ProductsYou noticed it in a photo taken in bright light: the brown spots on your cheeks and the backs of your hands look less like freckles and more like years of sun. I'm Dr. Debra Jaliman, and at my Upper East Side dermatology practice, I start by evaluating your spots and your skin type. An IPL photofacial is one treatment I recommend for flat spots like these on lighter skin. IPL stands for intense pulsed light. An IPL photofacial uses broad-spectrum light, meaning many colors of light at once, to break up clusters of extra pigment over one or more sessions.
The medical name for these spots is solar lentigines. A solar lentigo is a flat brown spot caused by long-term ultraviolet exposure. Age spots, another name for them, usually appear on sun-exposed skin such as the face, hands, and arms. They are one sign of photoaging, which is skin damage caused by sun exposure over time. In New York City, much of that exposure is easy to miss: the walk between appointments, or ultraviolet light passing through glass in a car or a sunny office.
What IPL treats: sun damage and brown spots
IPL treats flat sun spots, freckling, blotchy tone, and the dull look that scattered pigment gives the skin, because it works on pigment near the surface. Our IPL photofacial can be used on the face, chest, and hands.
IPL isn't the right treatment for raised or depressed scars, including acne scars, or for deep wrinkles. It can improve tone and mild texture, but rough skin, deep lines, and scars usually call for a laser. If redness or broken capillaries bother you more than brown spots, IPL can still help, and Laser Genesis, a laser for calming redness, and broken capillary treatment are other options. Melasma, which causes dark patches on the skin, is a separate condition, and I generally don't recommend IPL for it, because IPL carries a risk of recurrence and pigment changes in melasma. I may use Fraxel for melasma, a laser treatment, instead.
Not every brown spot is a sun spot. I check what each spot is before treating it. Any spot that is raised, irregular at the edges, more than one color, or recently changed should be checked first and may need a biopsy, which means removing a small sample to test it. For one or two isolated spots, a more targeted option may suit you better, and age spot removal covers those.
Who is a good candidate for an IPL photofacial, and why skin tone matters
You're likely a good candidate if you have lighter skin, flat brown spots, and no recent tan. I assess your skin type before I recommend treatment. Dermatologists describe skin tone using the Fitzpatrick scale. It sorts skin into six types, from type I, which always burns and does not tan, to type VI, which never burns.
IPL delivers many wavelengths, or colors of light, in each pulse, and pigment in the skin absorbs them. On fair skin, the sun spot is the darkest target and takes most of the energy. In deeper skin, the surrounding skin holds more melanin, the pigment that gives skin its color, which competes with the spot for that energy.
I find IPL works best on lighter skin tones, roughly Fitzpatrick types I to III. IPL is particularly challenging on dark skin. On deeper skin tones, it carries a meaningful risk of post-inflammatory hyperpigmentation. That term means darkening after skin injury or irritation.
Careful settings can lower that risk, but they don't remove it. On deeper skin, I usually recommend a different device, and RevLite for darker skin explains why I often choose that laser.
Sometimes it makes sense to wait. Before treatment, I review your medical history and medications. I'll postpone IPL if you have a tan, a recent sunburn, or an active skin infection, are pregnant, or take a medication that makes skin more sensitive to light. I'll also ask you to stop vitamin A creams called retinoids, and skin-peeling acids such as glycolic acid, about a week before your session. I'll ask you to stay out of the sun for at least two weeks beforehand, because the light is aimed at pigment and a tan adds pigment to the skin.
Photofacial before and after: what usually happens day by day
After an IPL photofacial, treated spots usually darken within a few days, then flake away over one to two weeks. Timing and how much each spot clears vary between patients.
- The session: you wear protective eyewear, a cooling gel goes on first, then a handheld device delivers quick pulses of light. A session takes 20 to 30 minutes.
- The first few hours: treated skin can look pink and feel warm, and this typically fades within a few hours.
- The first few days: treated spots commonly darken and look like coffee grounds on the skin. This is the expected response as the pigment moves toward the surface.
- Over one to two weeks: the darkened pigment usually flakes away on its own.
- After the flaking: tone usually looks more even, and the result of that session becomes clearer.
- Across a series: each session usually builds on the last.
Some spots lighten only partly and need another session, and pigment that sits deeper tends to clear more slowly. How many IPL sessions you need depends mostly on how much sun damage you start with. Most people need one to three sessions. With mild damage, one may be enough, and years of sun damage usually take all three. I space sessions about four weeks apart so we can see your response and adjust the settings. I suggest a single maintenance session every six to twelve months.
IPL downtime, aftercare, and what can go wrong
For most people, the only IPL downtime is how the skin looks until the darkened spots flake away, usually within one to two weeks. Most people can return to work the same day, and the darkened spots are the main thing others might notice. Aftercare means protecting your skin from the sun and leaving it alone:
- Apply a broad-spectrum sunscreen, which blocks both main types of UV rays, SPF 30 to 50, every morning.
- Leave the darkened spots alone, with no picking or scrubbing.
- Use cool compresses if you want them.
- Avoid sun exposure, heat, and harsh skincare products for a few days after treatment.
- Skip retinoids and skin-peeling acids for about a week.
Things that can go wrong include blistering, changes in skin pigmentation, and, rarely, scarring. The risk is higher with tanned skin and deeper skin tones. If something doesn't look right, call the office.
IPL vs laser: how they differ
IPL sends out many wavelengths in every pulse, while a laser sends out one wavelength aimed at one target. That lets IPL treat scattered spots and blotchy tone across a large area at once. A laser can be chosen to pass through surface pigment or to work at a specific depth, which suits deeper skin tones and rough texture.
One of our laser treatments may suit you better when your skin type, a single stubborn spot, or deeper texture calls for one.
FAQ
Do brown spots get darker before they fade after IPL?
Yes, treated spots usually darken first, within the first few days as the pigment rises toward the surface. If a spot blisters, call the office.
How long does the coffee-ground look last?
It usually lasts one to two weeks. Let it shed on its own, because scrubbing can irritate the skin.
Does an IPL photofacial hurt?
Most people find it manageable. Each pulse feels like a quick rubber band snap, and the cooling gel reduces the discomfort.
Will my sun spots come back after IPL?
New spots can form over time, because IPL doesn't stop your skin from making pigment. Continued sun exposure can bring new spots or darken treated ones again. Daily sunscreen is one of the most useful ways to protect your result.
What the first visit involves
Your consultation covers your whole face. I ask about your medical history and medications, then recommend only what fits your skin, whether that's IPL or a laser. I determine your treatment.
I'll tailor your treatment plan to your skin tone and medical history. We'll go over pricing at your consultation, and the consultation fee is credited toward same-day treatment or a future appointment.
How to have your sun spots evaluated
If that photo has you looking more closely at your cheeks or hands, I'll evaluate which spots are sun damage and which need a closer look before any treatment starts. At our office at 931 5th Ave on the Upper East Side of Manhattan, I recommend an IPL photofacial or one of our laser treatments based on your skin type. Request an appointment with Dr. Jaliman or call (212) 517-8855 to have your skin checked.
