Freckles, age spots (seborrheic keratosis without obvious thickening), sunspots (solar lentigines), café-au-lait spots, nevus of Ota, nevus fusco-caeruleus zygomaticus, lentigo simplex, pigmented Becker’s nevus (without obvious thickening), etc. Due to the complex treatment of melasma and its different postoperative reactions from the above-mentioned spots, it is not discussed together in this article.
- 532nm ultra-picosecond laser for freckles: After 1 treatment
- 755nm nanosecond laser for café-au-lait spots: After 4 treatments
- 1064nm ultra-picosecond laser for nevus of Ota: After 3 treatments
- Individuals who have been exposed to intense sunlight, sunburned, taken sunbaths, etc. in the past month, or who are about to be exposed to intense sunlight;
- Individuals with infectious skin diseases (such as verruca plana) or active inflammatory skin diseases (such as eczema, dermatitis, psoriasis, vitiligo, etc.) on the spots;
- Patients with scar constitution;
- Pregnant and lactating women;
Not all spots can be completely removed; some can only be lightened after treatment. Generally, epidermal spots closely related to ultraviolet rays, such as freckles, sunspots, and age spots, have better treatment effects but are prone to recurrence if sun protection is not paid attention to after treatment. Nevus of Ota and nevus fusco-caeruleus zygomaticus also have good treatment effects and are not easy to recur. The efficacy of café-au-lait spots varies greatly among individuals.
Freckles, sunspots, and age spots can achieve significant results with a single treatment; café-au-lait spots, nevus fusco-caeruleus zygomaticus, and nevus of Ota need multiple treatments for gradual improvement.
Superficial spots such as freckles, sunspots, and age spots often scab after laser treatment. After the scabs fall off, the local color may be lighter than the normal skin color. This is mostly transient hypopigmentation, which can gradually return to normal over time.
The treatment process may cause obvious pain, and topical anesthetic cream can be applied in advance to relieve discomfort.
A burning pain will gradually be felt after treatment. An ice pack can be used to apply cold compresses to the treated area for 20-30 minutes immediately to reduce temperature and relieve pain. If obvious edema or signs of blistering are found after surgery, a topical glucocorticoid ointment can be applied once to reduce the risk of blistering. If there is concern about wound infection, it can be used in combination with a topical antibiotic cream.
Keep the treated area away from water. Medical dressings, moist burn ointment, or growth factor drugs can be used to promote wound repair.
The wound usually scabs in 2-3 days after treatment and falls off naturally in 7-10 days. Do not pick off the scabs with hands or wipe them off violently, otherwise, it is easy to cause pigmentation, and in severe cases, there is a risk of scarring.
After the scabs fall off, topical serums such as vitamin C, tranexamic acid, arbutin, or astaxanthin can be used to prevent pigmentation.
Strict physical sun protection (such as wearing a hat, sunglasses, sun protection mask, etc.) is required, and sunscreen (SPF50, PA+++) can be used in combination. Sun protection should be persisted for at least 3 months.
Erythema and swelling often occur after surgery, which can be improved by cold compresses. Generally, the symptoms can be relieved the next day.
If superficial small blisters appear (diameter less than 1cm), no treatment is usually needed, and they can be absorbed naturally. If large blisters appear (diameter greater than 1cm), medical staff need to perform puncture and drainage, followed by anti-infection treatment and pressure bandaging to reduce local tissue damage and promote wound healing.
Improper wound care or lack of sun protection after surgery may lead to pigmentation. Hydroquinone cream and tranexamic acid serum can be used for treatment. If necessary, gentle methods such as chemical peeling and photorejuvenation can be used.
If the treatment energy is too high or the local reaction is too severe (such as the appearance of large blisters), there may be a risk of scarring. After the scabs fall off, scar ointments or patches, such as silicone gel and Mepiform, can be used as early as possible to reduce the risk of scarring. If scars are unfortunately formed, they can be faded by treatments such as fractional laser in the later stage.
