Sunspots / Solar Lentigo: Why Do They Occur, How Are They Treated?

What are sunspots?

Sunspots, or solar lentigines as they are medically known, are generally brown, well-defined pigmented spots that appear especially in sun-exposed areas as a result of accumulated ultraviolet exposure over many years.

It most commonly appears on the face, backs of the hands, décolleté, shoulders, and forearms.

Solar lentigines are benign; however, they can sometimes be confused with other pigmented lesions, particularly atypical nevi or melanoma.

Are sunspots and freckles the same thing?

No. Freckles usually begin in childhood or adolescence, darken with sun exposure, and can lighten significantly in winter. Solar lentigomas, on the other hand, are more the result of accumulated sun damage over the years and may increase in number with age.

Are sunspots and melasma the same thing?

No. Solar lentigo usually presents as individual, well-defined brown spots. Melasma, on the other hand, is more often symmetrical, widespread, and patchy; it also has hormonal, genetic, and vascular components.

Therefore, a laser that is very successful in treating solar lentigo may not be used in the same way in treating melasma.

Are all brown spots sunspots?

No. A brown spot could be solar lentigo, seborrheic keratosis, nevus, melasma, post-inflammatory hyperpigmentation (PIH), lentigo maligna, or melanoma.

Especially newly appearing, rapidly growing, shape-changing, multicolored, irregularly bordered, bleeding, or crusting lesions require dermatological examination before laser treatment.

Why is dermoscopy important?

Dermoscopy allows us to evaluate the structures of pigmented lesions, which are not visible to the naked eye, in a magnified view.

Before performing pigment-removing procedures such as laser, peeling, or cryotherapy on a suspicious lesion, the possibility of malignancy must be ruled out.

What causes solar lentigo?

The most important factor is chronic ultraviolet exposure. Repeated sun damage over the years leads to changes in the epidermis and melanocytes.

Therefore, solar lentigines are not just a cosmetic blemish, but also an indicator of cumulative photoaging.

What methods are used to treat sunspots?

Pigment-targeting lasers, Q-Switch lasers, intense pulsed light (IPL) systems, cryotherapy, chemical peels, topical retinoids/pigment-modifying products, and some non-ablative fractional lasers can be used.

Is Q-Switch laser effective for sunspots?

Yes. Q-switched pigment lasers are a powerful option, especially in well-circumscribed epidermal solar lentigines.

532 nm Q-switched Nd:YAG can target superficial melanin and significantly lighten solar lentigines.

Why might the spot darken first after a Q-Switch?

Following pigment laser treatment, the targeted lesion may darken, form a thin crust, and detach from the surface within a few days. This is often an expected treatment reaction.

Can a Q-Switch laser perform PIH (Pelvic Injection Hypnotherapy)?

Yes. Post-laser epidermolysis bullosa (PIH) can develop, especially in dark or pigmentation-prone skin types. Using the correct energy source, selecting the appropriate skin type, and protecting yourself from the sun after the procedure are important.

Can BabyFace Ultra / thulium laser be used for sunspots?

Yes. 1927 nm fractional thulium lasers may be more meaningful when widespread sun damage, multiple fine lentigos, irregular pigmentation, general photoaging, and skin tone/texture irregularities are present together, rather than specifically targeting a single dark lentigo.

The BabyFace Ultra 1927 nm thulium laser we use in our clinic is therefore one of the options for suitable patients with widespread photoaging and pigment irregularities.

Which is more suitable, Q-Switch or BabyFace Ultra?

For individual, sharply defined solar lentigomas, Q-Switch may be more targeted. For widespread photodamage + numerous fine pigment spots + skin tone irregularities, BabyFace Ultra / 1927 nm thulium may be more comprehensive.

In some patients, both technologies can be used together at different times.

Can cryotherapy be used for sunspots?

Yes. Liquid nitrogen has been used to treat solar lentigo for many years. However, hypopigmentation, PID (Pelvic Inflammatory Disease), and uncontrolled tissue damage can be problematic, especially in pigmented skin types.

Can IPL be used on sunspots?

Yes. IPL is not a single laser wavelength; it produces a broad spectrum of light. It can be used if common lentigomas, redness, photoaging, and uneven skin tone are present together.

It should be applied cautiously on skin types prone to pigmentation.

Does peeling remove sunspots?

Superficial peels can improve overall skin tone, superficial pigmentation, and photoaging. However, for a single, prominent solar lentigo, targeted pigment lasers like Q-Switch lasers often provide more direct results.

Can sunspots turn into skin cancer?

Classic solar lentigo is a benign lesion and is not considered a direct precursor to melanoma. However, solar lentigos indicate that a person has received sun damage over many years.

The same individual may also have an increased risk of UV-related diseases such as actinic keratosis, basal cell carcinoma, squamous cell carcinoma, or melanoma.

Frequently Asked Questions

Which laser is best for sunspots? There is no single best laser. For individual, well-defined lentigomas, Q-Switch lasers may be more suitable; for widespread photodamage and pigment irregularities, systems like 1927 nm thulium laser may be better suited.

Can it be resolved in one session? Some lentigines can significantly improve in a single session; others require additional treatments.

Is darkening of the pigmentation normal after Q-Switching? Yes. The treated pigment may darken for a few days and then flake off in the form of thin crusts.

Can BabyFace Ultra be used for sunspots? Yes. Especially if there is widespread photodamage, numerous superficial pigment irregularities, and skin quality problems together.

Will the spots recur? The treated lesion may disappear; however, new lentigines may develop with new UV damage.

Dermatologist's Note

The most important step in treating sunspots is identifying the type of spot before considering laser treatment.

Solar lentigo, melasma, seborrheic keratosis, and melanoma can all appear in the same brown color family; however, their treatments are entirely different.

Therefore, at our clinic, we evaluate pigmented lesions with dermoscopy when necessary, and then choose the treatment according to the type of lesion.

For isolated, well-defined solar lentigomas, Q-Switch can be a strong option. For more widespread sun damage, uneven skin tone, and numerous superficial pigments, non-ablative fractional technologies like BabyFace Ultra 1927 nm thulium may provide a more holistic approach.

The goal is not to remove all spots with the same laser; it is to treat the correct pigment with the correct technology, with the lowest possible risk of inflammation and PDI.