Pigmented lesions share the characteristic of increased amounts of dark brown pigment known as melanin. Some lesions, such as moles or nevi, may be present at birth, while others, such as freckles or lentigos (“age spots”), often develop later in life due to sun exposure.
These lesions are very common and can be quite noticeable. While many are harmless, some may require evaluation or treatment. Fortunately, pigmented lesions are often very amenable to both surgical and laser-based treatments.
Types of Pigmented Lesions
Pigmented lesions include a wide range of conditions, such as moles (nevi), freckles, and lentigos (age spots). Some are present from birth, while others develop gradually over time, particularly with cumulative sun exposure.
Although many of these lesions are benign, any lesion that changes in size, shape, or color should be evaluated to ensure there is no concern for skin cancer.
When Surgical Removal Is Needed
Certain pigmented lesions, particularly moles, may need to be removed surgically. This is especially important if there is concern that the lesion has changed in appearance.
Surgical removal allows for proper diagnosis and treatment, as the tissue can be examined when necessary. Any suspicious or changing lesion should be brought to Dr. Berlin’s attention.
Laser and Light-Based Treatments
Other pigmented lesions, such as freckles and age spots, can often be treated with laser or light-based devices. These treatments can be performed on the face as well as on other areas of the body, including the neck, chest, hands, and forearms.
Lasers have long been used in dermatology for a variety of conditions, including vascular lesions, tattoos, and pigmented lesions. These devices produce concentrated beams of light that selectively target specific structures in the skin.
How These Treatments Work
Pigmented lasers are designed to target melanin within the lesion. The laser energy breaks the pigment into smaller particles, which are then gradually eliminated by the body.
Q-switched lasers deliver very short pulses of energy, creating acoustic waves that break up melanin particles. Intense pulsed light (IPL) devices can treat broader areas of pigmentation and are especially useful when brown discoloration is combined with redness, as seen in sun-damaged skin.
Treatment Expectations
Treatments are generally well tolerated, and most patients are able to return to their regular activities immediately afterward.
With IPL treatments, mild redness may occur and typically resolves within several hours to a day. Treated pigmented lesions often darken initially and then peel off over the course of 3–7 days.
Q-switched lasers may produce a mild purple discoloration around the treated area, which can usually be covered with a concealer.
Depending on the type and depth of the lesion, multiple treatment sessions may be necessary to achieve the best outcome. If a series of treatments is recommended, this will be discussed prior to beginning the treatment plan.
Frequently Asked Questions
Do all pigmented lesions need to be treated?
No. Many pigmented lesions are harmless and do not require treatment. However, any lesion that changes should be evaluated.
Are laser treatments painful?
Most patients tolerate these treatments well, with only mild discomfort.
What happens to the spots after treatment?
Pigmented lesions typically darken initially and then peel off over several days.
Is there downtime after treatment?
There is little to no downtime. Most patients resume normal activities immediately.
How many treatments will I need?
The number of treatments depends on the type and depth of the lesion. Some require a single session, while others benefit from multiple treatments.
Pigmented lesions can often be effectively treated with surgical or laser-based approaches. Schedule a consultation to determine the most appropriate option for your skin.