How it works
Everything begins with a consultation. Your doctor looks closely at the area, distinguishes freckles from melasma and from other kinds of pigmentation, and assesses how deep the pigment sits along with your skin type. This step matters, because each type responds to laser differently, and a darker patch that looks like melasma sometimes calls for a separate plan. Your doctor also asks about the medications you take, your sun habits, and any previous skin treatments you have had.
Before the session, the area is usually cleaned, and a layer of numbing cream may be applied to the skin so you feel more comfortable. How much numbing you need depends on the laser and the size of the area being treated. Both you and the person treating you wear protective eyewear throughout, because laser light can harm the eyes.
During treatment, your doctor moves the laser handpiece over the area. The beam delivers energy into the pigment particles, breaking them into smaller pieces that your body clears away over the days that follow. You may feel something like the light snap of a rubber band, or a warm tingling on the skin. A session usually lasts somewhere between 15 and 45 minutes, depending on the area.
Freckles, and melasma especially, usually need a course of several sessions spaced a few weeks apart, and rarely finish in one visit. After each session, your doctor reviews how your skin responded and adjusts the settings for the next one. The exact number of sessions depends on the type and degree of your pigment.