Age spots are not an ageing problem. They are a sunlight problem that took twenty years to show up.
That distinction matters, because it decides what will actually work. A flat brown patch on the cheekbone or the back of the hand is a deposit of melanin left behind by ultraviolet exposure you had years ago. Nothing you apply at home removes a deposit that sits that deep. It has to be broken up or lifted out, and then the light that made it has to be kept off the skin, or it comes back.
This guide is written by the team at Halcyon Medispa, an aesthetic clinic at 2 Hinde Street in Marylebone, London W1U 2AZ, and it covers what age spots are, which of our treatments genuinely fade them, what each one costs, and the cases where we tell people not to bother. Prices quoted are the ones on our published treatment prices list.
In this guide:
- What age spots actually are
- Age spots, freckles, melasma: telling them apart
- Why they appear where they do
- The mark that needs a doctor, not a laser
- What actually fades age spots, treatment by treatment
- What each option costs in London
- How many sessions, and how long before anything shows
- What will not fade them
- Who each treatment suits, and who it does not
- Keeping them off once they have gone
- Frequently asked questions
The short answer: age spots, also called solar lentigines or liver spots, are flat brown, grey or black patches of concentrated melanin caused by cumulative ultraviolet exposure. They respond well to in-clinic pigment treatments: laser toning from £100, the carbon laser facial at £150, Aerolase at £250 a session, a medical peel such as BioRePeel or the Obagi Blue Radiance at £180, or the Cosmelan depigmentation protocol at £1,800 for stubborn, widespread pigment. Most people need a short course rather than one visit, and every result depends on daily sun protection afterwards.
What age spots actually are
Melanin is the pigment that gives skin its colour, and it is also the skin's own sunscreen. When ultraviolet light hits skin, the melanocytes make more of it and push it up into the surface cells to absorb the damage. Do that once and you have a tan. Do it every summer for thirty years and some of those melanocytes stop switching off.
An age spot is the result: a small patch where pigment production has become permanently overactive and the melanin has built up in a defined area. Our age spots page sets out the clinical picture, but the three features that matter for treatment are that the spot is flat, that its edges are fairly clean, and that its colour is even. Flat means there is nothing raised to remove, so this is a pigment job rather than a surgical one.
They are harmless. Nobody needs to treat them. People do because a face reads younger when the tone is even, and because the backs of the hands give away age faster than almost anything else.
Age spots, freckles, melasma: telling them apart
These three get lumped together and they behave completely differently under treatment, which is why a plan built for one can make another worse.
| Age spots | Freckles | Melasma | |
|---|---|---|---|
| What they are | Fixed patches of accumulated melanin from years of UV | Small genetic spots that darken in sun and fade in winter | Larger, blotchier patches driven by hormones as well as light |
| Typical age | Usually from the late thirties onward | Often since childhood | Commonly twenties to forties |
| Where | Face, backs of hands, forearms, chest, shoulders | Nose, cheeks, shoulders | Cheeks, upper lip, forehead, often symmetrical |
| Edges | Defined | Defined, small | Diffuse and irregular |
| Behaviour | Stay put and slowly multiply | Come and go with the seasons | Flare with pregnancy, the pill, and heat as well as sun |
| Response to laser | Generally good | Good, but they return with sun | Unpredictable. Heat alone can worsen it |
If the patches are blotchy, symmetrical across both cheeks and appeared during pregnancy or after starting the pill, read our melasma page rather than this one. Melasma is the reason the Cosmelan peel exists, and it is the one pigment condition where reaching for a laser first is frequently the wrong move. Freckles and general hyperpigmentation each have their own page too.
A flat brown patch is a deposit, not a stain. You are not bleaching it out. You are breaking it up and letting the skin carry it away.
Why they appear where they do
Look at where people get them and the cause is obvious. The left cheek and the left forearm in the UK, because that is the driver's side of the car. The backs of the hands, which sit on a steering wheel in daylight for years and almost never see sunscreen. The upper chest, above every summer neckline. The tops of the shoulders. None of that is coincidence.
Three other things push them along. Age itself, because skin repairs itself more slowly and clears pigment less efficiently as the years go on. Genetics, since lighter skin types burn more readily and family history counts. And sunbeds, which do exactly what daylight does, faster and with no seasonal break.
There is a practical consequence. If you treat the spots on your face but keep driving without sunscreen on your hands, you will pay for one area twice and watch the other get worse. Treat the pattern, not the patch.
The mark that needs a doctor, not a laser
Read this before booking anything. A pigment treatment is only appropriate for a mark that is confidently benign. If a spot has changed size, shape or colour, has an uneven or ragged border, sits higher than the skin around it, itches, crusts or bleeds, or simply looks different from every other mark you have, it needs to be examined by a doctor or a dermatologist before anyone points a laser at it. We will say the same thing at consultation and send you to your GP. Removing a lesion that should have been assessed is worse than leaving it alone.
This is not a formality. It is the single reason a pigment consultation is a medical appointment rather than a beauty one, and it is why every plan at our Marylebone clinic is set by our Medical Director, Dr Osman Bashir Tahir, or by a clinician working to his protocols.
What actually fades age spots, treatment by treatment
Every option below works in one of two ways: it heats the pigment until it fragments so the skin can clear it, or it lifts the pigmented surface layers away and slows the cells making the melanin. Lasers do the first. Peels and depigmenting protocols do the second. Which suits you comes down to how deep the pigment sits, how much of it there is and how much downtime you will accept.
Laser toning
The lightest option we offer, at £100 a session on the price list. Low energy laser passes break up superficial pigment gradually across a course, with essentially no downtime. It suits scattered, faint spots on someone who wants no visible recovery and is happy to come back several times.
The carbon laser facial
A layer of carbon is applied, settles into the surface and the pores, and the laser targets it. £150 a session. It brightens overall tone and shifts superficial pigment while also cleaning out congestion, which is why people with age spots and enlarged pores together often start here. We have written it up in full in everything you need to know about a laser carbon peel.
Aerolase
The most versatile laser in the clinic and, for defined brown spots, usually the most direct route. It delivers energy in pulses of 650 microseconds, short enough to reach the pigment before much heat spreads into the tissue around it, which is what allows it to be used across skin types rather than only on fair skin. A session is around 40 minutes with no anaesthetic, and the guide course is four to six sessions two weeks apart. The Aerolase facial is £250 a session. Full detail is on the Aerolase treatment page and in our guide to what the Aerolase laser treats.
Medical peels
BioRePeel and the Obagi Blue Radiance peel are both £180 and work by accelerating turnover of the pigmented surface layers. They suit dull, uneven tone with light spotting more than they suit one dark, well defined lentigo. Our post on which skin concerns a chemical peel can treat covers where the line falls, and the chemical peel page lists the full range.
Cosmelan
The heavy artillery, at £1,800 including the two week home preparation kit and the aftercare kit. A mask is applied in clinic, worn for a set number of hours, then followed by a months long home phase that suppresses melanin production rather than only removing what is already there. First changes show within about two weeks and the biggest shift lands at around a month. It was designed for melasma and widespread stubborn pigmentation. For six flat spots on the backs of two hands it is the wrong tool and we will tell you so.
Microneedling
Dermapen microneedling starts at £170 for the face. It is not a pigment treatment in itself, but it improves the texture and tone that surround the spots and it is often sensible after a pigment course rather than instead of one.
What each option costs in London
These are our published prices. A consultation with Dr Osman Bashir Tahir is £200, with an aesthetic physician £100, and with an aesthetician it is complimentary. If your plan involves any laser, the patch test beforehand is also complimentary.
| Treatment | Price per session | Downtime | Best suited to |
|---|---|---|---|
| Laser toning facial | £100 | None | Faint, scattered pigment across a course |
| Carbon laser facial | £150 | None to a few hours of redness | Uneven tone with congestion and pores |
| BioRePeel | £180 | Light flaking for a few days | Dull tone, light surface pigment |
| Obagi Blue Radiance peel | £180 | Light flaking for a few days | Surface pigment and texture together |
| Aerolase facial | £250 | Redness for hours, occasionally a day | Defined brown spots, all skin types |
| Halcyon Aeropeel facial | £350 | As above plus peel flaking | Combining laser and peel in one visit |
| Cosmelan peel | £1,800 including both kits | Visible peeling, then a months long home phase | Widespread or stubborn pigment and melasma |
Where a course makes sense, the whole plan and its cost are set out at consultation before anything is booked. The full list, including finance options, is on the prices page.
How many sessions, and how long before anything shows
Nobody clears years of accumulated pigment in one appointment, and any clinic promising that is selling you something. With laser treatment, this is the shape of it.
| When | What is happening | What you see |
|---|---|---|
| The session | Pigment absorbs the energy and fragments | Treated spots often look darker, sometimes almost coffee coloured. This is normal and is the point |
| Days 3 to 10 | Fragments work their way to the surface | The darkened spots flake or fade away. Do not pick them |
| Weeks 2 to 4 | The skin settles and clears the debris | First honest assessment of how much lighter the area is |
| Across a course | Each pass reaches pigment the last one did not | Steady lightening. Deeper spots take the most sessions |
| Three months on | Nothing further happening unless you are still in the sun | The settled result, which holds or does not depending entirely on sun protection |
The darkening in the first days catches people out. It is the treatment working, not a burn, and it is the reason we ask you not to book a laser session in the week before a wedding.
What will not fade them
- Exfoliating harder. Age spot pigment sits below the layers a scrub reaches. Scrubbing irritates the skin, and irritation makes melanocytes produce more pigment, not less.
- Lemon juice and other kitchen remedies. They lower the skin's pH, they photosensitise it, and a few of them cause a genuine chemical burn that leaves a darker mark than the one you started with.
- Most high street brightening creams. A good vitamin C or a prescription strength retinoid will fade the shallowest marks over months and will help hold a clinic result. Neither will clear an established lentigo on its own.
- Waiting for winter. Freckles fade in winter. Age spots do not. If a mark is still there every February, it is not a freckle.
- Treating the face and forgetting the hands. The hands are usually worse and are almost always left out of the plan.
Who each treatment suits, and who it does not
Here is where we take a position rather than list options.
If you have a handful of defined brown spots and otherwise decent skin, a short Aerolase course is the cleanest answer. It goes at the pigment directly, it is safe across skin types, and you are not paying for a whole face protocol to fix six spots.
If your whole complexion reads dull and blotchy rather than spotted, start with peels or the carbon laser facial. Chasing individual marks on skin like that leaves you with lighter spots on unchanged skin, which looks worse than where you began.
If the pigment is widespread, has resisted treatment before, or is hormonal, Cosmelan earns its price. Nothing else in the clinic suppresses new pigment production the way it does. But it demands a two week preparation, real visible peeling and months of discipline afterwards, and if you will not do the home phase you should not start it.
If you have very few spots, they are pale, and you are under about thirty five, our honest advice is to spend the money on daily SPF and a retinoid and come back in five years, if at all. That is not a treatment we can sell you, and it is still the right answer for some people who walk through the door.
If you are pregnant or breastfeeding, wait. Pigment behaves unpredictably while hormones are shifting, and results achieved now can be undone within months.
Keeping them off once they have gone
This is the part people skip and then blame the laser.
- Broad spectrum SPF 30 or higher, every day, all year. UVA passes through cloud and through window glass, which is why the driver's side arm is always the worse one.
- The backs of the hands, every time. Keep a tube in the car. It is the single highest return habit for anyone treating age spots.
- No sunbeds. There is no version of this that is compatible with keeping pigment away.
- Antioxidants in the morning, a retinoid at night, if your skin tolerates them. They will not do the clearing, but they hold the ground the treatment won.
- A review, not a reflex. If new spots are appearing quickly, the answer is usually a change to your sun habits rather than another course of laser.
Frequently asked questions
Can age spots be removed permanently?
The individual spot can be cleared and, treated properly, it generally does not come back. What treatment cannot do is stop new ones forming, because that depends on how much ultraviolet light your skin sees from now on. People who wear daily SPF hold their result for years. People who do not are usually back within two summers.
What is the best treatment for age spots on the hands?
Laser, in most cases, because hand pigment is well defined and the skin is thin and heals cleanly. At Halcyon Medispa that generally means an Aerolase course at £250 a session. Hands are also the area most likely to be left out of a plan and most likely to relapse, so they need the same daily sunscreen as the face.
Do age spots come back after laser treatment?
The treated spot does not usually return. New ones can appear nearby if the skin keeps getting sun, and untreated pigment sitting deeper than the course reached can surface later. Both are managed with sun protection and a maintenance session rather than starting again.
Is laser treatment for pigmentation safe on darker skin?
It depends entirely on the device and the settings. Aerolase delivers its energy in 650 microsecond pulses, short enough to act on the pigment before heat spreads into the surrounding skin, which is why it is used across skin types at our clinic. Any laser used on richer skin tones needs a patch test first, which is complimentary here, and a clinician who adjusts the settings rather than running a preset.
How much does age spot treatment cost in London?
At Halcyon Medispa in Marylebone the range runs from £100 for a laser toning session to £1,800 for the full Cosmelan depigmentation protocol including both kits. The commonly chosen options sit between: carbon laser facial £150, BioRePeel or Obagi Blue Radiance peel £180, Aerolase facial £250. Consultation is £200 with Dr Osman Bashir Tahir, £100 with an aesthetic physician and complimentary with an aesthetician.
How many sessions will I need?
For laser, plan on a course rather than one visit. Our published guide for Aerolase is four to six sessions two weeks apart, with the exact number confirmed at consultation and reviewed as you go. Deep or long standing pigment takes more; faint surface marking takes fewer.
Will the spots look worse before they look better?
Usually, briefly. After a laser session the treated marks often darken for several days before they flake or fade away. That is the fragmented pigment travelling to the surface, and it is the sign the treatment reached its target. Leave it alone and keep it out of the sun.
Can I treat age spots and melasma at the same time?
Not with the same plan. Melasma is driven by hormones as well as light and can be aggravated by heat, so a laser that clears a lentigo can make melasma darker. If you have both, the melasma is stabilised first, usually with a depigmenting protocol, and the individual spots are addressed afterwards.
Should I have a mole checked before treatment?
Yes, if there is any doubt at all. Any mark that has changed in size, shape or colour, has an irregular border, is raised, itches, crusts or bleeds should be examined by a doctor or dermatologist before any pigment treatment. We assess this at consultation and will refer you rather than treat it.
What can I do at home between sessions?
Daily broad spectrum SPF 30 or higher on every treated area, including the backs of the hands. A vitamin C serum in the morning and a retinoid at night if your skin tolerates them. No scrubs, no acids in the days immediately after a session, and no picking at flaking pigment.
Talk to someone who will tell you which one you need
Age spots are one of the few concerns where the assessment matters more than the machine, because the same brown patch can call for a £100 session or a £1,800 protocol depending on what is underneath it. A consultation at Halcyon Medispa, 2 Hinde Street, Marylebone, London W1U 2AZ, sorts that out in one visit. Our patient journey page walks through what a first appointment involves, and this piece explains how a medical clinic differs from a salon. You can see the full device list on our technology page or reach us through contact.
