The best laser for these types of age spots is erbium laser.
The treatment is quick and easy and with little pain.
The spots are treated individually by the laser, which vaporises the tissue to remove it. It is a very precise laser and scarring with this type of laser for these types of lesions is very rare.
The area of skin in the area where the spot was removed may remain pink for several months, but after that will return to become the same colour as the skin around it.
In a patient like this who has different types of pigmented lesions, I prefer to treat the flat brow lesions with my BBL first and clean all of that up and see what is left (i.e. any lesions which have a thickness to them). In this case I didn’t do that, as the patient didn’t want all of her background sun damage improved, she just wanted these particular spots gone.
The treatment takes about 15 minutes and is not too painful. The patient can have happy gas if they need it, but most wouldn’t. The spots that are treated are often bleeding after the treatment. Bleeding is common from the wounds over the next 24 hours. After that, they should form into scabs.
The covering we use on the larger lesions is called duoderm. On the smaller lesions, we may not dress them, but will use paw paw ointment or vaseline.
Ideally, the covering should stay on for 7 days, but most patients will tolerate it for 3. In darker skin types, it is a good idea to keep the duoderm on for the full 7 days. When the dressing is removed at approx 7 days, the area is usually healed and slightly pinker than the skin around it. This will resolve over time, sometimes this can take up to several months. Makeup can be used on the area once the scab has gone (usually at around day 7)
Often 2 treatments will be required. The second treatment is usually performed at 4 weeks or more after the first treatment.
Patients who have these spots on their face should have a maintenance laser treatment every 1-2 years to keep on top of these lesions, so that when we perform the treatment, there are a smaller number of spots to treat.
Thanks to our wonderful patient for sharing her story and images.
