Freckle removal treatment: What are the options for freckle removal?

Freckles, also known as lentigines (or a lentigo if there’s just one), are patches of pigmentation on the skin, usually caused by long-term exposure to the sun. They aren’t dangerous and don’t require medical treatment, but some people want freckle removal treatment for cosmetic reasons.

How to get rid of freckles

Freckles appear when the skin produces pigmentation in response to ultraviolet light. It’s common for fair-skinned people to have multiple pale tan freckles when they are young. With increasing age and sun exposure, larger and darker freckles appear. These are often called “age spots”, “liver spots” or “sun spots”. They tend to appear in areas that receive lots of sunlight, such as the face, hands and chest/décolletage. The correct name for this type of freckle is lentigo/lentigines. The name “sun spots” sometimes refers to a different skin condition (solar keratoses). In this article, when we mention the term “sun spot” we are usually referring to a lentigo-type freckle.

Multiple treatments are available for getting rid of freckles. All the most effective treatments require a consultation at a medical or cosmetic skin clinic.

Some skin cancers can resemble freckles. If you have a freckle that’s changing, or in some way different from other spots on your skin, you should have it examined by an experienced skin cancer doctor or nurse before having it treated. After treatments for freckles or pigmentation reduction, it’s important to keep your skin out of the sun since pigmentation can return with exposure to light.

Different types of freckle treatments

There are several effective treatments for fading freckles. Each has advantages and disadvantages and should be considered with your specific requirements and preferences in mind.

Laser freckle removal

Laser treatment involves shining a high powered light on the skin. Depending on the wavelength of the light, it is absorbed by skin structures of different colours, generally red (blood vessels) or brown(freckles and other pigmentation).

Lasers are extremely effective at removing freckles. They use a single wavelength of light, optimised for a specific function. This meanwhile a laser can do one job extremely well, any given laser might not be as effective for other purposes. For example, a hair removal laser often might not be able to perform laser freckle removal or laser pigmentation removal.

The difference between laser and other light-based treatments such as IPL (intense pulsed light) and BBL broadband light) is that IPL and BBL use a wider range of frequencies during treatment. Even though laser and IPL are different treatments technically, for convenience we often refer to any light-based treatment as “laser treatment”.

IPL laser treatment

IPL (intense pulsed light) is similar to laser, but a wider range of wavelengths (colours) of light is used. This means an IPL device maybe able to treat other problems while it is treating freckles. For example, most people with sun-damaged skin have both freckles and redness or prominent blood vessels. IPL laser treatment can manage both problems in the same treatment session.

IPL treatments are typically not as intense as traditional laser, so there may be less pain, redness, inflammation and downtime after treatment.

BBL and laser treatment

Broadband light (BBL) is the form of intense pulsed light we use at Spot Check Clinic. The benefits of BBL treatment include:

• Multiple different treatment settings: more than one issue can be treated in one session, e.g. blood vessels as well as pigmentation or freckles.
• Large areas of freckles or other sun damage can be treated quickly and comfortably using the “in motion” technique. The dermal therapist or nurse gently glides the treatment handpiece over the skin rather than repeatedly “stamping” the skin.
• Other treatment benefits are frequently seen: these include reduction of wrinkles, smoother skin and a generally younger appearance.

BBL treatment is effective for many skin conditions

At Spot Check Clinic, we have successfully used BBL for:

• Flattening raised scars.
• Tightening loose skin, e.g. under the eyes and on the neck.
• Hair removal: BBL has substantial advantages over traditional hair removal laser due to its “in motion” capability. Large areas can be treated with much less pain than traditional laser.
• Rosacea, a condition of inflammation and enlarged blood vessels in the facial skin.
• Acne.

Effectively removing freckles usually requires a course of several treatment sessions.

Using retinoids to remove freckles

Retinoids are a form of vitamin A which have powerful anti-ageing effects. They have been shown to reduce pigmentation, redness and fine wrinkles. Due to their effect on stimulating collagen production, retinoids can make ageing and sun-damaged skin smoother and thicker.

The most powerful, effective and best value-for-money topical retinoids are only available with a prescription from a doctor. Prescription retinoid is often combined with hydroquinone, often found in skin-lightening products. If used over several months, this combination has been shown to lighten freckles.

“The most powerful, effective and best value-for-money topical retinoids are only available with a prescription from a doctor.”

This treatment has the advantage of being less expensive and less uncomfortable than laser freckle removal. However, some people experience skin redness and sensitivity from topical prescription retinoids and can’t tolerate this treatment.

Chemical peels as a freckle treatment

Chemical peels can be used to treat freckles, and some types of peel are especially useful if there are also “sun spots”, known as solar keratoses by doctors. These are small patches of pre-cancerous sun damage.

Chemical treatments used at Spot Check Clinic include:

• Prescription cream: Used twice daily for 4-6 days (depending on the area and the condition being treated).
• Photodynamic therapy: A cream is applied in the clinic and left on the skin for 2-3 hours. It is then activated using LED red light or BBL.

Both treatments cause redness, pain, and sometimes swelling, blistering and sores in the treated area. This takes 2-3 weeks to settle.

Due to the significant discomfort after treatment, we usually reserve these treatments for people with substantial pre-cancerous sun damage or certain types of skin cancer. These are often present in the same area as freckles.

Chemical peel treatments used at Spot Check Clinic have a skin rejuvenation effect. In most cases, the skin is much smoother and clearer following treatment.

When the 4-day prescription cream is used, the treated area is less likely to develop certain types of skin cancer for 2-3 years.

Cryotherapy for sun spot removal

Individual sun spots (either freckles or solar keratoses) can be removed by cryotherapy (freezing with liquid nitrogen). This inexpensive treatment can be performed quickly during a medical consultation.

There is a risk of lighter or darker pigmentation following treatment, so it’s usually best to treat one or two freckles away from the face as a test before treating multiple freckles or large freckles on the face.

Before you choose, remember:

• Some skin cancers resemble freckles, so you should have freckles checked by an experienced skin cancer doctor or nurse before having them removed. Most laser skin clinics in Australia can’t offer this service.
• A combination of treatments is usually more effective than a single treatment. If you have BBL treatment for freckles at Spot Check Clinic, we will discuss ongoing skin maintenance, which may include a range of topical products, including a prescription retinoid.
• Ongoing skin care and reducing exposure to sunlight is essential to reduce the risk of future freckles and skin cancers.
• Freckles are a normal and harmless result of sun exposure. If you don’t mind your appearance with freckles, there’s no need to have them treated.