Taula de Continguts
- Solar lentigines, freckles and age spots: they are not the same
- Which Harmony XL Pro head can suit each spot
- Spots a doctor needs to check before any laser
- The Madrid sun and your spots: protection before, during and after
- How we work at Santé Madrid
- After the session: what can be normal and when to message us
- Frequently asked questions
If you are looking for a sun spot laser in Madrid, the first step is knowing which spot you have, because a solar lentigo, a freckle and a spot that is changing are not handled the same way. At Santé Madrid the medical team assesses every spot before suggesting anything and, when laser is indicated, chooses between the AFT light and Q-Switched heads of the Harmony XL Pro platform according to the type of spot, your skin and the time of year. In this guide we explain how the most common spots differ, which option can suit each one, which spots need a doctor to check them first and why the Madrid sun is part of the plan.
Key points
- Solar lentigines, freckles and age spots are different lesions: their origin and how they behave with sun exposure are not the same.
- At Santé Madrid two Harmony XL Pro heads can be considered for spots: AFT light intense pulsed light and the Q-Switched laser.
- A spot that changes shape, colour or size, that bleeds or that looks different from the others needs a medical check before any laser.
- Daily sun protection is part of the treatment: without it, spots can become more visible again.
- The medical team decides the head and settings after assessing your skin; results vary from skin to skin.
Solar lentigines, freckles and age spots: they are not the same
Many people call any small spot a "freckle", or every spot that appears over the years an "age spot", although they are not always the same thing. Putting a name to each spot is the first step towards choosing well.
A solar lentigo is a well-defined brown macule that appears after sun exposure, acute or chronic. The AEDV Fundación Piel Sana page on lentigo notes that its older names include "senile lentigo" and "liver spot", which is what many people call age spots. They become more frequent with age, appear mainly on the face, hands and neck, and according to the same source they do not go away on their own.
Freckles, or ephelides, are something else. The AEDV explains that they have a genetic origin, that they are more common in fair skin and blond or red hair, that sun exposure influences how visible they become, and that they tend to appear in childhood and fade in adulthood.
There is a third category worth separating: spots that fit neither group because they are raised, have mixed colours or look different from the rest. Those are the ones a doctor needs to look at first, as we explain below.
Which Harmony XL Pro head can suit each spot
The Harmony XL Pro platform accepts several heads. For the pigmented spots this article covers, the heads the medical team can consider are AFT light and Q-Switched.
AFT light is Alma's intense pulsed light. According to the manufacturer's Harmony XL Pro page, its applicators offer different spectrums and cut-off filters, aimed at pigmentation, vascular conditions and acne. A review of intense pulsed light lists ephelides and solar lentigines among the pigmented lesions treated with this technology, and notes that darker lesions or those with deeper pigment tend to respond more slowly.
Q-Switched is a 1064 nm Nd:YAG laser that, according to the same manufacturer, is designed to remove pigmentation and tattoos. A letter published in the Journal of Cutaneous and Aesthetic Surgery explains that Q-Switched lasers emit nanosecond pulses, that they are used for pigmented lesions because these very short pulses act selectively on pigment, and warns that in skin types IV to VI the risk of post-inflammatory hyperpigmentation must be taken into account.
| Type of spot | How it usually looks | Option the doctor may consider | Worth knowing |
|---|---|---|---|
| Solar lentigo | Flat, well-defined brown spot on sun-exposed areas | AFT light or Q-Switched, depending on size, number and your skin | Does not go away on its own; without sun protection others can appear |
| Freckles (ephelides) | Small, numerous dots on the cheeks, nose or shoulders | AFT light, if they bother you and your skin allows it | They have a genetic basis and can become more visible again with sun |
| Several spots spread across the face or hands | Uneven tone with many small spots | AFT light, often over several sessions | The plan is adjusted to how your skin responds |
| Spot that changes, bleeds or differs from the rest | Irregular borders, several colours, growth | None until a doctor has checked it | Laser is not the first step |
The table is a guide. The final choice is made by the doctor after examining your skin, and sometimes both heads are combined in the same plan. If the doctor suspects your spots are melasma, the approach is different; we explain it on our melasma laser page.
Spots a doctor needs to check before any laser
Laser acts on pigment, but it cannot tell whether a spot is benign. That is why, before treating anything, the medical team looks calmly at each lesion. The AEDV itself reminds readers, on its page on lentigo, that before removing a lesion for cosmetic reasons it is advisable to make sure it is benign.
These signs match the warning criteria that the AEDV Fundación Piel Sana describes for melanoma: asymmetry, irregular borders, uneven colour, diameter over 6 mm, evolution and the "ugly duckling" sign. The same source notes that some lesions do not meet these criteria and should still be checked, and that any lesion that changes or grows quickly deserves a consultation without delay. It also describes a type of melanoma, the one that arises on a lentigo maligna, which usually appears on the face on chronically sun-damaged skin and changes subtly.
If during the assessment the doctor sees a spot that does not fit as a lentigo or freckle, the prudent step is not to treat it with laser and to have a dermatologist assess it first. It is a decision made out of caution, not a diagnosis.
The Madrid sun and your spots: protection before, during and after
Madrid has a continental climate with sunny summers and cold winters, and it can be easy to build up sun exposure without seeking it: a walk through the city, a terrace, the daily commute. For anyone prone to spots, this often shows. The AEDV notes on its lentigo page that these spots tend to be more visible in summer than in winter and that it may be possible to prevent them by avoiding sunburn and chronic sun exposure.
The sun also matters during treatment. Tanned skin has more pigment and this can change how it responds to light, so the doctor may prefer to wait or adjust the plan. That is why, in many cases, spot treatments are planned for the months with less sun, although the decision depends on each skin.
The AEDV sun protection guide sums up the basic rules, which we apply all year round:
- Do not skimp on the amount of sunscreen, and reapply it every 2 to 3 hours and after sweating or swimming.
- Seek shade in the middle hours of the day in summer.
- Wear a wide-brimmed hat, covering clothes and sunglasses.
- Avoid tanning beds: UVA rays can also damage the skin.
Treatment acts on the spots you already have. If the skin keeps receiving sun without protection, others can appear over time.
How we work at Santé Madrid
Our clinic is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid. This is the usual path when someone comes in about spots:
- First consultation. You can start with an aesthetic assessment with a Beauty Coach, which is free, or with a medical consultation for €50 (this is the price of the consultation, not of the treatment).
- Checking the spots. The doctor looks at each spot, asks how long you have had it and whether it has changed, and separates those that can be treated from those that need another assessment.
- History and skin. We go over your recent sun exposure, the medicines and products you use, pregnancy or breastfeeding, and your tendency to develop marks after a wound or a burn.
- Choosing the head. The Santé Madrid medical team decides whether to use AFT light, Q-Switched or neither, with which settings and in what order.
- Session and follow-up. We protect your eyes, apply the treatment and review progress to adjust the plan. The number of sessions depends on your skin and your spots.
Results vary from skin to skin and we do not promise that a spot will disappear. To learn more about the treatment, see our pigmentation laser page, and if you are interested in the platform as a whole, our guide to the Harmony XL Pro laser in Madrid.
After the session: what can be normal and when to message us
After a spot treatment, the skin usually shows visible signs that the pigment is responding. The review of intense pulsed light describes how, after pulsed light, treated spots usually darken, form a thin crust and come off within about a week. Knowing this in advance avoids worry.
- There may be redness or a feeling of warmth for a few hours, depending on the head and the skin.
- Do not scratch or pick the crusts: let them come off on their own.
- Gentle cleansing and a simple moisturiser; avoid exfoliants, acids and retinoids until the doctor tells you otherwise.
- Sunscreen every morning and reapplication if you go out, including on cloudy winter days.
- Avoid saunas, intense heat and direct sun for as long as we advise.
- If you notice blisters, increasing pain, signs of infection or a darker mark that does not improve, message us so we can check it.
In skin with more pigment, the risk of hyperpigmentation after treatment is higher, according to the pulsed light review and the letter on Q-Switched lasers cited above, which is why follow-up is part of the plan and not an extra.
Frequently asked questions
How do I know if my spot is a lentigo or a freckle?
Freckles are usually small, numerous and appear from childhood in fair skin. Solar lentigines usually appear over the years on sun-exposed areas and do not go away on their own. In any case, the doctor confirms the difference during the assessment.
Which is better for spots, pulsed light or Q-Switched?
There is no single option that suits everyone. It depends on the type of spot, how many you have, their size and your skin type. Sometimes they are combined. The medical team decides after examining your skin.
Can spots on the hands be treated?
The hands are one of the areas where lentigines tend to appear, and they can be assessed for treatment. As with the face, the doctor checks each spot first and chooses the head according to your skin.
Can spots come back after laser?
New spots can appear if the skin keeps receiving sun without protection, and freckles can become more visible again in summer. That is why daily sun protection is part of the plan.
Can I treat my spots if I have darker skin?
Many skins with more pigment can be assessed for treatment, but the risk of hyperpigmentation after treatment is higher, so the doctor chooses the head and settings with more caution.
Why won't you treat a mole with laser?
Because laser does not tell us whether a mole is benign. If a lesion changes or shows warning signs, the prudent step is for a dermatologist to assess it before any cosmetic treatment.
Can I have the treatment in summer?
It depends on your skin and your sun exposure. With tanned skin the doctor usually prefers to wait, which is why spot treatments are commonly planned for the months with less sun.
Identifying each spot correctly is the basis of a good plan. The first step is to look at each one calmly, separate those that can be treated from those that need another check, and agree on a plan that includes sun protection. The Santé Madrid medical team can help you take that step.
