Freckles, Lentigos and Age Spots
The commonest manifestation of sun-induced changes to skin is freckling, lentigos, age spots and brown spots. Fair-skinned people are more prone to freckling but freckling can occur in the dark-skinned as well.
Freckles will be seen on areas of skin exposed to the sun, with freckles more numerous, larger and darker in proportion to the extent and duration of sun exposure over a lifetime. The best treatment for freckles is good sun protection.
Technically, the freckles seen on the nose and cheeks of fair-skinned children are called ephelides. The only appropriate treatment of those is sunscreen and hats, and most of them will fade with time.
In older people who have had prolonged sun-exposure, the freckles are referred to as lentigines. However, not all pigmented marks and “freckles” on older people are lentigines. Seborrheic keratoses and solar keratoses can resemble lentigines and an accurate diagnosis is needed before discussing appropriate treatment or removal. Melanomas and moles can also be mistaken for benign lentigines, as can melasma.
Before considering reduction or removal of “freckles” it is important to have the skin carefully assessed by a doctor who is competent and experienced in dealing with the multiple presentations of pigmentation disorders of the skin.
Once it has been established that the “freckles” to be removed are indeed benign, then treatment options can be discussed.
Laser treatment can be used if the freckles are large and relatively few.
Intense Pulsed Light (I.P.L.) is very effective for removal or reduction of freckles where they are very numerous and widespread. Whereas laser targets individual lesions or small patches of freckles, I.P.L. targets areas of freckling (face, chest, back, arms, hands, shoulders).
One, two or three treatments may be required, depending on the area being treated (greater care required on face) and the intensity of pigmentation in both the freckles and the background skin.
Before proceeding with treatment, test patches are done to determine the level of light intensity which will provide optimum freckle removal without burning the background skin.
Topical treatments may be advised where the freckling or pigmentation is lighter, more poorly defined or “mottled”, especially on the face, Laser and IPL are less effective as there is less pigment for the high energy light to target.
In these situations, Skin Doctor SA has topical treatments (creams) which are very effective in gradually fading out the light freckling, at the same time as generally rejuvenating the skin and reducing fine wrinkling. These are prescription-only strength because of their scientifically-proven mechanism of action and efficacy. These products are designed to enhance and maintain the results achieved by our broad range of treatments, but are also very effective in their own right as agents of skin rejuvenation and repair.
Melasma, also sometimes referred to as chloasma, is spotty, patchy or blotchy brown pigmentation of the face and occasionally neck and shoulders. It is most common in women, particularly those who tan easily. Melasma does occasionally occur in men, particularly dark-skinned men.
The causes of melasma are varied and sometimes unknown. Melasma may occur in pregnancy but will usually disappear gradually after delivery. Hormonal changes, contraceptive or hormonal medications, allergic reactions to toiletries or medications or sun exposure may trigger melasma. It is generally amenable to treatment, but caution needs to be exercised as individual responses are varied. Treatment options depend on the skin type and distribution of the brown patches.
There are various approaches to treating this condition. Our clinical staff will discuss the pros and cons of each treatment bearing in mind efficacy and safety and together decide on the most appropriate treatment for your situation. Laser treatments are sometimes helpful but usually the most effective (and safest) option is to gradually fade out the abnormal pigmentation with lightening creams.
Solar or Actinic Keratoses are rough scaly red, brown, greyish flat or slightly raised patches. Solar Keratoses are caused by cumulative sun-damage, and therefore become larger, thicker and more extensive with aging. Solar Keratoses respond well to treatment but caution needs to be exercised to exclude other conditions, especially skin cancer. It is generally amenable to treatment but caution needs to exercised as individual responses are varied.
Treatment options include Laser, Freezing, Photodynamic Therapy (PDT) and topical treatments.
Poikiloderma is patchy red-brown pigmentation and blotching with prominent hair follicles and blood vessels on the front and sides of the neck. The shaded area under the chin is usually spared. oikiloderma occurs in both men and women but is more common in women, particularly those with fair skin, allergies and accumulated sun exposure.
There are various approaches to treating this condition. At Skin Doctor SA our clinical staff will discuss the pros and cons of each treatment bearing in mind efficacy and safety and together decide on the most appropriate treatment for your situation.