Hello doctors. My mother, who is 61 years of age has a few age spots/liver spots on her face. There is one, under her eye, about the size of a dime that is really bothering her. I would like to get these removed for her but am not sure what is the best laser for this. Her age spots are light brown to dark brown in color. The size is anywhere from 3mm to nearly a dime size in diameter. There are only 4-8 spots that she wants to get treated. She is also full Asian. Thanks.
Liver Spot Laser Treatment
Doctor Answers 4
Best Laser for Age Spots is the Fraxel Dual - 1927 wavelength
The newest laser from Fraxel, the Dual, has 2 wavelengths - 1550 and 1927. The 1927 is a brand new wavelength, with no other laser company at this time having it. It has no downtime and can resolve most pigmentary issues with 1-3 treatments.
There is some bronzing of the skin of the face for a few days and then that peels off with the pigmentation. Particularly with Asian skin, I find that IPL is hard to get rid of spots because you have to turn the settings lower (because the regular skin will compete for the IPL heat). I would consider hydroquinone if you do the 1927 after the treatment.
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532 oor 1064, or Erbium laser- fully ablative
Sunprotection before and after any laser is critical. My next choice (if they are raised) is an erbium laser (fully ablative)
Other techniques I use include BBL or IPL, 520 filter, followed by 1927 Fraxel. May require 3 treatments for optimal outcomes.
Dr Davin Lim
Aesthetic and Laser Dermatologist
Brisbane and Gold Coast
Treatment for aging sun spots
The best laser to remove dark skin patches assuming they are senile lentigines (aging sunspots) is the 1064nm laser because it can be done with little or no damage to the skin surface cells. It is the same one that is used for tattoo removal. It can be Nd:Yag or Alexandrite.
More than one treatment may be required. If your mother is a darker skinned asian the skin should be cooled at the same time as the laser application so that the surface cells are not damaged.
It is imperative that you have the correct diagnosis before undergoing this treatment. Other types of skin disorders may not be affected by this laser and some such as melasma can be made worse.
The aging sunspots are caused by the gathering of skin pigment cells into clumps rather than the usual wide spread of the cells over the skin surface. This gathering is a natural part of the aging process. If there is a large number of these sunspots on the face most doctors would recommend an ablative laser treatment instead of the 1064nm laser to try and even out the skin color.
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Removing Age Spots under the eye
Ordinarily, the best laser for removing sun / age / liver spots is not strictly a laser but IPL. It emits light energy which is selectively absorbed by the darker pigment of the lesion destroying it without heating the adjacent normal skin. However - this will be problematic in your case because:
- it cannot be used in darker (Asian or Black) skin where other pigment attracts the energy as well
- the size of the lesion and its proximity to the lower lid needs to be closely evaluated. Any removal of lesions here MAY pull the lower lid down if the lid is loose causing SCLERAL (white) Show or an ECTROPION (picture Google these terms to see what I mean).
There is no simple pat answer to your question. A photograph and an examination of the lid tone are needed to select the best removal modality.
Dr. P. Aldea
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.