Pigmentation spots

Pigmentation spots on the skin

Pigmentation spots on the skin are caused by an accumulation of pigment. When several pigment cells are close together, they form a brown spot on the skin, also called freckles. A pigment called melanin is actually produced by cells in the epidermis. This pigment gives colour to our skin, hair and the iris of our eyes. The pigment cells protect us from the ultraviolet sunrays. Too much sun is one of the causes of pigmentation spots. That is why pigmentation is more common on the face and hands. 

Possible causes for pigmentation spots on the skin

  • The sun
    When we lie, stand or walk in the sun lot, our skin produces more melanin to protect us from UV rays. However, in the case of too much exposure to UV radiation, our body gets confused and produces too much melanin and this pigment can accumulate in one place. This is how pigmentation spots on the skin begin.
  • Age
    When we get older, pigmentation spots on the skin appear more often. Mostly, we refer to these as age spots. Age spots are pigmentation spots that are also related to sunlight exposure. That is why they mainly occur on the face and the backs of our hands.
  • Pregnancy mask
    Some women produce more pigment during pregnancy due to the influence of changing hormone levels. This creates the so-called pregnancy mask (melasma or chloasma). Dark spots can appear on the face and sometimes in the neck region. After pregnancy, these pigmentation spots usually disappear by themselves.
  • Inflammation response
    Pigmentation spots can also occur in response to wounds, acne, skin irritation or a surgery scar. Due to inflammation of the skin, pigment cells can be stimulated and pigmentation can occur. This type of inflammatory response to a healing wound (post-inflammatory hyperpigmentation) is seen more often in people with a darker complexion.
  • "Café au lait" spots
    Pigment spots, which we also sometimes call “café au lait“ spots, are flat, light to dark brown spots, which give the skin an overall "dirty" look. These brown spots are usually not from any apparent cause and if not exposed to the sun, they can fade with time.

Malignant pigmentation spots on the skin

Although most pigmentation spots originally develop and behave as benign, they can become malignant. We are then talking about skin cancer (malignant melanoma) which originates from degenerated pigment cells. It is of vital importance to always keep a close eye on pigmentation spots. At the slightest suspicious change to the appearance of a pigmentation spot, it is best to consult a dermatologist as soon as possible. 

Laser treatment of benign pigmentation spots on the skin

The Cutaneous Laser Centre has a number of laser devices that can be used in the function of the pigment spot type in order to selectively remove pigmentation spots without forming scars.

These laser devices produce a very powerful light wave of a particular wavelength which is selectively absorbed by the pigmented cells. The intense flashes of laser light are purposively targeted at the pigmentation spots. They penetrate the epidermis and cause a thermal explosion in the targeted cells only, which you will experience as a slight heat jab. The paralysed pigment cells crumble into many smaller particles which are discharged through the white blood cells. After the laser treatment, the body is actively involved in the removal of the pigmentation spots. This clean-up process takes up to 8 weeks. The light flashes are so short that they hardly affect the surrounding normal cells and tissues.

After about 8 weeks, you can expect the optimal result of one laser treatment on your pigmentation spots. After which, an optional subsequent treatment can be performed. Depending on the type of pigmentation, one or multiple treatments may be necessary.

Although laser treatment aims to completely eliminate unsightly pigment spots, we can never perfectly guarantee this in advance. If the outcome is difficult to predict, we can perform a preliminary test treatment on a small area. This way, we can better assess the results.

Types of laser devices for the treatment of pigmentation spots on the skin

The Cutaneous Laser Centre has several selective pigmentation laser devices:

  • the Candela PicoWay laser, the most powerful picoseconds laser
  • the Candela TriVantage laser, a combination of the Q-switched Nd-YAG and the Alexandrite laser that can produce three different wavelengths
  • the Palomar Starlux G
  • the 800 nm diode lasers

The type of laser used is chosen by the physician based on the nature of the pigmentation and the position of the pigmentation spots on the body.

Is laser treatment for pigmentation spots painful?

  • Laser treatment for pigmentation spots on the skin is usually well tolerated by most patients.
  • A mild pain is typically experienced as a rubber band snapping against the skin.
  • Although a local anaesthetic is usually not necessary, it can be considered for patients with a lower pain threshold.

What to expect after the laser treatment?

  • After laser treatment, a slight reaction can occur in the form of light swelling (oedema), redness or a blue dyschromia (purpura). During the first days after the treatment, the skin may also have a darker colour.
  • Sometimes, there is point-size bleeding and a slight scab formation.
  • The risk of scarring is negligible.
  • The risk of slightly lightened texture cannot be ruled out entirely, but is rather rare.
  • After the (last) treatment, lightening of the surrounding skin colour (hypopigmentation) may sometimes occur. This phenomenon will disappear within a few months, on the condition you did not expose yourself to UV radiation (sun and / or sunbed) shortly before the treatment to treat the deviating pigmentation.

Aftercare following laser treatment for pigmentation spots

  • For comfort reasons, it is recommended to apply Flamigel on the skin 1 to 2x daily after the laser treatment. This ointment does not only have a smoothing effect, but it also reduces the risk of possible contamination.
  • The day after the laser treatment it is best to use a moisturising or restorative cream.
  • Rubbing or the use of soap is not recommended during the first few days after the treatment.
  • If you want to wash the treated zone, we recommend to only dab it lightly with water during the first few days.
  • Maximum protection from the sun is recommended for at least one month before and after laser treatment for pigmentation spots. 

What you also need to know

  • We can never be 100% certain that the pigmentation spots will not recur over time (recurrence).
  • During treatment, the patient, the physician(s), staff and any attending family have to wear special glasses to protect the eyes from the laser light.

If you have any question about the laser treatment of pigmentation spots, do not hesitate to contact us.