COSMETIC SOLUTIONS:

1 ) Use a concealer (like Maybelline) for a masking effect before applying a sunless tanner. Be careful about spreading the sunless tanner on. Get too aggressive and you'll rub off too much of the concealer. After about a minute or two, once the sunless tanner dries, then you can get more aggressive about trying to rub off some of the concealer. For best results, wait over night, wash off with water, then use apricot kernel oil to rub off the residual concealer.

It takes a little practice but you'll be looking pretty normal! Combine with sun avoidance and people won't even know that you have this condition.

If you find that some DSAP spots absorb the sunless tanner, then next time you might try rolling up pieces of tissue, dab them in water and do your best to remove sunless tanner from DSAP spots.

2) Avoid the sun! Even if you're driving in your car you should wear sunscreen, and throw a shirt over skin that may be directly exposed to the sun. I've read that wearing a long sleeve shirt is only considered to be about the equivalent of wearing SPF - 30 sunscreen. I suggest wearing Neutrogena SPF-100 if you go outside on sunny days, but avoid direct sunlight as much as possible.

3) Here's a product that temporarily covers up tattoos that could be used to cover up DSAP.

4) DesOwen Cream (generic name: Desonide Solution) DesOwen is a form of steroid. I DO NOT recommend using this drug for cosmetic effect. For post-flouruoracil treatment I was given DesOwen Cream to supposedly speed up healing. But I held on to it for cosmetic purposes. This DesOwen seems to perhaps inhibit blood circulation(?) and thus cause redness to go away. Too bad it's only temporary, and it has a sort of reflex action (when it wears off). A few days after cessation of use (perhaps 2 or 3 days and continuing for about a week) the spots where DesOwen was applied will actually look redder than normal. This reflex action makes DesOwen only worth using on rare occasions. I have noticed that this DesOwen stuff has diminishing effectiveness if you try to use it continuously. Each time I use DesOwen it has less effect and takes longer and more applications to hide the hyper pigmentation of DSAP. By the 3rd or 4th time I use DesOwen (every other day) it doesn't seem to really be WORTH using anymore. But I nevertheless hold on to this Desnowen stuff to use when I REALLY need to wear short sleeves (at night or INDOORS of course!). I only use DesOwen once in a long while when I absolutely need to look normal. I apply it about 15 hours before I need to wear short sheeves, then again about 7 hours and 4 hours before. The result is that I look totally normal for a night - and sometimes 2 nights! If you wish ask your doctor for a prescription. If he says "no" then try another doctor or maybe attempt to order online if possible.

Keep in mind that 15% of DSAP patients have it on the FACE. Why chance it if you have DSAP on legs and /or arms? It's worth wearing SPF-50 sun screen on your face too. If you insist on living in hot climates then consider becoming more of a night owl. ALSO: you are being exposed to ultra-violet rays from just reflective sunlight beaming into your living room! I've read that everyday healthy people actually show signs of aging from years of merely being exposed to REFLECTIVE sun light in their living rooms! So draw the shades when you're indoors too. If all of this seems extreme just consider that many dermatologists will tell you that you should be doing this ANYWAY. Before sunscreen was invented (1940's?) people HAD to wear long-sleeve shirts when outside for extended periods of time. 

I can't stress how important it is to minimizing sun exposure and wearing SPF-100! Just because it may have taken you 30 years to develop 10 DSAP spots doesn't mean that it will take 30 more years to develop 10 more spots. Your skin has reached the end of it's rope.

Your body naturally produces vitamin D when exposed to sunlight. Since you will be avoiding the sun, don't forget to compensate by taking vitamin D supplements.

Reader recommendation: "Sally Hansen Air Brush Legs (spray on panty hose) – this works MUCH better for me than self tanners. Does not sweat off during the summer months. Plus, it does not make spots darker. Apply a moisturizer, and then use the Air brush legs. I can't spray evenly, so i spray in my hands and rub it on my legs. It washes off in shower, but you have to use soap to remove it. Very little smell with this as compared to a self tanner. You can purchase this at Walgreens. I think Amazon sells a similar product, but I have not tried it. I use Cetaphil lotion every day. This is a really good moisturizing lotion. Daily use of this has really helped me, especially my legs. I use this and the Air Brush legs together during the summer."