Pigmentation Removal

Pigmented Lesions

Say goodbye to pigments and hello to clearer skin.

Regardless of whether you were born with pigmented lesions or if you have developed them over time, we can help you get the right treatment to reduce and banish dark spots on the skin.





Freckles, Sun Spots, Melasma, Moles, Age Spots, Keratoses, Poikiloderma, and Café Au Lait are all names given to the different types of pigmented lesions that can occur at any time in people of all ages. While some people are born with these lesions, others develop them over time.

Pigmented lesions result from melanocytes which are specialized cells that are responsible for the production of melanin. When these cells become damaged, or they are unhealthy, the production of melanin is affected. This is one of the key factors that lead to the development of pigmented lesions.

Café-au-lait are characterized as flat, pigmented lesions or birthmarks evenly distributed on the surface of the skin. Café-au-lait are light to dark brown in colour, with well-demarcated, smooth or irregular borders. Contributing factors include: genetics or an excessive number of melanosomes.

Freckles are characterized as small, flat, circular, tan, light brown, brown or black spots on the surface of the skin. Freckles are caused by an overproduction of melanin from repeated exposure to sunlight or ultraviolet rays. Freckles appear mainly on the nose, cheeks, upper shoulders or arms in people with fair skin, blond or red hair and green or blue eyes.

Sun spots are characterized as harmless, flat or slightly raised skin lesions with clearly defined borders. Sun spots range in color from light to dark brown, red, gray or black. Appearing mainly on the nose, cheeks, forehead, neck, chest, forearms or back of the hands. Contributing factors include the sun’s ultraviolet (UV) rays, indoor tanning, sunburns or PUVA photo therapy.

Melasma is a common skin condition that causes the appearance of brown to gray-brown patches of skin due to the body producing too much melanin, a natural substance that gives color to our hair, skin, and eyes. It usually appears on the face, although it can also develop on the forearms and neck. No one is really certain exactly what causes melasma, but there are many factors that can trigger it including pregnancy, birth control pills, hormone therapy, cosmetics, and anti-seizure medications. Because melasma is so common during pregnancy, it is sometimes referred to as “the mask of pregnancy.” Sun exposure is also a major melasma trigger because ultraviolet (UV) light from the sun can increase melanin production.

Age spots — also called liver spots and solar lentigines — are small dark areas on your skin. They vary in size and usually appear on the face, hands, shoulders and arms — areas most exposed to the sun. Age spots are the result of an excess production of melanin, or skin pigment. Doctors don’t always know why age spots develop. Skin aging, sun exposure, or other forms of ultraviolet (UV) light exposure, such as tanning beds, are all possible causes. Age spots are very common in adults older than 50. But younger people can get them too, especially if they spend a lot of time in the sun.

Seborrheic keratosis is a common skin growth. It may seem worrisome because it can look like a wart, pre-cancerous skin growth (actinic keratosis), or skin cancer. Despite their appearance, seborrheic keratoses are harmless. Most people get these growths when they are middle aged or older. Because they begin at a later age and can have a wart-like appearance, seborrheic keratoses are often called the “barnacles of aging.” It’s possible to have just one of these growths, but most people develop several. Some growths may have a warty surface while others look like dabs of warm, brown candle wax on the skin. They range in color from white to black; however, most are tan or brown.

Poikiloderma of Civatte, also known as sun aging, is a condition caused by sun exposure. The skin changes as a result of chronic, long term exposure to the sun as well as normal aging. Chronically exposed children can acquire significant damage by age 15. These effects may also become apparent as early as age 20. Lesions associated with poikiloderma of Civatte are usually asymptomatic, although some patients do report mild burning, itching and increased sensitivity of the affected skin. These chronic reddish-brown discolorations are commonly found on the neck and cheeks. Although the exact causes of poikiloderma of Civatte are unknown, many contributing factors have been identified. Chronic exposure to ultraviolet light is the primary factor, explaining why sun-exposed areas are the most prone to developing these lesions. Photosensitizing chemicals in perfumes and cosmetics have been identified as a possible cause of poikiloderma of Civatte. A genetic predisposition may also exist.

At First Ave Medical Spa, we provide effective and targeted treatment using The Gentle Max PRO system. This is an ultra-modern treatment for pigmented lesions using a non-invasive aesthetic procedure.

A controlled amount of therapeutic energy is individually targeted, and laser pulses are directly applied to the entire area of the lesion. The thermal energy is then absorbed by the target melanin or hemoglobin, and any skin cells that contain the excess melanin are forced to degenerate. This then helps to break down the pigmented lesions in the affected area and once the treatment area reforms and heals; the immune system will get rid of the dead cells and reveal a lighter looking skin beneath.

We also use a cryogen cooling system in tandem to ensure patients maximum comfort. The procedure is fast and effective, and the overall time of the pigmented lesion process will vary depending on the size of the target lesion.





It will depend on the number of spots or the size of the area that you want to be treated, along with the location and depth of the lesion. When we meet with you for a consultation, a treatment plan will be outlined that will give you a precise number of sessions that we feel are needed in order to completely banish the appearance of the pigmented lesions on the skin. For some clients, there are spots which can be removed after a single treatment, and for others, it can take between1-3 sessions for the spots to be completely removed. Treatments are usually spaced at four-six-week intervals.

The majority of our clients will see clear results after just a single treatment. Results are evident between 2-4 weeks after the date of the session.

Once you have a pigmented lesion removed, it will return following your treatment. However, it is important to note that other factors, such as exposure to the sun, aging, and changes to hormones could potentially impact the development of new pigmentations.

Clients report a mild level of discomfort during the treatment. However, it is not described as painful, and due to the length of time, the treatment takes, it is perfectly bearable. At First Ave Medical Spa, we use a specialist cryogen cooling system in tandem with the treatment in order to reduce any discomfort while the treatment is taking place.

Following the treatment, clients will usually experience a reddening or darkening of the area that was treated. It is important to understand that this is perfectly normal, and it is only temporary.

After the treatment, it is important to use sunscreen on a regular basis. Protect your skin from UV rays to ensure that there is no development of new pigmented lesions. It is also widely regarded that regular exercise can increase your circulation and provide additional support to the lymphatic system.



2-1864 West 1st Ave, Vancouver BC V6J 1G5

(604) 568 – 0558