aging spots that are due to the gathering of skin pigment cells into patches or blotches as a result of aging & sun exposure, most commonly on the back of the hands. Freckles have the same etiology & are found in younger people or redhaired individuals. They are best treated with 1 or 2 ruby or yag Q-switched laser treatments. These can be performed with local or topical anesthetic. If large areas of the face are involved the CO2 or erbium laser is a better bet as the extra benefit of overall facial rejuvenation is achieved.