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

27 Jun
 
2023

Freckles are patches of pigmentation on the skin, usually caused by long term sun exposure. They aren’t dangerous and don’t require medical treatment, but some people want freckle removal treatment for cosmetic reasons. The most effective treatment for removing freckles is light-based treatment such as laser or BBL intense pulsed light. Careful skin care and avoiding excessive sun exposure are essential to keep pigmentation to a minimum.

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” is sometimes used to refer 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 freckle or pigmentation reduction, it's important to keep your skin out of the sun since they 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 in -references 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 aftertreatment.

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.

Before and after photos: BBL freckle removal treatment

The following photos show patients treated at Spot Check Clinic using our Sciton mJoule BBL device for treatment of freckles and pigmentation.

Before and after freckle removal with 3 BBL intense pulsed light treatments. Significant freckle reduction, improvement with skin tone and texture.

BBL treatment is effective for many skin conditions

BBL is versatile: the operator can adjust the settings so that it can treat multiple 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

Removing freckles effectively 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. This combination, if used over several months, has been shown to lighten freckles.

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 for treatment of 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 of the treated area. This takes 2-3 weeks to settle

Due to the significant discomfort after treatment, we normally 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 is an inexpensive treatment that 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.

Choosing the right kind of freckle removal treatment for your skin

When considering treatment for freckles, take into account the benefits and disadvantages of each treatment.

Treatment Benefits Disadvantages
Intense pulsed light / broadband light (BBL)

Effective at fading large numbers of freckles

Good for treating a large area quickly

Almost no risk of scarring or hyper/hypopigmentation after treatment

No downtime after treatment

Useful for treating multiple skin problems including blood vessels, angiomas, pigmentation, wrinkles, loose skin, keloid scars, rosacea and acne

Usually requires several treatment sessions

More expensive than cryotherapy, retinoids or skin peel treatments

Laser

Effective at fading large numbers of freckles

Almost no risk of scarring or hyper/hypopigmentation after treatment

Powerful lasers are more effective for very resistant freckles and pigmentation

Usually requires several treatment sessions

More expensive than cryotherapy, retinoids or skin peel treatments

May lead to redness and soreness and downtime after treatment

Cryotherapy

Inexpensive (sometimes free if part of a medical consultation)

Quick: each freckle is treated in seconds

Useful if treating a single freckle

May form a blister or sore after treatment, which can take 2-3 weeks to heal

May lead to increased or decreased pigmentation of the treated skin

Gentle treatment (to reduce the risk of hyper/hypopigmentation) might not be as effective

Some people find cryotherapy painful

Retinoids

Painless

Relatively inexpensive

Long course of treatment

Not as effective as other methods

May cause skin irritation

Chemical peels / photodynamic therapy

A single treatment session, or a brief course of topical medication applied at home

Highly effective at treating sun damage other than freckles, and some types of skin cancer

Rejuvenation effect: skin is noticeably smoother and clearer after treatment

May prevent certain types of skin cancer

Photodynamic treatment is more expensive than topical treatments or cryotherapy (but usually cheaper than laser or IPL)

Usually causes significant redness and soreness of the treated area

May lead to swelling, blistering and sores

Photodynamic therapy can be very painful

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 important 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.