Note that both freckles and the lentigines are classified as brown spot, a type of skin pigmentation, giving rise to uneven skin tone. Therefore, they have nearly identical treatment modality.
What is described here can be employed for other pigmentation treatment.
Freckle Treatment: Sunscreens must have high SPF, sun protection factor, minimum SPF 50+,
good broad spectrum sunscreen cover against ultraviolet radiation (UVA), and
should be applied liberally and
applied every 4 hourly, applied frequently. NOTE: Sunscreen is the only weapon in the arsenal for protection during sunbathing, as fully exposed skin can be shielded from harmful UVA rays.
Prevention of brown marks/freckles/lentigines
Not all brown marks/freckle/lenginies can be prevented. General prevention includes:
- Careful sun protection will reduce the number of new solar lentigines.
- Staying out of the sun under the shade or use umbrella, long sleeve, and
- Using sun protective clothing is much more effective than sunscreens alone.
- Sunscreens must have high SPF, sun protection factor, minimum SPF 50+,
- good broad spectrum sunscreen cover against ultraviolet radiation (UVA), and
- should be applied liberally and
- applied every 4 hourly, applied frequently.
Treatment of brown marks modalities are;
Laser 1064 nm.
• Carbon dioxide laser and
• Erbium:YAG lasers.
• A fractional laser
Intense pulsed light
Treatment of brown marks
Brown marks may fade with careful sun protection, broad spectrum sunscreen applied daily for 9 months of the year.
Regular applications of anti-aging or fading creams may also help. These lightening may contain:
- alpha hydroxy acids
- azelaic acid.
However, brown marks may be removed more rapidly and effectively by
- chemical peels,
- cryotherapy or
- certain pigment lasers that target melanin in the skin. Multiple treatments may be necessary.
Laser 532 nm
Suitable green-light laser devices include:
- Flashlamp-pulsed tunable dye laser
- Frequency doubled Q-switched Nd:YAG laser (neodynium:yttrium-aluminium-garnet)
- KTP laser
- Krypton laser
- Copper bromide laser
Laser 1064 nm
Suitable Infra-red light laser devices include:
- Q-switched Alexandrite laser
- Q-switched Ruby laser
- Q-switched Nd:Yag laser
- Carbon dioxide laser and
- Erbium:YAG lasers. Both CO2 laser and Erbian laser vaporise the surface skin thus removing the pigmented lesions.
- A fractional laser may also be effective.
With superficial resurfacing techniques, there is minimal discomfort and no down-time but several treatments are often necessary.
Intense pulsed light, IPL
IPL treatment is highly effective for fairer skin type, type 2 and below. Normally a single treatment is sufficient. However, for skin type 3 and more, there is always a lot of problems, such as PIH.
IPL is very effective for the freckle and lentigines treatment. This is because both the lesions are of very superficial origin. IPL employs a broad spectrum of light wavelength to treat.
Result, Side effects of laser & IPL treatment
- Results are variable but
- sometimes very impressive with
- minimal risk of scarring.
- Unfortunately the treatment occasionally makes the pigmentation worse ending up with post inflammatory hyper pigmentation, PIH.
Post treatment observation
Continued careful sun protection is essential, because the pigmentation is likely to recur next summer.