In The Press

Banishing Brown Spots

Learn how to maximize the results of IPL treatments.

Jul 1, 2006
By:David Sayah, M.D.
Medical Spa Report

We all know that the best way to avoid age spots is to stay out of the sun and use sunscreen, preferably one with an SPF higher than 45. But what's a former sun-worshipper to do? Many medical spas offer intense pulsed light (IPL) facials as stand-alone treatments for freckles and age spots. But in order to maximize the benefits of IPL, the skin needs to be adequately prepped.

To maximize the procedure, it is important to first understand what causes freckles and age spots. Here's how it works: melanocyte skin cells produce melanin, which is the pigment responsible for tanning. These skin cells produce pigment in the skin in response to various stimuli or damage, including UV rays from the sun and cuts and scratches on the skin. The pigment becomes trapped in the melanocytes—as well as in the surrounding skin—and appears as brown spots.

The most effective way to maximize IPL treatment of these spots is to prep the skin with a combination of hydroquinone and Retin-A. Hydroquinone is a bleaching agent that decreases melanin production, in turn reducing the appearance of dark spots on the skin. In preparation for the IPL treatment, hydroquinone bleaches the skin while deactivating the melanocytes so that they do not react unpredictably to the laser. Retin-A is a vitamin A derivative that sloughs the skin, making it more reactive to laser treatments. In addition, it improves the appearance of fine lines and wrinkles. For best results, it is recommended that patients begin applying hydroquinone and Retin-A on alternating nights for two weeks before their first IPL treatment and continue with the nightly regimen during and after the series of treatments.

IPL treatments work to eliminate brown spots by "shocking" the cells into releasing the pigment, which is then reabsorbed into the body. The light also penetrates deeply into the skin to damage the collagen in a controlled manner. The damaged collagen regenerates by bundling more densely, thus resulting in tighter and smoother skin. Because the wavelength of the laser is adjustable, the treatment is safe for any skintone or type. There is no down time for this procedure, and many patients get it done during their lunch hour. Patients may experience a feeling of heat during the treatment and some mild redness, which will dissipate within a few hours. A very light peel (similar to the experience of a mild sunburn) may occur for a few days afterward.

Depending on the patient's skin type and the severity of the sun damage, three to six IPL treatments over a period of four to six sessions is recommended with a maintenance regimen of hydroquinone and Retin-A. At the end of the period, patients report positive results, such as the fading and disappearance of freckles, age spots, fine lines, and wrinkles, as well as tighter and smoother skin and more even skintone.—David Sayah, M.D.

David Sayah, M.D., developed the Centre Épiderme at the Frederic Fekkai Salon & Spa in Beverly Hills, CA, to complement his plastic and reconstructive surgery practice. He is known for his integrated approach to patient care and has been lauded for his research in the field of wound healing and scar formation. Sayah is a staff member at UCLA, St. John's, and Cedars Sinai hospitals and a Diplomate of the American Board of Plastic Surgery. For more information, visit




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