The Pigmentation Guide
Age spots or freckles. How to tell which you have.
Two pigments that look alike. One is genetic and switches on with UV exposure, then quiets in winter. The other is cumulative damage that doesn't fade. The self-check that tells them apart, how laser clears each, and when a GP appointment comes before a laser one.
If you've stood in front of the mirror trying to decide whether those small brown spots are freckles or age spots, you're not the only one. They look similar at a glance. They aren't the same condition. Freckles are driven by active melanin production. Age spots are driven by an actual increase in the number of pigment-producing cells. They appear at different life stages, behave differently in the sun, and respond to laser differently. The same Q-Switched Laser platform treats both, configured differently for each.
What follows is the self-check, the biology, and what laser actually does to each.
Freckles and age spots look similar. They aren't.
Freckles (the clinical term is ephelides) are small, flat, pigmented spots that usually appear in childhood and fade in winter. They're genetic. If you have them, you were born with the tendency to produce extra melanin when UV hits your skin, and UV is what switches them on. The melanocyte count in freckled skin is normal. It's the output of those melanocytes that's elevated.
Age spots (solar lentigines) are a different story. They're larger, often 5–20mm across, and they don't fade seasonally. They appear in the thirties and accelerate through the forties, and they sit on the faces, décolletage, and hands of people who've spent a lifetime under Australian sun. The biology underneath them is different too. You're not looking at normal skin producing more pigment. You're looking at an increased number of pigment-producing cells concentrated in one patch. That's why an age spot is permanent if left alone. Seasons don't shift it. Winter doesn't quiet it down.
Clinically, the two conditions sit at different places on the pigment spectrum. Freckles are an activity problem. The melanocyte population is normal, but those cells are producing more pigment than they need to. Age spots are a population problem. There are simply more pigment-producing cells in that patch than elsewhere, and they're all producing pigment at the same time. Treating an activity problem and treating a population problem are different tasks. They respond to laser differently.
A simple self-check: freckle or age spot?
Here's the quick diagnostic most consultations start with. None of this replaces a clinical assessment, but it gives you a sensible read on what you're looking at.
| Feature | Freckles (ephelides) | Age spots (solar lentigines) |
|---|---|---|
| When did they appear? | Childhood | 30s onward, mostly 40s |
| Size | 1–2mm | 5–20mm |
| Seasonal behaviour | Darken in summer, fade in winter | Stable year-round |
| Distribution | Face, shoulders, arms, sometimes across the bridge of the nose | Face, décolletage, hands |
| Family history | Usually yes | Not required |
| Background driver | Genetic plus UV trigger | Cumulative UV exposure |
| Texture | Flat | Flat |
If you've had them as long as you can remember and they get more visible every summer, you're almost certainly looking at freckles. If they showed up in the last ten or fifteen years and they don't care what season it is, age spots are the more likely answer. If you have both, which is common in your thirties and forties, you have both.
One more note. If the spot you're looking at is raised, has irregular edges, is changing, or looks different to anything else on your skin, stop the self-check and see a GP first. Flat pigment is straightforward laser territory at Pink. Raised tissue needs a GP assessment before any laser comes near it. Some raised lesions then come back to Pink for cosmetic flattening with Er:YAG; some need a medical pathway rather than a cosmetic one. The next section covers that properly.
Why the UV story matters
Freckles are seasonal because their mechanism is seasonal. UV reaches the skin, melanocytes respond, melanin output rises, and the freckles darken. Once UV exposure drops over winter, production drops, and the freckles fade. Nothing structural has changed. The same cells are there, just quieter.
Age spots don't work that way. By the time you see an age spot, the skin has already banked years of UV. Melanocytes in that patch have multiplied. You now have more of them than you used to, concentrated in a defined area. Reducing UV exposure from here on slows further damage, and it's absolutely worth doing, but it won't reduce the spot that's already visible. There's simply more pigment-producing machinery in that patch than the skin next to it.
This is why the prevention conversation is different for each. For a freckled person, sun protection suppresses visibility while it's applied and lets freckles fade when it isn't. For someone with age spots, sun protection is more consequential. Every unprotected exposure from here adds to the cumulative load that drove the spots in the first place. Both matter. They matter for different reasons, and they protect different outcomes.
This is also why the laser conversation is a different one for each. For freckles, the laser is targeting surface-level melanin inside normal cells. For age spots, the laser is also breaking apart the denser, deeper pigment that a higher cell count has produced. Same technology. Different work for the laser to do.
How Q-Switched Laser treats each
Q-Switched Laser is the technology that treats both freckles and age spots. The Fotona StarWalker MaQX is the platform Pink uses, with a Q-Switched Laser at its core. Q-switching means the laser delivers its light in extremely short pulses, measured in nanoseconds.
That pulse duration is the whole story. Pigment absorbs energy faster than surrounding tissue can heat up, so the pigment shatters into microscopic fragments while the skin around it stays cool. That's selective photothermolysis. It's the reason a Q-Switched Laser can clear a freckle without burning the skin next to it.
Why are the pulses so short? Because pigment has to absorb the energy and fragment before it has time to transfer heat to the cells around it. A millisecond pulse would cook the tissue. A nanosecond pulse hits the pigment and is gone before the skin notices. That's the difference between a Q-Switched Laser and the older pigment lasers it replaced. It's why a properly configured Q-Switched Laser can clear flat pigment without scarring.
Freckles and age spots get the same Q-Switched approach configured differently for each. Freckles sit shallow and are driven by overactive but otherwise normal cells, so the laser is set up to address the surface. Age spots sit deeper, with more pigment-producing cells in a defined patch, so the laser has to reach through more of the skin's thickness to fragment the pigment that's there. Different conditions, same technology, different settings.
After the pulse, the shattered pigment fragments are cleared by the skin's own immune system over the following days and weeks. That's why laser pigment removal isn't instant. The laser does the fragmentation. Your body does the removal.
What the session feels like
A Q-Switched Laser pulse is sharp but brief. Patients describe it as a quick flick of a rubber band against the skin. The sensation is over before the nerves fully register it, which is the practical effect of pulses measured in nanoseconds. Sensitive areas are treated with a cooling protocol for comfort.
Downtime is minimal. Expect mild redness for a few hours after the appointment. The treated pigment will look darker for the next one to two weeks as fragments rise to the surface and flake off. Makeup goes on the next day. Direct sun exposure on treated skin needs to be strictly avoided in that window, which is why many patients prefer to start a course in autumn or winter rather than summer.
What a course actually looks like
A laser pigment course runs over several sessions, spaced across weeks. The exact number depends on what you have, how dense it is, the size of the area being treated, and how your skin responds. Some patients clear after a few sessions. Others need more. The right number for your skin gets set at the consultation by Pink's clinical team, and reviewed as the course progresses.
Between sessions, pigment will look darker before it clears. That's the fragmented melanin rising to the surface, then flaking off naturally over the following one to two weeks. If a spot looks worse before it looks better, that's the treatment working, not a problem.
Gentle skincare is your best ally in that window. Avoid active ingredients like retinol or AHAs for a week after a session. Keep the treated area out of direct sun. Use a physical SPF every morning whether you feel the sun or not. If the area was your face, a light moisturiser and your usual cleanser are all it needs.
About the result holding
Age spots that have been cleared usually don't return in the same location. The excess pigment-producing cells have been fragmented and removed, and the skin underneath has stopped concentrating pigment in that patch.
Freckles can return if new UV exposure triggers new pigment production. The underlying genetic predisposition doesn't change with treatment. Daily SPF and sensible sun habits are what hold the result long-term. The maintenance side of the work is covered in detail in How to Keep Freckles From Coming Back After Laser, the companion piece in this guide.
When to see a GP instead of booking laser
A responsible clinic doesn't treat everything. There are pigmented lesions that need a medical assessment before anyone puts a laser near them, and Pink is firm about this.
Book a GP appointment first if any of the following apply to a spot you're considering for treatment:
- It's raised, not flat. Moles, skin tags, and dermatofibromas are tissue-based, not pigment-based. Laser won't remove them, and some of them need pathology before anything is done.
- It's changing. Size, shape, colour, or texture shifts over weeks or months are a reason to get a dermatology check.
- It has irregular edges, or uneven colour within the same spot.
- It bleeds, crusts, or itches.
- It's different to anything else on your skin. A spot that stands out from the pattern of everything else you have is worth a second opinion.
This is the ABCDE framework. Asymmetry, Border, Colour, Diameter, Evolution. It's how dermatologists triage pigmented lesions, and it's a sensible self-check for anyone deciding whether to book a treatment or book a GP.
What happens at a skin check is straightforward. The GP examines the spot and the skin around it, often with a dermatoscope, a magnifying lens that lets them see the structure beneath the surface. If anything looks off, they'll take a biopsy or refer you to a dermatologist. If everything is benign, you leave with clearance to book cosmetic treatment, and you've answered the question for yourself at the same time.
A skin check takes fifteen to twenty minutes.
At the clinic
Pink treats freckles and age spots with the Fotona StarWalker MaQX. Each course starts with a VISIA scan and a conversation about your skin's specific pigment pattern, your UV history, and what the result needs to hold across a year. The pigmentation work itself is on Pink's pigmentation treatment page.
