Best Treatment for Dark Spots and Heavy Freckling?

What's the best treatment (Laser, IPL, etc.) for dark spots and heavy freckling? I have tried Fraxel, which worked for a while before browning came back. I'm ready to try it again or better yet, other options. I have a medium tone skin (not fair skin); what options do I have?

Doctor Answers 3

IPL excellent for freckles and brown spots

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Dear Pelusa,

You will get lots of different answers to this question depending on what light system the doctor has.

I have a Palomar StarLux, and freckles and brown spots respond very well after a series of 3 or 4 treatments. Darker brown spots respond the best, while lighter ones can be more persistent.

Unprotected sun exposure will make any treatment less effective, and possibly harmful for your condition.

Using a glycolic acid product daily, along with a broad spectrum SPF30 are good products to add to your regimen of skin care.

Since you're medium skin color, ask your doc to do a test on a couple of spots to see how you respond, rather than doing your whole face at once.

I hope this helps, and best regards.

West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Lasers, IPL, and bleaching creams can help with pigmentation and freckling

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There are a number of different lasers that can help with pigmentation.

Fraxel is one of the best however Alexandrite lasers and Diolite can also be used as well as IPL.

No matter which of these modalities are used, in order the decrease the recurrence of the the brown spots you will need to use bleaching cream on a nightly basis as well as daily use of sun block.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Dark Spots and Heavy Freckling

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Hi Pelusa,

The successful treatment of freckles and brown spots depends on multiple factors. Fraxel is very effective, but takes multiple treatments (4 to 6, with a yearly maintenance treatment).

Pre-treatment with bleaching cream, avoidence of sun exposure, use of sun block and protective clothing, and multiple laser treatments. If you have melasma that has returned after a series of Fraxel treatments, then I would recommend a peel masque such as Cosmolan or Melanange.

You may also look into a series of light setting fractionated CO2 laser treatments. Your results will depend upon your ability to avoid sun exposure.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

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.