How do the lasers work on pigmented lesions?

Some lasers are excellent for the removal of these pigmented lesions because their wavelengths are attracted by melanin. The laser energy seeks out that specific chromophore (melanin) and, it is preferentially absorbed by those cells that have higher concentrations of melanin, but not well absorbed by normal skin cells. The result is the destruction of the melanin-containing cells, but not the normal skin cells. If your skin is sun-tanned, it is better to wait a few weeks for the tan to "wear-off" before any laser treatments because the tan will absorb some of the laser energy and may increase the chances of skin irritation or blistering.

How many treatments will I need?

Depending on the size and numbers of freckles and age spots, treatments usually range from 15 to 45 minutes.

Are the treatments painful?

There may be mild discomfort from the laser energy on the skin, and some people do require topical anesthetic creams to make the skin laser treatments more comfortable. Ice packs to the areas treated will also help decrease any discomfort.

What to expect after the treatment?

Right after the skin laser treatment, your skin may feel hot (like a sunburn), and it may be red and slightly swollen. The redness and swelling will fade away in a day or two without any particular treatment for it. This is normal after almost any skin laser treatment.

There may be pinpoint bleeding and superficial bruising on parts of the treated areas, and these will resolve over the next several days. There is also the chance of having superficial blisters or crusting over the treated areas a few days after the laser treatment, and these will also fade and heal in 5-7 days. Your skin should return to normal after 1-2 weeks.

Keep in mind that if you take aspirin or ibuprofen, Vitamin E, or any other medication or natural supplement that inhibits or diminishes the coagulation of your blood, your bruising may be more significant after the laser treatment. If you do take any of these substances, tell your physician about it before the treatment.

Do not expose your skin to the sun after the treatment. The skin will be more sensitive to the sun for many weeks after and you need to be aware that sun screens are a must to protect the skin from possible hypo/hyperpigmentation.

How many treatments are required?

How well your lesions respond to the laser treatments depends on several factors. Superficial lesions such as freckles and age spots tend to respond more quickly as compared to deeper, more complex lesions. In the majority of patients with simple age spots or freckles, one treatment usually suffices. Deeper and more complex pigmented lesions such as pigmented nevi, melasma, and others, may require two or more treatments. No one can truly “promise” that a certain number of treatments is all that is required. Laser treatment will not prevent the development of new pigmented blemishes. You can reduce the rate at which new pigmented blemishes appear by using sunscreen and by protecting your skin from the sun.

How long should I wait between treatments?

It is best to wait at least 6-8 weeks between treatments so that the maximum amount of fading can take place.

Will the freckles and age spots disappear completely with laser treatments?

Yes. In most cases of simple freckles and age spots, they will disappear completely with the right lasers and the right number of treatments. New ones may appear if you continue to suntan your skin, and if you do not follow the post-treatment instructions given to you by your physician. Other, more complex pigmented lesions may be more difficult to remove with lasers, or they have an inherent tendency to reappear, such as melasma. But laser treatments, along with particular bleaching creams, are the best way to either make them fade away to an almost unnoticeable level, or to get rid of them altogether.

What are the risks of treatment?

In most cases, the laser treatment leads to satisfactory fading or complete removal of the freckles and age spots without significant side effects.

  • The most common problem is incomplete removal of brown spots or of deeper pigmented nevi. Some spots are relatively resistant, although there is almost always a worthwhile amount of improvement.
  • Scarring is very rare.
  • Infection is also very rare and is usually prevented or treated by using antibiotic ointments like Polysporin. Loss of pigment from normal skin is rare and usually minimal.
  • You can reduce the chance of irregular tanning - and reduce the chance that the freckles and age spots will come back -- by protecting the treated area from sun exposure.
  • Hypopigmentation (lightening of the skin) or hyperpigmentation (darkening of the skin) are infrequent, and are almost always temporary.

Is laser treatment of freckles, age spots and pigmented lesions covered by insurance?

Laser treatment of freckles, age spots and pigmented lesions is not covered by insurance, but it is often a tax-deductible medical expense.