wear protective clothing, hats, and sunscreen.

• Conventional remedies: The easiest way to get rid of age spots is to have them removed by a dermatologist. For solar lentigos, Welsh recommends laser treatments; though expensive, the procedure typically requires only one to two visits and is relatively painless. For thicker keratoses, she suggests either applying liquid nitrogen or having them removed surgically. Another method is an in-office micro-peel, which carries a very slight risk of scarring or pigmentation. You can also opt for prescription-strength alpha hydroxy acids or retinoic acids that fade the spots over time.

• Alternative remedies: Fading creams are gentler than zap...

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