Freckles and lentigines are two of the most common hyperpigmentations that dermatologists encounter in their practice. It will be good to identify which kind you have in order to find the right treatment for you.
Freckles are 1-2 mm brown spots, commonly seen on the face, shoulders, back of people with fair skin.
Some people find them cute, while others find them a beauty blemish. Family history, genetic factors, and cumulative sun exposure affect the extent and severity of freckles, with sun being the single most important factor. Hence, careful and thorough sun protection is essential in preventing freckles.
Freckles |
Lentigines |
|
---|---|---|
Origin | Sun exposure and genetic factor | Largely due to sun exposure and age |
Appearance | Occurs soon after sun exposure; especially in people with light skin and red or blonde hair; fade with age and sun protection | Accumulative with age, especially after 30-35 years old; unlikely to fade |
Common site | Face, neck, chest and arms | Face, hands, forearms, chest and backs |
Sun exposure | Primary trigger | Contributory factor |
Size | 1 to 3 mm | 5 mm or larger |
Border | Irregular and quite well-defined margin | Usually well-defined margin |
Colour | Light brown | Light to dark brown |
Recurrence | Common, especially upon sun exposure | Variable. Some recur while others don’t |
Lentigines have a strong association with sun exposure and are commonly known as the “sun-spots” or “solar lentigines”. Careful and thorough sun protection will reduce the numbers and severity of lentigines, but not all can be prevented.
It is most common on the face and arms and appears as single or multiple round patches of pigmentation. They can be treated with topical creams or Stellar M22 OPT (Optima IPL) treatment, as well as Q-switched YAG laser, all with excellent results!
Temporary darkening of the skin (post-inflammatory hyperpigmentation) may occur especially with laser treatment. However, this usually settles over time or with lightening cream treatment.
In Dr. Wong’s experience, the best treatment is the Stellar M22 OPT (Optima IPL) treatment. Optimal Pulse Technology (OPT) is an upgraded version of IPL. It is a patented technology launched by Lumenis – the company who invented IPL.
Each OPT light pulse the Stellar M22 machine produces is able to penetrate skin tissues and create controlled destruction to the freckles. Often with 1-3 sessions of Stellar M22 OPT treatment, the freckles would nearly be all gone!
Laser treatment is a good alternative. These include Q-switched Nd:YAG, ruby laser, and alexandrite laser. But the risk of post-inflammatory hyperpigmentation is slightly higher with the use of laser treatment. Good maintenance is prudent and this is done through good sun protection and intermittent OPT treatment.
In essence, removing freckles is fairly straightforward. The challenge lies in the prevention of its recurrence and we cannot overemphasize the importance of good suncare!
Dr. Wong Soon Tee is a MOH accredited Dermatologist and he has 28 years of experience treating facial pigmentations and helping many patients to lighten and brighten their skin. Make an appointment now.
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