Freckle and Lentigine Clearance: The Picosecond Session Plan

Flat epidermal pigment (freckles, solar lentigines) is the most satisfying pigment category to treat — and the easiest to over-promise. Structure the clearance plan around realistic counts and hard follow-up rules.

The Standard Plan

1. Mapping: distinguish epidermal flat spots from raised lesions and melasma background — only the first category goes on the clearance plan
2. Sessions 1-2: single passes at moderate fluence, expected micro-crusting for 5-7 days, visible lightening by week 3
3. Sessions 3-4: remaining spots re-hit individually; typical cumulative clearance 60-80%
4. Touch-up policy: reassess at 8-12 weeks; new freckles are new sun damage, not treatment failure

The Crust Rule

Micro-crusts (tiny dark dots) must shed naturally — picking causes PIH that outlasts the freckle. Written aftercare with this single rule bolded prevents most complaints.

Sun Discipline Is the Real Protocol

Every cleared freckle returns under UV pressure. SPF reapplication, physical shading, and seasonal maintenance sessions (1-2 per year) keep the clearance permanent in practice. Picosecond platforms clear flat pigment in fewer sessions than nanosecond systems; pair the plan with the photofacial checkpoint discipline for photo documentation.