What is the best way to treat brown spots with the alexandrite laser?

I would start with an intense skin rejuvenation protocol for age spots that includes fractional laser, Covalent chemical peels, and daily skin brightening creams to improve your skin’s complexion. Laser therapy must be combined with a proper skin regimen to enhance and maintain youthful results.
The following skincare products for dark age spots: Melarase
MelaClenz Brightening CleanserMelarase AM: Day-time skin lightener with SPF 30Melarase PM: Night-time skin lightenerMelapads: Daily Exfoliating PadsReplenish Retinoid Cream: Exfoliating and skin-stimulating night creamBest, 
Dr. Karamanoukian
Realself100 Surgeon

This is difficult to answer without pictures and needs an in-person evaluation. Dark spots can be improved with a combination of lasers, Aerolase, microneedling/prp, skin lightening, peels, and skin care. Sun protection is essential. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

I am a board certified dermatologist and I would approach your face as follows: First, confirm that the brown spots are truly benign. Then, use fine scissors or a blade to remove any raised lesions (Q-switched alexandrite is not very good at treating raised lesions). On any flat brown spots, the Q-switched alexandrite can be a great choice, but I treat to a skin response, not by setting the laser on certain parameters. The response your laser provider should be looking for is a light "ashing" of the spots, but no tissue "splatter". Also, I recommend pursuing treatment in months with less UV light and taking great care to avoid UV exposure after treatment, to avoid post-inflammatory pigmentation. 

Thank you for your question. We offer a variety of treatments including Alexandrite laser, Fractional CO2 and Endymed Intensif for aging skin with brown spots. It’s difficult to say with a formal evaluation. I recommend getting a in person consultation with a board-certified dermatologist. 

Thank you for your question. It is very hard to give you a great answer without seeing you, but the alex laser is definitely a potential option. My concern is that you are saying that the spots are raised like moles. With lasers like the alex or picoway, we can remove pigment, not elevation; so, we may use erbium or another method. Your first step should be to see a dermatologist to have the spots checked to be sure that it is safe to remove them with a laser. Next, do some research to ensure you see a reputable physician with experience using lasers. Best of luck to you!

Thanks for your question, but these decisions are best left to the experts treating you.  Nothing compares to an in-person consultation and developing a treatment plan.  You assume that every alexandrite laser is exactly the same and fires with the same intensity.  Do yourself a favor and leave the settings to the expert.  BTW:  The Alex may not be the best option for your concerns.  Best of luck.

Really do need to see the lesion, if it is raised possibly a 755 alex may not work, and CO2, erbium ablative laser is the treatment of choice- or a simple shave biopsy. See a dermatologist for a diagnosis and treatment. All the best, Dr Davin Lim