As we age, the hands often become a mirror of the passing years. Exposed daily to daylight, the sun, and environmental aggressors, they are prone to visible changes that reflect accelerated photodamage. Among these signs, pigment spots—also called solar lentigines—are prominent. These small brown spots, often diffuse or clustered on the back of the hands, are a direct consequence of chronic UV exposure.
While the face has long benefited from specific aesthetic treatments, the hands are still too often neglected. Yet, their rejuvenation is now an integral part of a comprehensive aesthetic approach.
Among the treatments available in a medical setting, pigment lasers stand out as one of the most effective, precise, and long-lasting solutions to eliminate pigment spots without affecting surrounding tissues. Thanks to technological advances, new-generation lasers can now selectively target the melanin responsible for spots, with an excellent tolerance profile.
Skin pigmentation is regulated by cells called melanocytes, located in the basal layer of the epidermis. Under the effect of ultraviolet (UV) rays, these cells increase their production of melanin, a pigment responsible for protecting the skin against sun damage.
Due to repeated exposure, particularly on uncovered areas such as the backs of the hands, this production becomes irregular. Hyperpigmented areas appear; these are commonly referred to as age spots or solar lentigines. Although benign, these spots make the skin appear older.
Their appearance is influenced by several factors: age, repeated sun exposure, hormonal changes, certain photosensitizing medications, and the patient’s phototype.
While depigmenting creams can sometimes reduce the most recent spots, only medical laser treatment allows a truly targeted and effective approach, with visible results from the first session.
There are several types of lasers, but not all are suitable for treating pigmented lesions. The choice of the right device depends on the nature of the pigmentation, the depth of melanin deposits, and, of course, the patient’s skin phototype.
The lasers most commonly used for pigmented spots are :
A laser treatment session lasts on average 10 to 20 minutes, depending on the number and density of spots to be treated. Before any procedure, a prior consultation is essential to make an accurate diagnosis, rule out any suspicious lesion, and adjust the laser settings to the skin type.
The area to be treated is cleaned, and protective glasses are provided. The laser beam is then delivered directly onto the spots. Each pulse may produce a tingling or warming sensation, similar to a small snap of a rubber band on the skin. No anesthesia is necessary, but a soothing cream can be applied immediately afterward.
In the hours that follow, the treated spots may darken slightly, then form small superficial crusts. These naturally fall off within a few days, revealing more even and visibly lighter skin.
Results are visible quickly, often from the first session : the spots gradually fade, the complexion evens out, and the skin appears smoother and younger. This treatment restores the hands to a clearer, more luminous appearance without damaging the skin.
Unlike creams or peels, which may require multiple applications or sessions, the laser works in a targeted and immediate way, with long-lasting results when photoprotection guidelines are followed.
The treatment of pigmented spots on the back of the hands cannot be reduced to a simple transposition of the protocols used for the face. It is a different anatomical area, with its own characteristics. The skin is thin, poorly vascularized, and low in sebaceous glands, which limits its regenerative capacity. Thus, the post-laser healing phase may be longer, especially in patients over 60 years old or with dry skin.
Moreover, the hands are exposed to repeated aggressions: sun exposure, temperature variations, frequent washing, contact with household products. These factors can compromise the quality of healing if post-procedure recommendations are not scrupulously followed. A progressive, cautious, and clearly explained therapeutic approach is therefore essential to ensure an optimal and safe result.
The success of a laser treatment is not measured solely by the immediate disappearance of spots. To ensure its long-term effectiveness, a rigorous prevention strategy is indispensable, and photoprotection plays a key role.
Often neglected when applying sunscreen, the hands are nevertheless one of the areas most exposed to ultraviolet rays throughout the year, including in urban environments. After a laser session, the skin is fragile, and even moderate exposure can promote the appearance of new spots, sometimes more pigmented or more diffuse than the previous ones.
It is therefore imperative to apply photoprotection with a broad-spectrum sunscreen (SPF 50+) several times a day. Wearing UV-protective gloves, especially while driving, can be a relevant complementary measure. This discipline is essential to sustainably preserve the benefits of the treatment.
It is important to remember that not every skin spot is necessarily eligible for laser treatment. Some pigmented lesions have a different etiology: actinic keratoses, café-au-lait spots, cherry angiomas, atypical lentigines, or even precancerous lesions.
A rigorous dermatological diagnosis is therefore essential before any procedure. The physician’s role is fundamental here: to distinguish a benign lesion, which can be safely treated, from a skin abnormality requiring specific monitoring or specialized consultation, or even a biopsy.
This medical discernment guarantees not only a satisfactory aesthetic result but also care that meets safety and professional ethical standards.
Article written by Dr Romano Valeria
SHARE THIS ARTICLE ON
