Recurring Brown Spots After Photofacial Treatments

I had Photofacial treatment done last month. First, all the brown spots were gone, nice and clean, and I was very happy about it. Then, 3 weeks later, the brown spots come back, so I went and have it done again last week. My face is nice and clean, but the brown spots keep coming back, and becomes darker and larger. Why does it keep coming back despite these treatments? What can I do about it? Thank you.

Doctor Answers 4

Brown spots will always recur without sufficient sun protection.


I don't know if your physician has explained clearly to you that the brown spots are always likely to recur because the cells in that area are "permanently" damaged and will always have the tendency to turn the skin brown in those spots.

Once you have had a successful session of IPL or laser, maintain a diligent, major routine of sun protection ALL THE TIME, and the spots will recur more slowly or not at all.

In addition, as other answers have stated, make sure your treatments are optimal for your skin type and as powerful as you can safely tolerate with no side effects, so that you get the most out of it, but remember the machine is only getting you started. It is your job to maintain the improvement.

New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Recurring brown spots

Be diligent with decreasing sun exposure and using a sunscreen on the areas after IPL/photofacial treatments.  This will help to minimize recurrence of the brown spots.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Brown spots that recur following photofacial.

Pre and post treatment with a skin lightner (hydroquinone) may be beneficial.  Sun protection is important (sun block of at least a SPF of 30) to maintain results for a longer time (photofacials are not permanent).  Perhaps a more aggressive approach would be beneficial.  Results are generally seen with 1 - 2 treatments but can require more (3 - 6).  A combination of treatments (such as peels, profractional laser) may also be helpful for the more resistant pigmentation.

Robert Sleightholm, MD
Brampton Plastic Surgeon
5.0 out of 5 stars 9 reviews

Recurrent brown spots despite photofacial

The photofacial treatment that you are utilizing has not used enough power thus far to fully remove the discoloration. Most IPL and BBL systems have a number of parameters like intensity, pulse width, and skin cooling that can be changed to allow more aggressive treatments while maintaining a safe treatment window. If your overall settings are getting aggressive, than a different treatment modality like ablative laser resurfacing or spot chemical peels may be advantageous.

Darker pigmented individuals have a higher tendency to repigment. With this in mind, suppressing the pigment cells both before and after treatment with a bleaching agent like hydroquinone is also prudent.

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 14 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.