Sun Spots and Age Spots on the Face After Summer: What a Dermatologist Assesses First

Sun spots on face treatment London

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By Dr Hiba Injibar | Consultant Dermatologist, Dermasurge Harley Street

Most people notice them in September. The tan has settled, the light has changed, and suddenly there are discrete brown marks across the cheekbones, the bridge of the nose, the forehead and the upper lip that were not obvious in June. They do not fade with exfoliation. They do not respond to the vitamin C serum that was supposed to brighten everything. And they look darker in photographs than they do in the mirror.

These are usually solar lentigines, commonly called sun spots or age spots. They are one of the most common reasons patients arrive at a London dermatology clinic in autumn, and they are also one of the concerns where the diagnostic step matters more than the device. A flat brown mark on the face can be a benign lentigo. It can also be a seborrhoeic keratosis, a pigmented actinic keratosis, or occasionally something that needs formal assessment before anyone considers a cosmetic laser. Establishing which of those it is comes first, always.

What are solar lentigines?

A solar lentigo is a flat, well-defined patch of increased pigmentation caused by cumulative ultraviolet exposure. UV drives melanocytes in the affected area to produce more melanin and, over years, to become locally more numerous and more active. The result is a stable brown mark, usually between a few millimetres and a centimetre across, with a fairly clear border and an even tan-to-dark-brown colour.

They appear where sunlight lands most reliably: the face, the backs of the hands, the forearms, the upper chest and, in men, the scalp where hair has thinned. On the face they cluster over the malar cheeks and temples, which is why they read as a scattered pattern rather than a single mark.

The name matters clinically. “Age spot” is a misleading term because age is not the cause. Cumulative UV is the cause, and age is simply how long a person has been accumulating it. That distinction shapes the treatment plan, because if the driver is UV exposure and the UV exposure continues unchanged after treatment, the pigmentation will return.

How solar lentigines differ from melasma and freckles

These three are frequently confused online, and the treatment pathways are genuinely different.

• Solar lentigines are discrete, individual, stable lesions with defined borders. They do not fade appreciably in winter. They respond well to targeted light and laser treatment because the pigment sits in a defined target.
• Melasma presents as larger, symmetrical, diffuse patches with soft edges, typically across the cheeks, forehead and upper lip. It is hormonally influenced as well as UV-driven, it fluctuates, and it is well recognised for recurring. Aggressive laser treatment can make melasma worse rather than better, which is exactly why the diagnosis has to be confirmed before any device is selected. If your pigmentation is diffuse rather than discrete, read our guidance on melasma treatment and management.
• Ephelides (freckles) are small, often appear in childhood, are strongly associated with fair skin and red hair, and characteristically darken in summer and lighten in winter.

A patient often has more than one of these at the same time. Treating the lentigines while unintentionally aggravating an underlying melasma is a common way for pigmentation treatment to go wrong, and it is avoidable with a proper assessment.

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Why September to November is the correct treatment window

There is a practical reason autumn is the standard season for pigmentation work in the UK, and it is not a marketing convention.

Light-based and laser treatment for pigmentation works by targeting melanin. If the skin is carrying recent tan, that background melanin competes for the energy delivered, which reduces the precision of the treatment and raises the risk of unwanted effects, including post-inflammatory hyperpigmentation and, less commonly, areas of pigment loss. Treating skin that has just come off a summer of exposure is treating a moving target.

Equally, the skin needs protection after treatment. Following laser or IPL for pigmentation, treated lesions typically darken, crust lightly and shed over one to two weeks, and the skin underneath is temporarily more UV-reactive. Strict sun avoidance and daily broad-spectrum SPF are non-negotiable during that period, and realistically for months afterwards. Attempting that in June, in London, before a holiday, sets the treatment up to fail.

Autumn gives a genuine run of low-UV weeks: the tan has faded, exposure is naturally reduced, and there is time to complete a course and settle before the following spring. Patients considering laser treatment for pigmentation are generally best served planning from September onwards.

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What a consultant dermatologist assesses first

Before any discussion of platforms, settings or number of sessions, the assessment establishes what is actually being treated.

Confirming the lesion is benign

Every pigmented lesion on the face is examined, not only the ones the patient has pointed at. Dr Hiba Injibar, consultant dermatologist on the GMC specialist register, uses dermoscopy to look at the structural features beneath the surface: pigment network, border regularity, colour distribution and vascular pattern. Dermoscopy distinguishes a straightforward solar lentigo from a seborrhoeic keratosis, a pigmented actinic keratosis (which is a UV-related pre-cancerous change and is managed medically, not cosmetically), a lentigo maligna, or an early melanoma.

This is the single most important step in the appointment. Firing a pigmentation laser at a lesion that has not been examined can remove the visible pigment while leaving abnormal cells in place, delaying a diagnosis that matters. Where a lesion has any atypical features, it is investigated properly, which may mean photographic monitoring or biopsy. Cosmetic treatment waits.

A cosmetic laser appointment is not a substitute for a mole check. Patients with many moles, a personal or family history of skin cancer, or a history of sunburn should have formal mole checking and mapping as a separate, ongoing part of their care.

Fitzpatrick skin phototype

Once the lesion is confirmed as benign, suitability depends heavily on skin phototype. The Fitzpatrick scale describes how skin responds to UV, from type I (always burns, never tans) through to type VI (deeply pigmented, never burns).

Higher phototypes carry more background melanin in the surrounding skin, which means light-based treatment has to work harder to distinguish target from background. In practice, this raises the risk of post-inflammatory hyperpigmentation, and it changes which platforms are appropriate, what energy settings are safe, and how conservatively a course is staged. Some patients with higher phototypes are better served by a primarily topical and medical approach with laser used cautiously or not at all. That judgement is clinical, and it is why an assessment precedes any treatment recommendation.

History, medication and skin behaviour

The consultation also covers recent sun exposure, sunbed use, photosensitising medications, hormonal factors including pregnancy and contraception, prior reactions to treatment, and the current skincare routine. Retinoid use, recent chemical peels and isotretinoin history all influence timing.

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How platform choice follows the diagnosis

At Dermasurge Clinic the laser platforms are on site, which means the treatment can be matched to the diagnosis rather than the diagnosis being shaped around a single available device.

Q-switched laser

Q-switched systems deliver very short, high-energy pulses that fragment melanin with minimal thermal spread to surrounding tissue. They are well suited to discrete, well-defined solar lentigines, particularly where precision matters and the surrounding skin needs to be left alone. Treated spots typically darken within hours, then flake away over one to two weeks.

IPL and the M22 platform

Intense pulsed light delivers a broader spectrum and treats a wider area in a single pass. It suits patients with diffuse, multiple lentigines across the cheeks and temples, and it addresses associated background redness and vascular sun damage at the same time. The M22 platform allows filters to be selected according to the target and the phototype, which gives useful flexibility when a patient presents with mixed pigmentary and vascular changes.

Topical and medical adjuncts

Light-based treatment is often one part of the plan rather than the whole of it. Prescribed topical agents, retinoids and appropriate depigmenting formulations can be used to prime the skin beforehand and to suppress recurrence afterwards, particularly where there is a melasma component or a higher phototype. Most patients find a combined approach holds better than a device used in isolation.

Results vary between individuals, and the number of sessions required depends on the density, depth and distribution of the pigmentation. Realistic expectations are set at the consultation.

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The UV commitment that makes results hold

This is the part of the conversation that determines whether treatment is worth undertaking at all.

Solar lentigines are a record of accumulated UV. Removing the visible pigment does not remove the underlying photodamage or the tendency of that skin to pigment again. If a patient returns to unprotected exposure, spots recur, often within a season or two.

What is required is straightforward but genuinely ongoing: daily broad-spectrum SPF 50 on the face year-round, reapplication during prolonged outdoor exposure, shade and a hat in strong sun, no sunbeds, and strict avoidance in the weeks immediately before and after each treatment session. Patients who accept this get durable improvement. Patients who do not are treating a symptom repeatedly.

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Why choose Dermasurge Clinic

Dermasurge is a consultant-led practice in central London. Assessment and treatment are carried out by Dr Hiba Injibar, consultant dermatologist on the GMC specialist register, which means the same diagnostic rigour applies whether the presenting concern is a suspicious mole or a scattering of age spots on the cheeks.

Medical and cosmetic dermatology sit under one roof. That matters specifically for pigmentation, because the correct answer for a given patient is sometimes a laser, sometimes a topical regimen, and sometimes a biopsy. Q-switched, IPL and M22 platforms are available on site, so the plan follows the diagnosis rather than the other way round. Treatment plans are evidence-based and personalised to the individual’s lesion type, phototype and history.

An assessment with a consultant dermatologist is required to determine the appropriate treatment, and no laser or light treatment is carried out without one.

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Frequently asked questions

Can sun spots on the face be removed permanently?

An individual solar lentigo that has been successfully treated does not usually return in the same place. However, the skin that produced it remains photodamaged, so new lentigines can develop elsewhere with continued UV exposure. Results typically hold well in patients who maintain daily broad-spectrum SPF and sun avoidance. Outcomes vary between individuals.

How do I know whether my age spot is harmless?

You cannot reliably tell by looking. Colour, border and size give clues, but seborrhoeic keratoses, pigmented actinic keratoses and early melanoma can all resemble a benign lentigo to the naked eye. Dermoscopy by a consultant dermatologist is the appropriate way to establish this, and it is carried out before any cosmetic treatment is considered.

Is autumn really better than summer for pigmentation treatment?

Yes, for practical clinical reasons. Recent tan reduces treatment precision and increases risk, and treated skin needs strict UV protection afterwards. September to November allows both conditions to be met, with time to complete a course before spring.

Will laser treatment work on darker skin tones?

It can, but suitability depends on Fitzpatrick phototype and careful platform and setting selection. Higher phototypes carry a greater risk of post-inflammatory hyperpigmentation, so treatment is staged more conservatively and topical preparation is often used alongside. For some patients a primarily medical approach is the safer recommendation. This is assessed individually.

What does recovery involve after laser treatment for sun spots?

Treated spots typically darken within hours and form fine crusts that flake away over roughly one to two weeks. Mild redness and swelling in the first day or two are common. The skin is temporarily more UV-sensitive, so daily SPF and sun avoidance are essential throughout. Most patients return to normal activities immediately, though makeup is usually deferred for a short period.

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Arrange an assessment

If pigmentation has become more noticeable since the summer, autumn is the sensible point to have it looked at properly. The first step is diagnosis: confirming what each mark is, establishing your skin phototype, and determining whether laser is appropriate at all. Dermasurge Clinic offers consultant-led dermatology in central London, combining medical and cosmetic care with on-site laser platforms.

Book a consultation at Dermasurge Clinic to discuss sun spots on the face and the treatment options suited to your skin.

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