Sun Spots, Melasma & Freckles: What's the Difference and Which Laser Treats Each?
Laser by Tom — Skin Journal
Sun Spots, Melasma & Freckles:
Which Respond to Laser?
Not all pigmentation is the same — and treating the wrong type the wrong way can make it significantly worse. Here's how to tell them apart, which respond to laser, and why melasma is the exception.
Why it matters
Pigmentation Is Not One Thing.
If you've been researching laser for brown marks on your skin, you've probably noticed that clinics tend to treat all pigmentation the same way. They shouldn't. Sun spots, melasma, and freckles look similar on the surface but have completely different causes, sit at different depths in the skin, and respond to different treatments. Get the approach wrong and you either see no result — or in the case of melasma, trigger a rebound that's darker than what you started with.
The first step to treating pigmentation well is accurately identifying what type you're dealing with. For sun spots and freckles, a consultation here is usually enough. For anything that looks like melasma, the diagnosis needs to come from a GP or dermatologist — only a doctor can make it, and it changes everything about what should happen next.
"Treating melasma like a sunspot can cause a rebound that's darker than what you started with. Getting the diagnosis right first isn't a formality — it's the whole game."
Tom Seelbach, Laser by TomKnow the Difference
The Three Main Types of Pigmentation
Here's how to tell them apart — and what each one responds to.
Type 01
Sun Spots & Age Spots
- Flat, clearly defined brown or dark patches
- Caused by cumulative UV exposure over years
- Common on face, hands, décolletage, shoulders
- Usually appear from mid-30s onward
- Uniform colour within each spot
- Don't change with hormones or seasons
Generally treated with: Pico Laser
Type 02
Melasma
- Larger, diffuse patches — often symmetrical on both sides of face
- Driven by hormones, UV and visible light — common in pregnancy, on the pill
- Typically appears on cheeks, upper lip, forehead
- Worsens in summer, may improve in winter
- Sits deeper — dermal and epidermal layers
- Chronic and recurrent; high rebound risk if treated aggressively
Managed with: GP or dermatologist plan + tinted SPF. Laser only as a later add-on
Type 03
Freckles
- Small, light-to-medium brown spots scattered across face
- Genetic — common in fair-skinned individuals
- Appear in childhood, darken with sun, fade in winter
- Sit close to skin surface — easier to treat
- Often loved rather than treated — personal preference
- Sit close to the surface, which generally makes them more responsive to laser
Generally treated with: Pico Laser
The Treatments
Which Types Respond to Laser?
At Laser by Tom, pigmentation is treated with the Pico laser — a picosecond-pulse device that breaks pigment into fine fragments the body can gradually clear, with less heat than older nanosecond devices. Here's how it applies to each type.
| Pico Laser (Laser by Tom) | What to Watch Out For | |
|---|---|---|
| Sun spots | Typically planned as a course of 1–3 sessions. Spot treatment or full face depending on extent. Outcomes vary between individuals. | Avoid sun after treatment — UV can stimulate new pigment formation quickly. |
| Melasma | Not a first-line treatment. Melasma is a medical condition — diagnosis and a management plan from a GP or dermatologist come first, with daily tinted SPF. Once those are in place, low-energy Pico may help the appearance of persistent pigmentation as an add-on, in coordination with your doctor. I won't laser suspected melasma until it has been medically assessed. | High rebound risk. Aggressive settings, frequent sessions, IPL, or sun exposure can trigger darkening worse than the starting point. Results are not permanent without ongoing maintenance. |
| Freckles | Typically planned as a course of 1–2 sessions. Lighter freckles may need only spot treatment. Outcomes vary between individuals. | Freckles can return with sun exposure. Ongoing SPF 50+ is essential to maintain results. |
| Post-acne dark marks | Typically planned as a course of 2–4 sessions. Targets melanin deposits from post-inflammatory hyperpigmentation. Outcomes vary between individuals. | Active acne should be settled before treating pigmentation — treating over active breakouts can worsen marks. |
The Melasma Problem
Why Melasma Needs a Different Approach
Melasma deserves its own section because it's the type most likely to be mishandled. Unlike sunspots — which respond straightforwardly to laser — melasma is a chronic condition driven by hormones, UV and visible light, and it sits partly in the deeper dermal layer. Current guidelines, including the Australian GP guidance, put sun protection and prescription treatment from a doctor first, and laser last — as an add-on for cases that haven't responded.
The risk: aggressive laser or IPL generates heat and inflammation that can trigger melanocytes to produce more melanin — causing a rebound that leaves you darker than before, and in some cases patchy lightening that is hard to reverse. This is why the order of treatment, the settings used, and the aftercare all matter enormously for melasma specifically.
What works for melasma
The right order
- Diagnosis from a GP or dermatologist — several look-alike conditions respond very differently
- Your doctor's plan. Prescription options exist that I can't advise on; they are the first line of management and often the least expensive
- Tinted SPF 50+ with iron oxides every morning, and a hat — visible-light protection, not just UV
- A gentle routine with one over-the-counter brightening active (azelaic acid 20%, thiamidol or a tranexamic acid serum, for example)
- Only then, if needed: low-energy Pico as an add-on, spaced four or more weeks apart, for a fixed short course — with your doctor aware
- Maintenance for life, and back to your doctor when it flares
What makes melasma worse
What to avoid
- Skipping the diagnosis and going straight to laser
- Aggressive or high-energy laser at standard sunspot settings, or open-ended monthly "toning"
- IPL and other heat-based devices, ablative resurfacing, heavy peels
- Unprotected sun — including through car and house windows
- Scrubs, home peels, strong acids, DIY remedies and fragranced products that irritate the skin
- Ongoing hormonal triggers — raise contraception or hormone therapy with your GP rather than stopping anything yourself
At Laser by Tom
How Pigmentation Is Treated Here
Every pigmentation consultation at Laser by Tom starts with identifying exactly what type — or combination of types — you're dealing with. Sun spots, melasma, and freckles can overlap, and mixed presentations are common, particularly in women over 35.
For most sunspot and freckle cases, that's a straightforward Pico laser course. If what I see may be consistent with melasma, I'll say so, give you dated photos and a short note to take to your GP or dermatologist, and we'll talk again once you have a diagnosis and a plan — laser, if it has a role for you, comes later and as an add-on. A carbon laser peel can be added to a full-face pigmentation session — Sun Damage Only is $229, and $249 with the carbon laser peel included. Current pricing is listed on the treatments and pricing page.
Come in for a consultation. I'll look at your skin, and we'll work out what's actually going on before recommending anything.
Common Questions
Frequently Asked
How do I know if I have melasma or sun spots?
The main clues: melasma tends to appear as larger, more diffuse patches — often symmetrically on both cheeks, upper lip, or forehead. It commonly appears or worsens during pregnancy or while on the contraceptive pill, and tends to be worse in summer. Sun spots are usually more clearly defined, darker, and appear on areas of highest UV exposure. A consultation here can tell you what the pattern looks like; only a doctor can confirm a melasma diagnosis.
Can freckles be removed for good?
No — freckles are genetic and triggered by UV, so they can return with sun exposure regardless of treatment. Freckle treatment is usually planned as a short course, and how long the result holds varies considerably between individuals and depends heavily on ongoing sun protection. Daily SPF 50+ is the single biggest factor.
Is laser suitable for melasma?
Only as an add-on, and only after a doctor has diagnosed it and you're on a plan with daily tinted sunscreen. Every current guideline places laser last for melasma, because with aggressive settings, frequent sessions or the wrong device it makes melasma worse, and because results don't last without maintenance. Where it's used, it's low-energy Pico — which transfers less heat than older lasers or IPL — in a fixed short course, coordinated with your doctor. It is one part of managing the appearance of melasma, not a cure.
How many sessions does pigmentation take?
Sun spots and freckles are typically planned as a course of 1–3 sessions, and post-acne pigmentation as 2–4. Melasma isn't planned as a laser course at all — it's an ongoing management plan led by your doctor, in which a short course of low-energy laser may or may not have a place. These are planning guides, not predictions — the number of sessions needed and the result achieved vary between individuals. Sun protection between sessions is one of the biggest factors.
Why does my pigmentation look darker after treatment?
This is normal and expected. The laser fragments pigment, which then rises to the surface before shedding. How long that takes varies a lot depending on what was treated. Light toning and Carbon Laser Peel sessions usually settle within a day or two. Treatment of individual sunspots, freckles or body pigmentation is different — the marks typically go red, then noticeably darker, form fine crusts, and shed over one to three weeks, and sometimes longer. Body areas take longer than the face. Do not pick or exfoliate — let the skin shed naturally, and plan sessions around events where you would rather not have visible crusting.
Can I treat pigmentation while pregnant or breastfeeding?
No — laser treatment is not recommended during pregnancy or breastfeeding. If you have melasma triggered by pregnancy, focus on daily tinted SPF and a hat during this time, ask your GP which skincare ingredients are appropriate, and revisit the pigmentation after breastfeeding has finished. Melasma that starts in pregnancy often improves after delivery.
The Bottom Line
Get the Diagnosis Right First.
Sun spots, melasma, and freckles all look like brown marks — but they sit in different layers of the skin, have different causes, and need different approaches. Treating them the same way is the main reason laser for pigmentation doesn't always deliver, and why melasma sometimes rebounds worse than before.
If you're not sure what type you're dealing with, that's exactly what a free consultation is for. You'll leave knowing what the pattern looks like and what the realistic options are — and if it may be melasma, you'll leave with photos and a note for your doctor. No obligation to proceed.
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Not sure what type of pigmentation you have?
Come in and Tom will assess your skin and tell you what he's seeing — and if it may be melasma, send you to your doctor with photos and a note. No obligation to proceed.
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