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The Perfect Freckle / Sun Damage Removal Test Patch

When I perform freckle removal, I mostly like to perform a test patch first to find the optimal settings for that particular patient.

Here is the result that I’m looking for, ie  “The perfect freckle removal test patch results”

best IPL sydney

perfect freckle removal test patch results

 

23 Responses

  1. Peta says:

    Amazinggg! Can this be done on the face??

  2. Kathy says:

    wow! What laser did you use that took care of all this pigmentation so wonderfully?

  3. Peta says:

    OK I want to chat to you about it next visit as I hate my freckles on my face

  4. Aurora says:

    I have hypopigmentation (pale spots) where I removed a few pigmentation spots a few years ago. My skin tone is quite fair. Can anything be done to improve such spots? I asked at the clinic where I had the treatment, and they just told me to try and tan those areas, but I’m pretty sure those spots are not going to tan ever. What type of creams/lotions do you typically recommend the patient using before/after laser for pigmentation spots?

    I don’t have the name for the laser they used at the clinic, but it was a co2 laser. Are any of your lasers a co2 laser? What is your opinion on co2 lasers?

    • Dr Naomi says:

      Hi Aurora,
      Without looking at your pale spots I can’t be very accurate with my answer.
      in general there are not many options for treating areas of hypopigmentation. The options might include
      1. Treatment to the skin around it to lighten it so that the hypopigmented area blends better and doesn’t stand out as much
      2. Fractional laser
      3. Needling
      4. Tattooing
      If the area is permanently hypopigmented, then it will not be able to tan.
      Pre laser, if a patient is fitzpatrick 3 or above or at risk for hyperpigmentation (darker areas), we use a lightening cream to reduce the likelihood of pigmentation. We also use another cream after the treatment to reduce the inflammation
      Re CO2 lasers, I would really need more information about the intention of treatment and the machine itself, before I could give an opinion that is helpful to you. As the type of laser is not the only important factor when discussing treatments.
      With lasers, the most important things to take into consideration are:
      1. Is the laser of a decent quality
      2. Is it the correct type of laser for the problem that it is trying to treat
      2. Does the operator know how to use it.
      I see so many cases where these 3 factors aren’t met, and really, if they’re not, then the hope for adequate results aren’t really that great

  5. Carlos says:

    Hi Naomi,
    I’ve seen people on the internet saying that the best filter for freckles removal is 515 wavelength, but there are other variable as Joules, Ms and cooling temperature. When you’re testing which variables do you change? The wavelength, the joules, the ms or all those?

    • Dr Naomi says:

      Hi Carlos, 515 is my favourite wavelength on the Sciton BBL for freckle removal. I use the other variables and another variable is the use (or non-use) of gel. Sometimes I will have to resort to other lasers for freckle removal.

  6. Sarah says:

    Hi Dr. Naomi,

    I have freckles on my face and, since my teens, the ones above my upper lip have been darker than the rest. This gave the effect of a ‘freckle mustache’ and it always bothered me. I had some IPL treatments done on the area above my upper lip and it did lighten the freckles a fair bit. I moved cities and wanted to continue IPL treatments, so I consulted with a few skin clinics where I live now. The practitioners pointed out that the non-freckled skin in that area was getting too light and they didn’t think I should get any more treatments. The doctor at one clinic said we could do IPL on the whole face to try and even things out; the clinician at the other establishment disagreed and thought it best to leave things as is.

    In the winter months, when my skin sees less sun, I can live with how my face appears. The freckles of concern stay pretty light and, with some make-up, blend in with the face quite well. Come summer though, the freckles still get darker, which is always a bummer, and now the skin around them appears too light in contrast with the rest of my face (as it gets a little darker in the sun).

    Do you have any thoughts or suggestions about this? Would it be helpful if I attached a photo? With extra dark freckles, how detailed can the laser be? Meaning, does a whole area need to be treated, or can dark spots themselves be targeted precisely?

    Thanks so much!
    Sarah

    • drnaomi says:

      Hi Sarah,
      Sorry, but I don’t understand what is going on here. I am not sure of your diagnosis at all, as your history doesn’t make sense.
      Please email a photo dr@drnaomi.com.au and I will publish it as a separate blog post (please deidentify, ie don’t show your full face)
      The background skin should only be able to go to its normal colour, unless there is a complication called hypopigmentation. Is this what has occurred? is the skin on your upper lip unable to tan now?
      Do you actually have melasma involving the upper lip?
      Or is it just that you have only removed the sun damaged skin on your upper lip and the rest of your face is left with sun damage? Yet there are still freckles on your upper lip?
      Freckle and sun damage removal is quite easy, and once the sun damage has been removed and I am trying to pick up darker freckles, the background skin won’t be picked up with a BBL at the correct settings anyway.
      I can answer some of your questions:
      With extra dark freckles, these are the easiest freckles to treat. It is the low contrast freckles that are difficult. The freckles can be treated individually, but it is rarely my preference to perform freckle removal this way.

  7. Robin VanDenburgh says:

    Dr Naomi, I am so impressed with your results. I am also very sad I’ve been trying to get these types of outcomes without success for my freckles and sun damage. I’ve had IPL on full arms ($3k) with no noticeable improvement, full cook peel on both arms without improvement and a Fraxel patch test that showed no change. I am Fitzpatrick type I skin (very pale,brown hair and brown eyes) and do not tan. My arms, chest and back look similar to the pictures you posted of your patient. I am in the US (California) and wondered if you have any recommendations on finding a physician that has similar protocols for freckle removal. I appreciate any assistance. I would totally come to Sidney if I didn’t think i would require multiple treatments. Thank you!

    • drnaomi says:

      Hi Robyn,
      I’m sorry to hear your story, (disappointment with freckle removal is unfortunately such a common story) you just need to get rid of those freckles!!
      Thanks, if you have skin like the patient in this post, then the results are very achievable with the right machine and operator. This kind of patient to me is not even in the difficult category for freckle removal. However, I’m really sorry, I don’t know of any other freckle removal specialists. If you had a 4 week holiday in sydney, we could get arms chest and back treated if you have the same skin as this patient.

  8. Sarah says:

    Hi Dr. Naomi,

    Thanks for your response to my query about the freckles above my upper lip. From what I can gather, it may just be that sun damage has been removed from the area above my upper lip and so the skin isn’t blending properly with the rest of my face (it’s only really noticeable in the summer when my face is exposed to more sun).

    But yes, there are still freckles above my upper lip – and that’s where I ran into trouble with laser technicians where I live – they weren’t comfortable continuing to treat that one area of my face only. One doctor thought we should treat the whole face to even out the general tone, and then treat the freckles above my lip again after that. A technician at a different clinic didn’t seem to agree with this idea.

    After receiving your first response, I realized I’m not comfortable sharing a photo online (even if I’m only showing a part of my face). Sorry for changing my mind.

    Thanks again for your input on this,
    Sarah

  9. drnaomi says:

    Hi Sarah,
    No worries
    It is possible to treat freckles individually.
    Also, when I have removed sun damage, when the patient does tan again, their skin will tan

  10. Sarah says:

    Hi again,

    With the patch test seen in the photo of this blog post, say it were left that way (just a patch – I know it wouldn’t be – but for my question’s sake)…. would it eventually blend into the rest of the skin around it? (I know the patch wouldn’t have the freckles, of course).

    I’m still not sure what to do next with my skin. Perhaps I will save up money and book a Skype consult with you someday.

    Cheers,
    Sarah

  11. Rhonda says:

    Dr Naomi,

    I’ve been looking at your website for a couple of months and plan to come and see you next winter, my question is when you do freckle removal and you have tiger stripes which you treat on a second round……when this is all clear, can you use fake tan? Yes? Won’t the fake tan show up possible places that have been missed (so ends up looking a little stripy or patchy?)

    I am extremely fair with I guess low contrast freckles that you may not see missed areas? And addicted to fake tan so would die if couldn’t use it!

    • drnaomi says:

      Hi Rhonda,
      Fake tan is fine afterward.
      As you can imagine, as lots of people having this freckle removal treatment have the same skin and share your love of fake tan:)
      What we also do after the main treatment is you come back at 3-6 months after the final treatment and do any little spots that we missed.

  12. sandy says:

    Hi Dr Naomi,

    I read with admiration of your work and dedication in answering and helping everyone here!!
    argh i wish you were here, i would consult you in a second! I was wondering if you wouldn’t mind sparing a minute, and maybe could shed a little light onto my situation??
    Having fair chinese skin – and just a spatter of freckles on my cheeks, some lighter and some darker, I have undergone 2 BBL/Sciton treatments in Malaysia. Unfortunately, I have had little results. First treatment resulted in a little redness/scabbing, second treatment didn’t hurt at all and minimal scabs and very little effect. He used gel in both cases, but I do not know what settings he used. All my freckles are still present! (not even the small ones have disappeared). But they have lightened minimally from the first session.

    When approaching the doctor, he says that other options will cause blistering etc. i’m not sure if he means other lasers or if he uses higher strengths.

    i am feeling rather upset as I have spent quite a bit of money now with minimal results.
    My questions are:

    1. if they have had some benefit from the 1st treatment – why hasn’t the 2nd – do you think he reduced the energy level/frequency (not sure what variables there are)?? is there a possibility it will work if I ask him to increase the setting?
    2. what variables are there – is it reasonable to ask him to increase the setting … and how do i do this, despite risk of blistering/hypo/hyper pigmentation which i understand are possible complications?
    3. any suggestions what i do next??
    many thanks…..one upset lady… xx

  13. drnaomi says:

    Hi Sandy,
    1. Having some benefit from the first is great. This is a good sign, and you should be happy with this. Your story overall, isn’t a too unusual one, and I don’t think you should be too disappointed. Chinese skin is more difficult with freckle removal, because it is a serious balance for the doctor in “doing no harm” and getting a result. PIH (post inflammatory hyperpigmentation) is a real issue here, and the doctor will want to avoid doing this at all costs. This is a complication that the patient would consider much worse than just a smaller result. So I can see it from the doctor’s point of view as well. They are probably doing their best and aiming to keep your skin safe. Someone with Chinese skin (or any Fitzpatrick skin tone greater than or equal to level 3) can’t look at my Fitz 1 or 2 and expect the same results with as few treatments, it’s not a safe option. In patients with FItz 1-2 (fair skin), we can turn the laser energy up with much less risk of problems.
    Also in most of my cases of freckle removal, the second treatment will have less of a reaction than the first, because the first had more pigmentation to pick up, the second less, because the first picked it up. (this particularly true because I test patch.
    2. As to whether to ask him to increase the setting. This comes into what I said above about the doctor wanting to do no harm. So whatever you say to the doctor, the doctor still has to take the responsibility for all complications which occur with their treatment, so you have to understand this aspect. Of course the doctor wants to give you a good result, and raising concerns is always part of it.
    BUT personally, I have fired a patient because they were upset with me because I didn’t get the same result as I did with the test patch with their first freckle removal treatment and they complained and asked if they had to pay for their second treatment because of this. I was really upset by this, as I was doing my absolute best for this patient with very difficult skin. They were susceptible to PIH and I was just being really careful to avoid this. So something to consider is please don’t penalise your doctor for being cautious. You should be thanking them for this caution. If they are very experienced at freckle removal, they should know what settings to use.
    There are multiple variables.
    3. I can’t advise on treatments I can only give my experiences. I find test patching to be valuable.

    • sandy says:

      Thank you very much. That was very useful and I see the other side of the story. I think sometimes communication is key in these aspects, such as forewarning the patient may help reduce disappointment. I think if he didn’t say it’ll be a simple procedure and will only take 2-3 treatments I wouldn’t be so upset! I feel much calmer now and will see him on Saturday being armed with more knowledge from yourself! Thank you so much for your time.

      • drnaomi says:

        Hi Sandy,
        My pleasure. You are so right, communication and information are key here. In some ways it’s better for the doc to give each patient the worst case scenario rather than the best. There are problems with that too. It is such a balancing act:)
        Best of luck on Saturday.

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