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Aesthetics Practice Today

Laser Treatment for Brown Spots

Published January 9, 2013 11:02 AM by Mina Grasso

Brown spots may include:

  • birthmarks
  • freckles
  • brown patches
  • moles
  • hyperpigmentation (due to inflammation or trauma to the skin from acne)
  • insect bites
  • abrasions

The most common cause of brown spots or age spots on the face, chest, arms and hands is sun exposure. Melanocytes produce melanin to protect the skin from the sun's ultraviolet light; however, sun exposure can cause an excess production of melanin, leading to unwanted brown spots.

Patients frequently present in our clinic with complaints of unwanted brown spots or marks on their skin. After carefully taking a patient's history, evaluating the skin, and ruling out the need to refer to a dermatologist for suspicious lesions, a variety of brown spot treatment options can be offered. First, the most important step is prevention with broad-spectrum sunscreens.

Treatment Options

Topical bleaching agents such as hydroquinone and kojic acid, alpha hydroxyl acids and tretinoin may be helpful individually or in combination in reducing the pigment and may help in reducing the incidence of PIH (Post-Inflammatory Hyperpigmentation) as a result of treatment for the brown spots, especially in those with darker skin types. 

A range of laser and light-based technology has rapidly improved the efficacy and safety of treatment for brown spots. Laser or light based procedures that can be performed provide little to no downtime; however, several treatments may be required.

Photo-rejuvenation, also known as FotoFacial or IPL (Intense Pulse Light), is a light-based treatment used to break up melanin by reducing surface pigment gradually. Most devices now have contact cooling which makes the procedure much safer for most skin types. Laser toning using a Q-switch laser 1064 nm can break up pigment gradually, be used on all skin types and can be accomplished without giving the patient any down-time. 

The 532 nm wavelength for treating brown or age spots provides more rapid results, but requires social downtime. The laser emits the energy that is absorbed by the melanin and vaporizes the brown spot. During the procedure the lesion turns from brown to a grayish color, which develops into a small scab within a few days. After the scab comes off, the skin is pink initially and usually regains pigmentation blending with the surrounding skin. 

Healing time varies with the location of the body being treated and energy level used. On the face I have my patients expect 5-6 days of healing. The neck and chest may take 7-12 days while extremities may take 2-3 weeks. Great caution is needed when treating skin-types on the Fitzpatrick scale of 4 or greater.

There has been controversy with prepping the skin with bleaching agents and tretinoin pre- and/or post-treatment. I personally encourage pre- and post-treatment in conjunction with use of a broad-spectrum sunscreen daily post treatment. 

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    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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