Some of the most common questions that patients ask dermatologists concern pigmented lesions. Pigmented lesions are remarkably common and the overwhelming majority are benign, however, for aesthetic reasons they can be highly unpleasant to many people.

Among the most common lesions are keratoses, moles, freckles, sun spots and melasma. Sun spots, also known as lentigines, are harmless, flat, brown discolorations of the skin which usually occur on the back of the hands, neck and face of people over the age of 40. These spots give away a person’s age and are caused by the skin being exposed to too much sun over the years without adequate sunscreen protection. Melasma is an unrelated condition also characterized by dark pigmented patches on the face, but is usually caused by hormonal fluctuations due to pregnancy or the use of oral contraceptives.

General skin lightening treatments have become possible today thanks to advances in medical laser technology. Using non-invasive laser therapy, it is possible to effectively treat skin surface pigmentation conditions such as melasma, sun spots, and uneven dark patches due to the overproduction of melanin in the epidermis of the skin.

Laser treatment offers an effective means for the removal of pigmented lesions. The treatment is quick and painless, and there is no need for any needles or anesthesia.

The laser works by targeting the brown pigment, or “melanin,” present in the skin of these spots. This pigment absorbs the laser’s energy and becomes scattered within the skin’s tissues. The rest is done by the body’s own immune system as the skin’s cleansing cells, called “macro-phages,” digest the excess pigment and clear it from the area.

Usually sun spots require only one or two treatments for removal, although larger, darker spots may require more. Nd:YAG (1064 nm) lasers are used for the removal of sun spots since the laser’s wavelength is absorbed by the melanin in the spots. Once treated the spots will not return. However laser treatment cannot stop the ageing of the skin and other age spots will appear in time.

For more difficult-to-treat pigment conditions such as melasma, Q-switched (very short- pulsed, high-powered) Nd:YAG lasers are especially effective, allowing pigment removal to take place without ablating the skin – a unique feature that also allows other treatment possibilities, such as the safe and effective removal of multi-colored tattoos. Although in some cases gentle skin ablation is actually desired, such as when removing moles and keratosis.