1 ) Use a concealer (like Maybelline) for a masking effect before applying sunless tanner, then using rolled up wet tissue to remove sunless tanner from spots and you'll be very impressed with the results! Apply a LOT of concealer covering DSAP spots, then apply sunless tanner. Some of the concealer will inevitably come off as you carefully rub in the sunless tanner, BUT it still helps to mask DSAP spots. Immediately used some wet, rolled up tissue to dab and wipe off sunless tanner on spots because sunless tanner seems to come right off on contact with water. Then wait at least 6 hours or longer and then wash off, and rub in some Apricot Kernel oil to get all of the residual concealer off. You can then re-apply concealer and adjust with tissue if needed. You'll be looking relatively normal! It works best to apply concealer before going to bed. By the 2nd, 3rd or 4th day the concealer kind of "seeps in" to your skin and thus you can even rub in some sunscreeen without the concealer coming off.
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-85 if you go outside on sunny days, but avoid direct sunlight as much as possible.
3) DesOwen Cream (generic name: Desonide Solution) DesOwen is a form of steroid. 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 avoid the sun (or at least use full protection) and NOT wait for more trouble! 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.
4) Sunless tanning creams? From my experience the characteristic outer borders of DSAP spots absorb MORE of the cream and retains it longer, thus making DSAP spots stand out a bit. But (as mentioned above) the combination of sunless tanner and concealer makeup on DSAP spots can actually have you looking pretty good. By the way there is only one common active ingredient that is FDA approved for sunless tanners. So don't bother paying more for some silly exotic brands. They all use the same active ingredient.