Freckles are the most common form of brown pigmentation on the skin. These represent an area where a higher concentration of melanin is produced, usually in response to sun damage and are therefore mostly found in sun exposed areas especially face, hands and arms.
This laser, like most, produces a hot flick as it fires but as most freckles are small it is very quick, and most patients do not need local anaesthetic. Afterwards they feel a bit hot and stingy for an hour or two and it is essential to wear sunscreen straight away and for another 4-6 weeks after as that area of skin is even more sensitive to the effects of sun for that time.
Over the next hours, the freckle will become darker as it begins to develop a crust/scab. This is normal and depending where on the body the lesion is, will last 1-2 weeks before coming off and leaving a slightly pink area of skin underneath that gradually goes back to skin color usually by a month. This is a good time for a follow up to check everything has healed well or to redo any that haven’t quite gone .
It is important to note that freckles have occurred because of sun damage so they can recur over time, especially if you are not meticulous with sunscreen. Simple freckles can be retreated over the years if need be.
These lesions are incredibly common and may present as pigmented or skin-coloured lesions anywhere on the body, especially on the hands, chest and sides of the face, also very frequently under the breasts and on the back.
They are usually well-defined round or oval spots that have a dull waxy appearance and as they are often itchy, can be easily irritated and become scaly. They are benign and do not have to be treated. There is no Medicare rebate for the treatment of these lesions. However, they can be unsightly, large or itchy and can be treated with liquid nitrogen or an ablative laser.
Ablative lasers target water in these lesions and when water evaporates out with the laser shot, it leaves the lesion a bit fragile and unsupported so it can be wiped off gradually back to skin level, leaving a raw patch that will be a bit oozy for a few hours, may or may not bleed and will also crust over and look darker for a week or two. They can get wet in the shower but treat gently by patting dry, adding an emollient type of moisturiser like PawPaw cream or QV Body Intensive Moisturiser morning and night to keep the scab from drying out. Using a pH balanced soap or bath oils can help prevent these occurring.
Flat brown birth marks such as café au lait spots can be treated with the Revlite laser, but this may involve more treatments and is not always successful, each case needs to be looked at individually and discussed.
This is a complex type of pigmentation often seen in pregnancy or with the oral contraceptive pill that is aggravated by sun exposure and has a hormonal and genetic influence. It may occur on the upper lip, around the eyes and forehead. It tends to be patchy and irregular in appearance.
Treatments are predominantly non laser based and meticulous sunscreen is often as effective as other expensive products. Some kind of skin bleach such as hydroquinone in a lightening cream used at night can be helpful. It is good to use these creams in short bursts eg: after summer, there can be side effects from prolonged use.
Exfoliation helps to decrease the intensity and this can be done with products ( AHA’s ), microdermabrasion and peels (enzyme activations)
Superficial lasers such as IPL or Intense pulse light should NOT be used on melasma as the heat is too shallow and can cause hyperpigmentation or darkening of the pigment.