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Freckle Removal on Back

Author: Dr Naomi / 27 Oct 2015

We have multiple laser and light devices which we use to remove freckles.

The best laser for freckle removal is our Sciton BBL laser / IPL.

We also have an erbium laser and a Qswitched laser and 2 fractional lasers for pigmentation removal

For more information see our Freckle Removal FAQ

PROCEDURE FOR FRECKLE REMOVAL BACK


1. Consultation +/- test patch

Patient is to arrive with no makeup and no history of use of self tan/ spray tan for at least  2 weeks

The doctor will take a history

  • A. skin type and tanning
  • B. previous treatments and their success, complications etc
  • C. discussion of desired outcome
  • D. Assess risk of PIH

Doctor will examine the patient

Doctor will recommend test patching. If the patient is Fitzpatrick 1-2 (fair skinned) then they can go ahead with the test patch on the day. If they are darker skin toned or at risk for PIH (Post inflammatory Pigmentation) then they will be advised to use topical lightening agents for 8 weeks prior to treatment. These topical agents are sold at our clinic.

Photographs will be taken

There is opportunity to ask the doctor questions about the procedure

Consent form will be given to the patient with a discussion of risks, benefits, pros and cons of the treatment. If the patient signs the consent form, the procedure will go ahead.

The test patch

Test patch results for freckle removal back

Test patch results for freckle removal back


The patient will lie on the examination couch with protective goggles over their eyes.

Gel will be used on the skin of the  as the laser is used. With back freckle removal, the test patches will be performed typically in  multiple small areas  over the upper and lower back Immediately after treatment, the skin in the test patched area may be red and feel a little sunburnt.

Immediately after the test patch

A sunburn-like feeling is common after treatment. This is normal

Sunscreen or makeup may be applied immediately after the treatment to the treated area.

The patient may purchase a soothing gel for post laser care.

At Home aftercare of the test patch

Use the soothing gel regularly on the area.

Keep the area out of the sun.

Avoid acid or anti-aging skin products on the area for 3-6 weeks depending on area treated

Please contact Dr if there is any blistering after the treatment. This is not normal and means that the power was too high. This requires treatment.

What you should see on the skin after the treatment

Day 1 there may be redness in the test patch area and darkening of the freckles

Over the next few days the redness will reduce and the freckles will darken. Over the next 3 weeks the freckles will start to lift/ crumble revealing beautiful fresh freckle free skin underneath.

The back freckle removal typically heals within about 3 weeks

3 weeks later. Review appointment with the doctor

Your test patch results will be reviewed with the doctor. If it fits in with the patient’s life, the full treatment can be performed on this day.

Full Treatment

As the photos, consent and history taking have all been done already then the full treatment can go ahead straight away. The appointment is 30 minutes.

The patient will lay on the treatment bed

Goggles will be worn by the patient to protect the eyes

Clear ultrasound gel will be applied to the area.

One pass over the upper or lower back will be performed, with multiple zaps of the laser required during this full pass. The procedure of the freckle removal on that back  is painful, but most patients tolerate it very well. I do not like to use any form of anaesthetic when removing freckles and pigmentation (except when using a fractional laser) as I really need to know that I am not causing excessive damage to the skin. If I use a topical anaesthetic, then the patient is not able to give me this important information, and this could lead to side effects including hyperpigmentation, hypopigmentation or scarring. Typically patients will describe the pain as a 7/10.

After the treatment, the ultrasound  gel is gently cleaned off the skin.

Immediately after the first treatment

Immediately after BBL back for freckle removal

Immediately after BBL back for freckle removal


The patient will feel a strong sunburn-like feeling over the treated area.

The treated area will be red and the freckles will be darker than previously.

The patient will be soothed with cold and wet washers and then taken to another room where an assistant will spend about 5-25 minutes “rolling” the patient with an iced roller, which is very soothing

It is fine to apply sunscreen or makeup immediately after the sciton BBL treatment.

At home care after sciton BBL

The sunburn-like feeling will last several hours and then nearly disappear. It will commonly be brought on again by showering.

If the arms are treated, wetting a long sleeved shirt to wear afterwards is a very useful tip

On the drive home, it is great to have your car air-con nice and high.

Sun should be avoided. Be aware that while driving one is exposed to the sun

Sunscreen should be applied every morning and reapplied as often as is practical

Soothing gel may be purchased from the clinic and used twice daily.

Do not use acid or antiaging products for 2 weeks after treatment.

If you are at risk of PIH, the doctor will have given you instructions to buy some corticosteroid from the chemist to reduce the inflammation and lower your risk of PIH. This should be used for 7 days, twice daily. You should start your lightening agent again once the treatment area has healed or at the time advised by your doctor

What should you expect to see on your skin after body BBL freckle removal?

The redness will improve in the next few hours-days after the BBL treatment.

The freckles will darken over the first few days

There will be tiger striping in cases where there is a risk of having the pulses too close together. This will be treated at the next treatment

Over the next 2-3 weeks, the freckles will lift and start to crumble away revealing the clear, freckle-free skin you have always wanted!!

Treatment 2 (of the same skin area)

Treatment 2 will be at a minimum of from 3 weeks to 6 weeks after the first treatment, depending on the body area treated.

Treatment 2 will proceed exactly as treatment 1. The second treatment will mostly bring up fewer and lighter freckles than treatment 1, because treatment 1 should have lifted up most of the pigment. In most cases a higher power will be used for the second treatment. However the skin will look much less angry compared with the first treatment. Some patients are even worried because they think that the second treatment hasn’t worked because they don’t see as much redness or darkening pigmentation. Most of the tiger stripes will be improved after treatment 2.

After 2 treatments

Most patients will have a significant improvement after 2 treatments of freckle removal with Sciton BBL on the back. Those who would like further improvement should have further treatments

Complications/Risks

* Redness: nearly always occurs, should resolve within a few days

* Swelling: In the body this can occur especially in the upper limbs after Sciton BBL. We prefer to only treat half arms due to this complication. The swelling can be very uncomfortable, and movement can be restricted.

* PIH (post inflammatory hyperpigmentation) ie the laser can cause areas of brown pigmentation due to inflammation and the patient’s susceptibility to this. It is less common in the lighter skin tones.

Patients who are at risk for this are treated very differently to those who aren’t. Prevention is important, ie prelightening  is important, and steroids may be necessary after the treatment.

* Blistering: This is very uncommon, especially if the patient has had test patching at a certain power. If this occurs, the patient needs to call the doctor urgently.

* Infection: Very uncommon. Usually associated with broken skin eg blisters. The patient will notice a combination of redness, tenderness, swelling, pain and pus in an affected area. This is a very serious complication and needs to be treated immediately. The doctor should be contacted even if it is a night or a weekend. DO NOT PUT TREATMENT OF INFECTION OFF. Antibiotics are required, I typically use Cephalexin 500mg 4 times daily, with 1 repeat.

* Hypopigmentation/scarring: This is very uncommon, but possible if too high powers are used or may be associated with an infection

* Recurrence of freckles after removal: This is not common on the body, the important fact about this though, is that the past sun damage will continue to occur, so it may not be due to sun that is seen after the laser treatment, but due to the sun damage of the past appearing. I do find that after years, patients will return for a top up, but that it never goes back to the original freckled appearance, more so that the patient “raises the bar” for their skin and wants their skin to be even better than after the original treatment

* Tiger striping: This is very common with successful freckle removal. It just means that further treatment is required

Cost of Freckle Removal Back

At Dr Naomi, we only want to charge you for results. This is one of the reasons for test patching. We want you to see the result before you invest in your treatments, then you know what you will be paying for and if it will be worth it for you.

Consultation and test patching full body $240

upper back $850 per treatment

lower back $850 per treatment

The amount of areas that we are able to treat in one session depends on the amount of sun damage. If there is severe sun damage, then it is likely that we can only start with one area. If very mild sun damage (with no background actinic damage) , up to 3 areas may be treated.

As the sessions go on and the freckles and pigmentation are lifted, more areas are able to be treated in one treatment session.

Typically, each body area needs 2 treatments. Very occasionally, especially with those with darker skin tones, the area will need 3 treatments (eg face, back and chest are areas where occasionally 3 treatments are required)

Before and after freckle removal back 2 treatments BBL. Great result, but I think we

Before and after freckle removal back 2 treatments BBL. Great result, but I think we

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