How to remove sunspots on the face and décolleté?

Solar lentigines are the most common aesthetic complaint in my dermatological practice, and most patients arrive after months of trying creams that don't work. The most effective treatment for removing sun spots on the face is IPL or laser., with success rates of 74 to 90% according to the most recent systematic review. [(Mardani et al., 2025)]

But before any treatment, there's something fundamental that many overlook: making sure your sunspots are actually solar lentigines and not something else. Because some spots that seem harmless can hide a serious problem.

My name is Sebastian Podlipnik and I am Dermatologist at the Melanoma and Skin Cancer Unit of Hospital Clínic de Barcelona. Every week I treat sunspots with IPL and laser, and in this article I'll explain exactly what works, what doesn't, and why the preliminary step of diagnosis is more important than the treatment itself.

What are sunspots and why do they appear on the face?

Solar lentigines are flat, harmless brown spots that appear on areas of skin most exposed to the sun: face, décolletage, back of the hands, and forearms. They have nothing to do with the liver (even though they are called "liver spots") or with age per se: they are the result of years of accumulated sun exposure.

Your skin has a memory. All the ultraviolet radiation you've accumulated since childhood manifests decades later as sunspots. Melanocytes (the cells that produce pigment) respond to chronic sun damage by multiplying their melanin production in localized areas. According to consensus from the American Academy of Dermatology, sunspots are present in over 90% of Caucasians over the age of 60. [(Ortonne et al., 2006)] This is why I'm also seeing them in younger patients who have used tanning beds or exposed themselves without protection.

Solar lentigo

Benign pigmented lesion caused by chronic sun exposure. It differs from melasma (hormonal, diffuse) and from ephelides or freckles (genetic, appearing in childhood). Its treatment requires specific technology such as IPL or laser.

Why do you need a dermatologist before treating your sun spots?

Before thinking about laser or IPL, The most important step is to confirm that your sunspots are actually solar lentigines.. A lentigo maligna (melanoma in situ) can look identical to a solar lentigo to the naked eye. Only a dermatologist with dermatoscopy can differentiate them, and treating a melanoma with a laser would be a serious mistake.

A few weeks ago, a 58-year-old patient came to my office wanting to "get rid of some sun spots." She had five light solar lentigines, but upon examination with a dermatoscope, one of the lesions presented an asymmetric pattern with structures that did not correspond to a benign lentigo. The biopsy confirmed a lentigo maligna. If she had gone directly to an aesthetic center without a prior diagnosis, that melanoma would have been treated with IPL, and the lesion would have visually disappeared, but the tumor would have continued to grow underneath.

The European Society for Laser Dermatology guide says it clearly: lasers and IPL are very effective for treating lentigines, but The correct diagnosis is mandatory before any treatment.. The selection of parameters also depends on your skin type, something that a professional without dermatological training can hardly assess. [(Passeron et al., 2019)]

This is especially relevant today, as more and more aesthetic centers offer laser treatments without a dermatologist on staff. The difference isn't in the machine, it's in who looks at your skin before it's turned on. An online visit with me is enough to assess your blemishes, confirm the diagnosis with dermatoscopic photographs and plan the treatment before you come to the appointment.

IPL, laser, and peels: what is the best treatment for removing sun spots?

The most effective treatments for solar lentigines are laser- and IPL-based treatments, with complete response rates of 43 to 65%, much higher than cryotherapy (15%) or chemical peels (6%). These data come from the largest systematic review to date, with 48 studies and 1,763 patients. [Mukovozov et al., 2023]

Intense pulsed light

Es mi primera opción para la mayoría de lentigos solares en cara y manos. El IPL emite un pulso de luz de amplio espectro que es absorbido selectivamente por la melanina del lentigo, fragmentándola sin dañar la piel circundante. Un ensayo prospectivo con IPL y filtro KTP demostró un 74,6% de resultados buenos a excelentes en la cara y un 90% en las manos, con 3 sesiones separadas por 4 semanas. [(Friedmann and Peterson, 2019)]

The main advantage of IPL is that it has the lowest risk of post-inflammatory hyperpigmentation among all energy devices, which makes it especially suitable for the Mediterranean skin types I regularly see in Barcelona. [(Mardani et al., 2025)]

Picosecond laser

For deeper or more IPL-resistant lentigines, the picosecond laser is the most advanced alternative. A split-face clinical trial demonstrated that the picosecond laser produces only a 5%% of post-inflammatory hyperpigmentation, compared to 30%% for the traditional Q-switched laser. [(Kim et al., 2020)]

Cryotherapy and peels: why are they no longer first-line treatments?

Although cryotherapy was the gold standard treatment for decades, [(Ortonne et al., 2006)], today we know that its complete response rate is only 15%, with a 33%of adverse events including hyperpigmentation and a risk of scarring. Chemical peels are even less effective (6%). [Mukovozov et al., 2023]

Efficacy and safety data compiled from Mukovozov et al. 2023 (48 studies, 1,763 patients) and Mardani et al. 2025 (41 trials, 3,234 patients).

What is an IPL or laser session for sun spots like?

An IPL session for sunspots lasts between 15 and 30 minutes, requires no anesthesia, and allows you to resume your normal activities immediately. This is the step-by-step process I follow in my practice.

1. Dermoscopic evaluation: I examine each spot with the dermatoscope to confirm the diagnosis and rule out malignant lesions. This step is crucial and non-negotiable.
2. Parameter selection I adjust the wavelength, fluence, and pulse duration according to your skin type and the characteristics of each lentigo.
3. Treatment application: I apply light pulses to each lentigo. You will feel a sensation similar to a small rubber band snap. It's not pleasant, but it's perfectly tolerable.
4. Immediate reaction: The lentigo darkens and a fine microcrust may appear, which detaches in 7-14 days. New skin appears underneath, without the spot.
5. Post-treatment care: Daily SPF 50+ sunscreen and avoid direct sun exposure for 2-4 weeks.

The standard protocol is 1 to 3 sessions spaced 4 weeks apart. Many lentigines resolve in a single session. Darker or more extensive lentigines may require additional sessions. [(Friedmann and Peterson, 2019)]

"The best treatment for your sunspots starts with a good diagnosis. If I don't know exactly what type of lesion you have, I can't guarantee you a safe or effective result."

Dr. Sebastian Podlipnik

What results can I expect and how long do they last?

The improvement is visible from the first session: the lentigo darkens, forms a thin microcrust, and in 7-14 days the skin is clear. I'll show you real results from my patients.

Real cases from my practice

These are photographs of patients I have treated in my practice with IPL. All images show actual before and after, without retouching.

The IPL results for sunspots are visible from the first session, and more than 60% of patients maintain good to excellent results at 6 months Without the need for maintenance treatment. [(Friedmann and Peterson, 2019)]

Fortunately, the recurrence rate is low: a study with a Q-switched laser reported a 12.7%% recurrence rate in solar lentigines. [(Kaminaka et al., 2017)] The key to lasting results is subsequent photoprotection. Melanocytes remain active after treatment (IPL removes accumulated pigment, not the cells that produce it), so unprotected sun exposure can reactivate melanin production and generate new lentigines. [(Yamashita et al., 2006)]

What I recommend after treatment

• Daily SPF 50+ sunscreen: even on cloudy days, even in winter. If you want to know which ones I recommend, I wrote a Guide to the best sunscreens.
• Avoid direct sun exposure The first 2-4 weeks are critical. If you can do the treatment between October and March, even better.
• Repairing cream a cream with soothing ingredients during the first week to promote skin recovery.
• Follow-up review: I will schedule you for a 4-6 week follow-up to evaluate the results and decide if you need any additional sessions.

Frequently Asked Questions about Laser Treatment for Sunspots

How many IPL sessions do I need to remove sun spots?

The standard protocol is 1 to 3 sessions separated by 4 weeks. Many solar lentigines resolve with a single session, especially if they are superficial and well-defined. Larger or deeper lentigines may require 2-3 sessions. [(Friedmann and Peterson, 2019)]

What is the difference between IPL and laser for dark spots?

IPL emits broad-spectrum light (multiple wavelengths), which allows for the treatment of superficial lentigines with a lower risk of post-inflammatory hyperpigmentation. Lasers emit a single wavelength and are more precise for deep lentigines. In my practice, IPL is the first choice for most facial solar lentigines.

Is the treatment definitive?

The treatment removes accumulated pigment, but the melanocytes remain active. If you maintain daily photoprotection with SPF 50+, the recurrence rate is low (12.7%% in laser studies). Without sun protection, new lentigines may appear in the same areas. [(Kaminaka et al., 2017)]

Can sun spots be treated in the summer?

It is not recommended. The risk of post-inflammatory hyperpigmentation increases with sun exposure, and it's difficult to completely avoid the sun in the summer. I recommend doing the treatment between October and March, when UV radiation is lower.

Does laser treatment for dark spots hurt?

The discomfort is minimal, comparable to a rubber band snapping against the skin. No anesthesia is needed. The entire session lasts between 15 and 30 minutes, and you can resume your normal activities immediately.

Can sunspots be skin cancer?

A benign solar lentigo is not cancer. But lentigo maligna (a type of melanoma in situ) can look very similar to a solar lentigo to the naked eye. That is why I insist that Dermoscopic diagnosis before treatment is not optional.. If you want to know more about how to differentiate injuries, I wrote an article about Malignant moles and melanoma.

Can depigmenting creams remove sunspots?

Creams with retinoids have limited efficacy of 21%, compared to 74-90%for IPL. They may be useful as a supplement or maintenance after laser treatment, but rarely eliminate established lentigines on their own. [Mukovozov et al., 2023]

Do solar lentigines also appear on the hands and décolletage?

Yes, they are very common on the backs of the hands and décolletage, which are areas of high sun exposure. IPL works especially well on the hands, with a 90%% of good to excellent results. [(Friedmann and Peterson, 2019)]

Consultation with a specialist dermatologist

With the right treatment and daily sun protection, solar lentigines are perfectly treatable. Most of my patients see results from the first session and resume their daily lives the same day. If you are concerned about your sun spots, a dermatological consultation will give you the peace of mind of a correct diagnosis and a personalized treatment plan.

If you want to learn more about facial blemishes in general, I wrote a Complete guide on how to remove blemishes from the face where I explain all the available types and treatments. You can also consult my book on facial blemishes.