Laser Treatment for Brown Spots
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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