Freckle removal: laser, BBL and other treatments

Freckles and solar lentigines are benign patches of pigmentation that commonly develop after sun exposure. True freckles are usually small, lighter spots that may become more noticeable in summer, while solar lentigines are larger, persistent spots often called age spots, liver spots or sun spots. Both may be treated for cosmetic reasons.

How to get rid of freckles

Freckles develop when the skin produces additional pigment in response to ultraviolet light. They are particularly common in fair skin and may fade when sun exposure decreases. Larger, more persistent pigmented spots that develop over time are usually solar lentigines rather than true freckles.

Multiple freckle removal treatments are available, including laser treatment, IPL (intense pulsed light), retinoids and chemical peels. 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 during a skin cancer check by a doctor experienced in skin cancer detection before having it treated.

After treatment for freckles or pigmentation reduction, it’s important to minimise sun exposure, as pigmentation can return with ultraviolet light.

Freckle removal treatments: laser, IPL and other options

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 means that while a laser can perform one task extremely well, any given laser may 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 may be 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.

Effective treatment may require several sessions. The appropriate treatment depends on the type, depth and extent of the pigmentation, as well as your skin type. If the pigmentation has already been medically assessed, book a skin treatment assessment with a nurse. If the diagnosis is uncertain, book a skin condition assessment with a doctor.

Using retinoids to remove freckles

Retinoids are a form of vitamin A used to treat sun-damaged skin and improve pigmentation. They have been shown to reduce pigmentation, redness and fine wrinkles. Due to their effect on stimulating collagen production, retinoids can improve the texture and thickness of sun-damaged skin.

The most powerful, effective and best value-for-money topical retinoids are only available with a prescription from a doctor. Prescription retinoids are sometimes combined with other topical agents to improve pigmentation outcomes. Your doctor can advise on the most appropriate combination for your skin type. 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.

Concerned about a spot on your skin?

Freckles are very common and usually harmless. However, some pigmented spots that look like freckles can occasionally be early skin cancers or areas of sun damage.

If you notice a spot that is new, changing, bleeding, or different from other freckles on your skin, it is sensible to have it checked by a doctor experienced in skin cancer detection.

At Spot Check Clinic, our doctors examine freckles and other pigmented lesions using dermoscopy, a magnified examination technique that helps distinguish harmless freckles from other skin conditions.

Should a freckle be checked by a doctor?

Some pigmented spots that look like freckles can be skin cancers or solar keratoses. Before having freckles removed, it is sensible to have the area examined by a doctor experienced in skin cancer detection.

At Spot Check Clinic we assess freckles and other pigmented spots using dermoscopy before recommending treatment.

At our Melbourne CBD clinic we commonly treat freckles using BBL broadband light, laser and other medical treatments depending on the type of pigmentation present.

If you are considering freckle removal or would like a doctor to assess a pigmented spot, you can book one of the following appointments:

• Skin treatment assessment with nurse
• Skin condition assessment with a doctor

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.