It’s not enough to smoothen the bumps and creases on your skin to recapture your youthful radiance. Age spots can also make you look tired and, well, aged.
When people have this cosmetic problem, they may first try a cream or serum, often without medical advice. And that can be more harmful than good. To eliminate unwanted pigmentation effectively and safely, you need the help of a good dermatologist, especially one with laser expertise.
Do light treatments really work on age spots? And does laser age spot removal recovery take long? What can you do to keep them from coming back?
If this is the first time you’re thinking of getting a laser procedure for those unsightly marks, then this article is for you. Here, we discuss how age spots develop and the different ways doctors get rid of them. We also explain why lasers effectively remedy this skin issue and what you can do to make sure they stay gone after therapy.
What Are Age Spots?
Age spots are flat, light brown to black lesions usually appearing in sun-exposed skin areas. They are typically small, with diameters ranging from less than 1 millimeter to a few centimeters. Tiny ones are round or oval with smooth margins. But with continued sun exposure, they can grow and merge, forming lesions with irregular borders.
Age spots are also called by other names, most popular of which are “brown spots,” “liver spots” and “sun spots.” These terms either refer to their physical appearance or how they form. In medical lingo, age spots are called “solar lentigo” or “solar lentigines,” underscoring the role of sunlight in their formation.
This skin condition affects fair-skinned individuals more than those with skin of color, and it appears in middle to late adulthood. Years of UV phototherapy or tanning treatments may also increase its occurrence, even in sun-protected areas.
Age spots differ from freckles, which are more common among younger people. Freckles usually vanish after weeks to months of sun avoidance, while age spots tend to be more permanent.
You may find other signs of sun damage in the same places as these blemishes, e. g. wrinkles, spider veins, actinic keratoses, etc. These dark spots are benign, but continued UV exposure can increase their malignant transformation risk.
How Do Age Spots Form?
The skin has many types of cells, each with a different function. Two of them are involved in age spot formation:
- The keratinocytes, which are the predominant kind in the superficial skin layers. They are mainly responsible for the skin’s barrier function.
- The melanocytes, which produce the pigment melanin and pass it on to the keratinocytes.
UV energy causes oxidative stress in the skin, which promotes melanin production in the melanocyte. The pigment molecules are then distributed to the keratinocytes.
Melanin buildup in keratinocytes darkens the skin. In skin of color, pigment molecules scatter diffusely throughout the keratinocyte body. So people with this skin type tan easily. But in white skin, melanin forms a cap on top of the keratinocyte DNA. So fair-complexioned individuals form age spots rather than tan in response to UV exposure.
Melanin clustering near the keratinocyte DNA protects the latter from the rays of the sun. Chronic DNA damage leads to skin photoaging, which increases the risk of skin cancer.
Skin Cells Involved in Age Spot Formation
How UV Radiation Stimulates Melanin Production
How the Different Skin Types React to UV Exposure
How Do You Get Rid of Age Spots?
Dermatologists use topical treatments and cosmetic procedures to improve or eliminate these pigmented lesions.
Topical treatments include the following:
- Drugs that disrupt melanin production or transport. Hydroxyquinone, kojic acid, azelaic acid, tranexamic acid and niacinamide belong in this group.
- Exfoliants like glycolic acid and salicylic acid, which remove the melanin-filled outer skin layers
- Retinoids like tretinoin, which accelerate skin renewal and the sloughing off of highly pigmented cells
Meanwhile, in-office sun spot therapies include the following:
- Cryotherapy, which uses liquid nitrogen to destroy the cold-sensitive melanocytes
- Dermabrasion, which mechanically removes the skin’s darkened top layers
- Chemical peel, which uses more potent exfoliants to peel off thicker portions of skin
- Light-based surgical technologies, which stimulate skin rejuvenation using powerful light beams. Intense pulsed light (IPL) and laser treatment belong in this category.
Topical remedies require much time to apply, and it takes several weeks or months before they start to work. They are given to patients with mild to moderate pigmentation problems and those unfit for invasive treatments.
By comparison, cosmetic procedures can treat cases of varying severity in a few short sessions. But patients having in-office therapies must be in a good state of health to avoid complications.
Why Are Age Spots Best Treated with IPL or Lasers?
The main advantages of IPL and laser treatment over other therapies are their precision, effectiveness and unmatched cosmetic outcomes.
IPL and lasers are precise surgical devices. Light can destroy only the particles that absorb its energy. For that to happen, the light beams and the target must have compatible energy wavelengths.
Three light-based technologies are widely used for brown spot removal:
- Ablative lasers, e. g. CO2 and Er:YAG laser devices, which burn superficial keratinocytes, creating open wounds. The water molecules inside the keratinocytes absorb the laser light.
- Non-ablative lasers, e. g. the Vbeam laser, which injure the melanocytes and superficial blood vessels without cutting the skin surface. The light produced is absorbed by melanin or the blood pigment hemoglobin but not by other molecules.
- IPL, which uses less powerful, filtered light. It is also non-ablative, damaging melanocytes and blood vessels without producing an open lesion.
When treating age spots, the laser dermatologist sets up the equipment to selectively hit its target structures. Skin injuries are created, but only enough to stimulate inflammatory and repair mechanisms. Some melanin-containing cells are destroyed, but the healing process takes out the rest. Skin texture and elasticity improve, owing to enhanced collagen production and remodeling in the deeper skin layers.
Of the three, ablative lasers produce the most dramatic, cosmetically superior effects. Most patients need only one session. However, recovery from ablative laser resurfacing generally takes a few weeks. Some patients may even observe skin redness for months. But many are happy with the results.
By comparison, the changes are gradual after an IPL or non-ablative laser treatment. The downtime is also much shorter. Patients usually need multiple sessions to see significant improvement.
In terms of costs, laser resurfacing is generally more expensive than IPL. Safety-wise, non-ablative lasers and IPL are better for individuals with a dark skin tone.
What Should You Do to Prepare for Your Laser Age Spot Removal Procedure?
Preparing well for an IPL or laser skin resurfacing treatment is one of the many ways you can prevent complications. Your dermatologist may advise you to do the following:
- Avoid taking drugs that interfere with the blood clotting process. Some anti-inflammatory and heart medications have this effect.
- Stop therapies that can sensitize your skin to light and make you burn-prone. Examples are exfoliants and some acne treatment formulations.
- Light-based surgery can make you prone to cold sores, so your doctor may start you on antiviral meds days before your appointment.
If you are being treated for a chronic health condition, you may need medical clearance to make sure that the procedure is safe for you.
What Can You Expect During Your Laser Brown Spot Removal Session?
At the beginning of your procedure, your doctor will advise you to put on protective eyewear. They will then clean the treatment site. Pain medication is usually not necessary—light-emitting surgical devices have cooling mechanisms that can numb the skin.
For patients having IPL, cooling gel is typically applied to the treatment area before using the equipment, which must be in direct contact with the skin when light pulses are released.
The whole session may take 15 minutes to more than one hour, depending on the problem’s severity and the kind of light technology used.
What Is the Timeline of the Skin Changes After Age Spot Treatment by Light Therapy?
During the first few days after surgery, you will observe some redness, swelling and discomfort on the treated area. These are normal inflammatory symptoms that will resolve on their own.
Wounds created by ablative laser skin resurfacing procedures will scab within a week. The crust will fall off spontaneously by the second or third week. Outer skin renewal (re-epithelialization) should be complete after this period.
Collagen production starts as soon as the inflammation subsides, peaking in the third month after your procedure. With continued collagen formation and remodeling, your skin’s transformation can keep going for several months to a year.
What Are the Side Effects of Laser Therapy for Brown Spots?
The most common side effects of IPL and laser resurfacing are mild pain, redness and swelling. As previously mentioned, these are all to be expected after surgery and usually disappear in a few days. Susceptible individuals may observe mild bruising.
Applying an ice pack repeatedly within the first 24 hours helps suppress inflammation. Sensitive patients may feel less sore by taking acetaminophen or using topical low-potency anti-inflammatory meds. Patients with persistent redness after an ablative laser procedure may benefit from topical ascorbic acid application.
Rare side effects of light treatments include:
- Profuse bleeding
- Uneven pigmentation
- Eye complications
You can avoid these problems when you choose a highly experienced laser dermatologist to perform your procedure. But seek medical help immediately at the slightest sign of a complication after your therapy.
How Long Is the Laser Age Spot Removal Recovery Time?
That depends on the kind of surgery performed. IPL and non-ablative laser therapy cause little inflammation, so the downtime should be no more than a few days. On the other hand, recovery from an ablative laser resurfacing procedure usually takes 2-3 weeks. This allows the treated site to close up and heal properly.
Factors that can delay a patient’s recovery include advanced age, blood vessel and clotting abnormalities, immune dysfunction, blood sugar control problems, nutritional deficiency and connective tissue disorders.
How Do You Take Care of Your Skin After Age Spot Removal?
Preventing postop complications and good maintenance can help ensure that those dark spots never come back.
Good aftercare helps you avoid postop complications and ensures your speedy recovery. The following are usually part of the aftercare regimen:
- Gentle cleansing and moisturizing twice daily
- Restricting some activities to prevent accidental trauma to the site
- Staying out of the sun or using sunscreen (SPF 30 or greater) when outdoors
- Taking the prescribed postop treatments, e. g. antibiotics and skin vitamins, if there are any
- Avoiding scratching or picking at the treated site, especially when it is still actively healing
- Sleeping on your back with your head elevated in the first few nights after your session
- Avoiding harsh skin care products and makeup while the skin is still inflamed
- Refraining from smoking and drinking, which can delay your healing
- If you’re having an ablative laser procedure, your doctor will give you instructions for proper wound care. The routine usually consists of daily wound cleaning, emollient use and bandage change.
After your recovery, the following measures can help you maintain the effects of your treatment:
- Regular sun protection
- Hydrating adequately
- Sticking to a healthy diet
- Gentle cleansing and moisturizing
- Following the skincare regimen that your dermatologist prescribes. This is typically tailored to each patient’s needs.
- Staying on top of your maintenance therapy schedule
Light treatments get rid of unwanted pigment permanently. But it can come back, especially without proper care, since environmental UV exposure is inevitable. Maintenance IPL and non-ablative laser treatments are generally scheduled every 1-2 years. For ablative laser resurfacing, a repeat session may not be necessary until 3-5 years after the last. Regular sun protection and skin care lessen the need for repeat treatments.
Why Should You See a Dermatologist for Brown Spot Treatment?
Entrusting this skin issue to a board-certified dermatologist ensures that you get quality care.
First, their expertise in identifying various skin diseases can be lifesaving. For instance, a malignant pigmented lesion like melanoma can mimic solar lentigo. The wrong diagnosis can delay treatment and have dire consequences. But a board-certified skin care specialist spares you from such troubles.
Second, dermatologists have extensive IPL and laser treatment experience. They can guarantee that your procedure is free of complications and yields only the best results. Expect to look fabulous for your age by the time you’re done with your therapy.
Third, their deep understanding of skin care can help you figure out the most appropriate regimen for your needs. No costs will be wasted on ineffective treatments or remedying unwanted side effects.
Trusting a board-certified dermatologist to take care of these blemishes is your best move to look flawlessly younger once again.
Stubborn Pigmentation Is Best Zapped, Not Medicated
Age spots are small, pigmented skin lesions resulting from chronic UV damage. While topical medications are available, they are best remedied by IPL or laser surgery. Light treatments have the advantages of precision, effectiveness and highly satisfactory cosmetic results.
Preventing complications is key to a hitch-free recovery, and you can start doing that even before you come in for your appointment. After your session, good post-treatment care also helps ensure a speedy recovery. The effects of your therapy can last years, especially with religious sun protection and skin care.
Finally, no matter what age spot removal treatment you use, choose a board-certified dermatologist to work with you. Trust them to give you the best care for any skin problem.
Not a Fan of Dark Spots? Leave Them to LA’s Best Dermatologists
Age spots are stubborn marks that can keep you from looking your most gorgeous. It’s tempting to try over-the-counter whitening products to remove them. But how do you know if they are safe or effective?
At BHSkin Dermatology, our award-winning skin doctors offer a variety of treatments guaranteed to clear up those dark spots. So don’t second-guess! Visit us at our Glendale or Encino office or use our virtual portal for your initial consultation.
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