By late October the tan has faded and what it was hiding shows: brown spots on the cheeks, freckling that did not go away, a tone that looks less even than it did in spring. Fall is when clinics treat pigmentation, and the two treatments used most often are the chemical peel and the Lumecca IPL photofacial. They work in different ways and suit different skin. Here is how to tell them apart.
Why autumn is the season
Both treatments leave the skin more sensitive to the sun while it heals, and sun on healing skin is the main cause of pigment coming back darker. Light-based treatments also carry more risk on tanned skin, because the light is absorbed by the pigment of the tan as well as by the spot. That is why IPL requires no sun exposure and no self-tanner for four weeks beforehand.
From October to March in Montreal, the days are short, the UV index is low and most skin is covered. Sunscreen is still needed every day, snow included, but the conditions are far easier to manage than in July.
Know what kind of pigmentation you have
Sun spots are flat, well-defined brown marks on the areas that get the most light: cheeks, temples, hands, chest. Freckles are smaller and lighter, and they deepen with sun. Post-inflammatory marks are the brown or reddish traces left by acne or irritation. Melasma shows up as larger, symmetrical patches on the forehead, cheeks or upper lip, and it is influenced by hormones.
These do not respond to the same treatment. Melasma in particular can worsen with heat and light, so it is approached with caution. A spot that has changed in shape, colour or size, or one that bleeds, should be examined by a doctor before any cosmetic treatment. This is why the consultation comes first.
How IPL works
IPL stands for intense pulsed light. The handpiece delivers pulses of broad-spectrum light that are absorbed by melanin, the brown pigment, and by hemoglobin, the red pigment in blood vessels. The treated spots darken over the following days, then flake off within 7 to 14 days. Because the light also targets red, the same session can calm diffuse redness and small visible vessels.
A session takes 30 to 45 minutes, with mild redness and a feeling of warmth afterwards. Most people see improvement after one to three sessions spaced four weeks apart.
IPL is not suitable for tanned skin or for darker skin tones, where the risk of burns and pigment changes is higher. It is also avoided during pregnancy, with photosensitizing medications, and within six months of isotretinoin.
How a chemical peel works
A peel uses an acid solution, chosen and dosed for your skin, that is applied for a controlled time. It loosens the damaged surface layers and speeds up cell turnover. The skin flakes for three to seven days, and what comes through is brighter and more even. The physician selects the formula and the depth, from glycolic, lactic or salicylic acid to TCA.
A peel treats the whole surface, not individual spots. That makes it a good choice for diffuse dullness, uneven tone, marks left by acne and rough texture. One to three sessions spaced three to four weeks apart is typical. Superficial peels can also be adapted to a wider range of skin tones than light-based treatments.
A peel is postponed in case of pregnancy, an active cold sore, eczema or psoriasis in the area, or isotretinoin in the last six months.
Peel or IPL: how the choice is made
Distinct brown spots on fair to light skin, especially with redness or visible vessels alongside, point to IPL. An overall dull, uneven tone, acne marks or a texture concern point to a peel. Darker skin tones, or skin that tans easily, usually point to a peel as well.
Recovery differs too. After IPL the spots look darker for a week or two, then lift. After a peel the whole face flakes for several days. Neither stops you from working, but both are easier to plan when you know what to expect.
The two are sometimes used in sequence, a few weeks apart, when the skin shows both defined spots and diffuse dullness. That decision is made on your skin and not from a menu.
Before and after care
Before either treatment: stop retinoids about a week ahead, avoid waxing on the area, and wear sunscreen daily. For IPL, arrive with no tan and no self-tanner.
After: a gentle cleanser and a moisturizer only. Do not pick or peel the skin, since pulling off flakes early can leave a mark. Avoid heat and intense exercise for 48 hours. Wear SPF 50 every day for at least four weeks.
Keeping the result
Neither treatment changes how your skin reacts to the sun. New spots will form with new exposure, so daily sunscreen is what protects the result, along with a maintenance session when needed.
Once tone is more even, texture and hydration often become the next question. Our article on Morpheus8 covers firmness and texture, and a skin booster addresses hydration. If you are comparing clinics, how to choose an aesthetic clinic lists the questions worth asking. To have your skin assessed, contact the clinic.