Home — Aesthetic Dermatology — Skin Pigmentation
AESTHETIC DERMATOLOGY · TREATMENTSkin Pigmentation
Treatments for skin tone and pigmentation concerns such as sun spots, melasma, and red or brown marks after acne are planned with a personalized, combined approach following an accurate diagnosis. Rather than aiming for “complete removal in a single session,” the goal is gradual and realistic improvement. Below you will first find comprehensive information about the causes and types of pigmentation, followed by the main treatment options.
GENERAL INFORMATION
Skin Pigmentation: Causes, Types and Treatment Options
Skin pigmentation can develop as a result of increased pigment production, sun damage, hormonal changes, acne, irritation, or certain skin conditions. Not every brown mark is the same, and the same cream or device is not appropriate for every type of pigmentation.
The appearance and location of a mark, when it first appeared, and any accompanying symptoms are important for an accurate diagnosis. In particular, newly developed lesions or lesions that are growing, changing color, or bleeding should be evaluated before treatment.
Why Do Dark Spots Develop on the Face?
One of the most common causes of facial pigmentation is sunlight. Ultraviolet and visible light can increase melanin production in the skin, causing existing spots to darken and new ones to form.
Other causes of facial pigmentation include:
- Melasma,
- Post-acne pigmentation,
- Hormonal changes,
- Hormonal changes,
- Certain medications,
- Irritating cosmetic products,
- Waxing, threading, or friction,
- Eczema and other skin conditions,
- Age-related sun damage,
- Genetic predisposition.
Before starting treatment, it is important to determine whether the mark is a sun spot, melasma, post-acne pigmentation, or a different type of skin lesion. A treatment that improves one type of pigmentation may darken another.
Sun Spot or Melasma?
Sun spots and melasma can look similar, but they are different pigmentation disorders.
Sun spots are usually individual, well-defined, round or oval brown areas. They are most commonly seen on chronically sun-exposed areas such as the face, backs of the hands, arms, and décolletage. They do not disappear completely during winter.
Melasma usually appears as broader, more poorly defined brown or gray-brown patches distributed symmetrically on both sides of the face. It most commonly affects the forehead, cheeks, nose, upper lip, and chin. Sunlight, visible light, genetic predisposition, and hormonal factors can influence melasma.
Laser or light treatments that target individual areas of pigment may be effective for sun spots. Melasma, however, is chronic and prone to recurrence, so it requires a more cautious and long-term treatment approach.
Pigmentation Creams: Which Ingredient Is Used for Which Type of Spot?
Pigmentation products are used to reduce pigment production, support skin renewal, or regulate the transfer of pigment between skin cells.
Key ingredients that may be considered in pigmentation treatment include:
- Azelaic acid: It may be used for both active acne and brown marks that remain after acne.
- Retinoids: They support cell turnover and may be effective for acne, fine lines, and certain types of pigmentation.
- Vitamin C: It provides antioxidant support and may help reduce uneven skin tone.
- Niacinamide: It may support the skin barrier and help reduce pigment transfer.
- Thiamidol, arbutin, and kojic acid: They may target mechanisms involved in pigment production.
- Cysteamine: It may be used for melasma and certain forms of hyperpigmentation.
- Hydroquinone: It is a potent pigment-suppressing agent and should be used for a limited period under medical supervision.
- Tranexamic acid: It may be considered topically, or systemically in suitable patients, particularly for melasma.
Azelaic acid is one option that may help reduce both inflammation and hyperpigmentation.
Using several active ingredients at the same time without supervision can disrupt the skin barrier. Irritation, burning, and redness may cause pigmentation to darken rather than improve.
Laser Treatment for Pigmentation
The aim of laser treatment for pigmentation is to selectively target melanin in the skin. The device used is chosen according to the type and depth of the pigmentation and the patient’s skin tone.
Methods that may be used in pigmentation treatment include:
- Q-switched lasers,
- Picosecond lasers,
- KTP laser,
- Fractional lasers,
- BBL and IPL systems
may be used.
Sun spots and freckles may respond well to pigment-targeting lasers. In melasma, however, high energy and excessive heat can increase pigment production and cause the patches to darken again.
In darker or tanned skin, laser energy may be absorbed not only by the pigment in the lesion but also by normal skin. This can increase the risk of burns, darkening, or lightening of the skin.
Laser treatment should not be applied to an undiagnosed brown lesion. Moles and suspicious pigmented lesions should be evaluated with dermoscopy before treatment.
Can Pigmentation Treatments Be Performed in Summer?
Not all pigmentation treatments need to be stopped during the summer. Sunscreens, suitable pigmentation creams, and skin-care products can be used throughout the season.
However, the skin may become more sensitive to sunlight after laser, intense light, or strong peeling procedures. Treating tanned skin can increase the risk of burns and pigmentation changes.
During the summer:
- Use a broad-spectrum SPF 50+ sunscreen,
- Reapply sunscreen during the day,
- Wear a wide-brimmed hat,
- Avoid intense sun exposure,
- Avoid tanning beds,
- Do not use multiple irritating products at the same time.
Whether a procedure can be performed during the summer depends on the treatment method, skin type, degree of tanning, and the person’s ability to protect the skin from the sun.
How Are Hormonal Pigmentation Changes Managed?
Brown facial pigmentation associated with hormonal changes is most commonly melasma and is sometimes referred to as hormonal melasma . Hormonal changes, sunlight, and genetic predisposition may all contribute. Melasma most commonly appears symmetrically on the forehead, cheeks, and upper-lip area.
Hormonal pigmentation may partially fade after childbirth, but in some people it can persist.
During sensitive periods, the foundation of skin care includes:
- Consistent sun protection,
- Using a wide-brimmed hat,
- Tinted sunscreens that also help protect against visible light,
- Skin-care products suitable for the individual’s skin type
form the basis of care.
Retinoids and certain potent pigmentation medications should not be used during periods of hormonal change when they are contraindicated. A product being “natural” or available without a prescription does not necessarily mean it is safe during sensitive periods. Ingredients should be assessed by a physician.
Why Do Freckles Develop and How Can Their Appearance Be Reduced?
Freckles are small, light- to medium-brown spots that are generally seen in fair-skinned individuals with a genetic predisposition.
They may appear during childhood or adolescence. They darken with sun exposure during summer and may become less visible in winter. Unlike sun spots, their seasonal color change is more pronounced.
To reduce the appearance of freckles:
- Consistent sun protection,
- Suitable pigment-lightening products,
- BBL or IPL,
- Pigment-targeting lasers,
- Chemical peels
may be used.
Because the genetic predisposition remains after treatment, freckles can become more visible again with sun exposure.
Why Does Darkening Occur Above the Upper Lip?
Darkening in the upper-lip area can have several causes.
The most common causes include:
- Melasma,
- Sun exposure,
- Irritation after waxing or threading,
- Friction,
- Inflammation after laser hair removal,
- Irritating cosmetic products,
- Perioral dermatitis,
- Certain medications and hormonal factors.
Upper-lip melasma can create a symmetrical brown shadow, particularly along the upper lip. Pigmentation caused by irritation usually becomes more noticeable after waxing, threading, or the use of chemical products.
Pigment-lightening creams, sun protection, chemical peels, or suitable device-based treatments may be used. However, treating pigmentation alone is not sufficient if active irritation is still present.
Darkening of the Underarms and Groin
The most common causes of darkening in the underarm and groin areas are friction, shaving, waxing, sweating, and irritation caused by cosmetic products.
Other possible causes include:
- Contact dermatitis,
- Fungal and bacterial infections,
- Weight gain,
- Hormonal disorders,
- Acanthosis nigricans,
- Certain medications
may also be involved.
The underlying cause of the darkening should be identified first. Peels or intensive pigmentation treatments performed while friction and irritation continue may further worsen discoloration.
In suitable patients, pigment-regulating creams, controlled peels, and certain device-based treatments may be used. However, if the skin has a thickened, velvety appearance, metabolic causes should also be investigated.
Why Does the Neck Become Darker?
Darkening of the neck is not always caused by dirt, sun exposure, or inadequate cleansing.
A dark, thick, velvety appearance on the neck, underarms, and groin is called acanthosis nigricans . This condition may be associated with obesity, insulin resistance, hormonal disorders, genetic factors, and certain medications.
In acanthosis nigricans, using a pigment-lightening cream alone may not be sufficient. If there is accompanying weight gain, menstrual irregularity, blood sugar problems, or hormonal symptoms, appropriate investigations may be needed.
Sudden-onset or rapidly spreading darkening of the neck requires more detailed evaluation.
Brown Spots on the Backs of the Hands
The backs of the hands are among the areas most frequently exposed to sunlight throughout life. As a result, sun spots and age-related pigmentation changes are common on the hands.
Treatment options may include:
- Sunscreen,
- Pigment-lightening creams,
- Cryotherapy,
- BBL or IPL,
- Pigment-targeting lasers,
- Chemical peels
may be considered.
The skin on the backs of the hands may heal more slowly than facial skin. Picking crusts after a procedure or exposing the area to sunlight can increase the risk of persistent color changes.
Not every brown lesion on the hand is a sun spot. Raised, rough, enlarging, or color-changing lesions should be evaluated before treatment.
Sun Spots on the Décolletage
The décolletage is often exposed to sunlight for many years without adequate protection.
This area may show several changes at the same time, including:
- Brown sun spots,
- Diffuse redness,
- Fine visible blood vessels,
- Uneven skin tone,
- Fine lines
may be present.
In patients with both brown and red changes, light-based systems such as BBL or IPL may be used. Individual darker lesions may be treated with pigment-targeting lasers or cryotherapy.
Because décolletage skin is more sensitive and heals more slowly than facial skin, procedures should be performed using controlled parameters.
Pigmentation After Laser Hair Removal
Pigmentation after laser hair removal is most often associated with excessive heat, treatment on tanned skin, inappropriate device settings, or sun exposure after the procedure.
The skin may develop:
- Brown darkening,
- Lighter-colored areas,
- Burn marks,
- Crusting
may occur.
Using random pigment-lightening products or peels on a newly developed burn can increase irritation. The skin barrier should first be allowed to heal, after which any residual pigmentation can be assessed.
Avoiding tanning before laser hair removal and using sunscreen after the procedure can reduce the risk.
Pigmentation After Waxing and Irritation
Waxing, threading, shaving, scrubbing, or frequent peeling can trigger inflammation in the skin and lead to brown discoloration.
It is particularly common on the upper lip, underarms, groin, and legs.
The first steps in treatment should be:
- Stop the procedure that is causing irritation,
- Repair the skin barrier,
- Reduce friction,
- Protect the skin from the sun
should be the first steps.
Using strong acids or pigment-lightening agents while active redness and burning are still present can worsen darkening.
Pigmentation After Perfume and Sun Exposure
Perfume, cologne, and certain plant oils can cause a phototoxic reaction when applied to areas that are then exposed to sunlight.
Bergamot and citrus-derived ingredients in particular can cause irregular brown patches on the neck, wrists, or décolletage after sun exposure.
This may sometimes appear in the shape of drops, streaks, or fingerprints.
To prevent this, perfumes and essential oils should not be applied directly to skin areas that will be exposed to sunlight. If a reaction develops, the active inflammation should first be controlled, followed by treatment of any remaining pigmentation.
White Patches: Vitiligo or a Fungal Infection?
Skin discoloration is not always brown. Vitiligo and superficial fungal infections can also cause lighter or white patches on the skin.
In vitiligo , loss of pigment may produce sharply defined, milk-white patches. Treatment may aim to restore color, but the result may not be complete or permanent in every patient.
Pityriasis versicolor is a superficial fungal condition caused by overgrowth of Malassezia yeast and may appear as finely scaly lighter or darker patches.
Pigment-lightening creams should not be applied to white patches. The cause of pigment loss should first be identified.
When Can a Skin Spot Be Concerning?
Typical melasma, freckles, and post-acne marks are usually benign. However, some moles and skin cancers can also begin as brown or black lesions.
Medical evaluation should not be delayed if any of the following signs are present:
- A new and rapidly enlarging lesion,
- Marked asymmetry,
- Irregular borders,
- Multiple colors,
- Black, gray, blue, or red areas,
- Bleeding or ulceration,
- Repeated crusting,
- Itching or pain,
- An appearance that is clearly different from other spots.
Fading suspicious pigmented lesions with laser or peeling may delay diagnosis. Dermoscopic examination and biopsy may be needed when appropriate.
Aftercare Following Pigmentation Treatment
The result of pigmentation treatment depends not only on the device or product used, but also on post-treatment care.
After treatment:
- Use sunscreen regularly,
- Do not pick crusts,
- Do not rub the skin,
- Avoid scrubbing and peeling,
- Pause irritating active ingredients for the recommended period,
- Use moisturizers that support the skin barrier,
- Limit sauna, Turkish bath, and excessively hot environments.
After pigment laser or light-based treatment, spots may temporarily darken for a few days. However, severe pain, blistering, or open wounds are not expected.
Common Mistakes in Pigmentation Treatment
Common mistakes in pigmentation treatment include:
- Using pigmentation creams without a diagnosis,
- Applying multiple acids at the same time,
- Assuming that more peeling means the treatment is more effective,
- Applying too little sunscreen,
- Failing to reapply sunscreen,
- Picking crusts,
- Undergoing laser treatment on tanned skin,
- Treating melasma as if it were a sun spot,
- Targeting only pigmentation while active acne is still present,
- Buying products online with unclear or unknown ingredients.
Irritation can increase pigment production after inflammation. Therefore, stronger or more frequent treatment does not always mean faster results. After inflammation, melanin can accumulate in the upper and deeper layers of the skin and lead to persistent darkening.
Do Lemon, Baking Soda, and Vinegar Help Dark Spots?
Lemon juice, vinegar, and baking soda are commonly used home remedies for pigmentation, but they are not safe or controlled treatments.
Lemon and vinegar can:
- Irritate the skin,
- Cause chemical burns,
- React with sunlight,
- Make pigmentation darker.
Baking soda can disrupt the skin’s natural pH balance, leading to dryness and barrier damage.
Burning and peeling of the skin do not mean that pigmentation is being treated. On the contrary, the resulting inflammation may increase the risk of persistent pigmentation.
Why Is Pigmentation Treatment Personalized?
Two spots that look the same color may have different causes and be located at different depths within the skin.
When planning treatment, the following are considered:
- The diagnosis of the pigmentation,
- The depth of the pigment,
- Skin type,
- Tanning status,
- The presence of active acne or eczema,
- Hormonal factors,
- Medications being used,
- Response to previous treatments
are assessed together.
In some patients, sunscreen and topical treatment alone may be sufficient. Others may require peeling, laser, or light-based procedures. In chronic conditions such as melasma, long-term maintenance care should continue after treatment.
↑ Back to topSun Spot Treatment
Sun spots (solar lentigines) develop as individual, well-defined, round or oval brown areas as a result of long-term sun exposure. They are most commonly seen on sun-exposed areas such as the face, backs of the hands, arms, and décolletage, and they do not disappear completely during winter. Unlike melasma, they can often be treated by targeting individual areas of pigment.
The aim of treatment is to selectively target the pigment and reduce the appearance of the spot. Pigment-targeting lasers, light-based systems such as BBL/IPL, chemical peels, and suitable pigment-lightening skin-care products may be combined according to the individual. The most critical step is sun protection; without continued protection, new spots may develop and existing ones may darken.
What is it used for?
- Sun- and age-related brown spots
- Uneven skin tone on the face, backs of the hands, arms, and décolletage
- Individual, well-defined areas of pigmentation
How is it performed?
Depending on the type of pigmentation and skin tone, pigment-targeting lasers, BBL/IPL, peels, and skin-care products may be combined. Lesions that are undiagnosed or suspicious are evaluated with dermoscopy before treatment; laser is not applied directly to every brown lesion.
Results and longevity
Spots may temporarily darken and flake off after treatment; improvement becomes visible gradually. New spots may develop if sun protection is not maintained.
Aftercare and precautions
Sun protection is essential, and crusts should not be picked. Some devices may not be suitable for tanned or darker skin. During periods of hormonal change, certain products and procedures may not be appropriate; suitability should be discussed with a physician.
Who is it suitable for?
- People with sun-related spots on the face, backs of the hands, arms, or décolletage
- People bothered by well-defined brown spots that have increased with age
- People whose skin appears tired due to uneven tone
How many sessions are needed?
This varies according to the depth and extent of the pigmentation and the method selected. Individual superficial spots may lighten noticeably within a few sessions, while widespread uneven tone may require a series of treatments and periodic maintenance. The exact plan is determined after examination.
Frequently asked questions
Should pigmentation treatment be done in winter? Periods with less sun exposure are more convenient for light and laser treatments, but suitable methods can be planned throughout the year with proper protection.
Can the spots return? New spots may form as long as sun exposure continues; consistent sun protection is the key to maintaining results.
Why can pigmentation become noticeable again?
With sun spots, reducing the visible pigment alone is not enough; ultraviolet and visible-light exposure that triggers new pigment formation must also be controlled. If regular sun protection is stopped after treatment, if there is intense sun exposure, or if the skin is irritated, spots can darken again. Maintaining results therefore depends on daily skin-care habits as much as on the procedure itself.
How is treatment selection personalized?
The depth of the pigmentation, the person’s skin tone, previous procedures, and how strongly the pigmentation darkens with sun exposure are evaluated. In some people, pigment-lightening skin-care products may be sufficient, while others may benefit from chemical peels, light-based systems, or suitable laser options. In darker skin types, excessive energy can trigger new pigment formation, so a controlled and gradual approach is important.
During breastfeeding
In general, these treatments can be considered during breastfeeding. The pigment-lightening product, peeling ingredient, or device-based method is selected by the specialist physician according to the individual’s skin characteristics. Sunscreen use and avoidance of irritation remain essential parts of treatment during this period.
When should results be evaluated?
The appearance immediately after a pigmentation procedure is not the final result. With some methods, pigment may first darken and then shed from the surface; with others, lightening occurs gradually over several weeks. The skin’s response is monitored between sessions so that energy settings, product intensity, or treatment intervals can be adjusted. This approach helps reduce unnecessary irritation and allows treatment to progress in a more controlled manner.
↑ Back to listDermamelan / Cosmelan
Dermamelan and Cosmelan are professional depigmentation treatments used particularly for melasma and persistent pigmentation. A specialized mask is applied in the clinic, followed by a structured home-care program to maintain the effect. The goal is to reduce pigment production and even out skin tone.
Because melasma is chronic and prone to recurrence, strict adherence to home care and sun protection directly affects the outcome. Improvement develops gradually, and pigmentation may recur if protection is not maintained. For this reason, the treatment should be viewed not as a single procedure but as a structured program requiring consistency.
What is it used for?
- Melasma (hormone-related pigmentation)
- Persistent sun spots
- General uneven skin tone
How is it performed?
A mask is applied in the clinic, followed by a structured home-care routine. The entire process continues under physician guidance together with sun protection.
Results and longevity
Results become gradually more noticeable over several weeks. Recurrence may occur if home care and sun protection are not maintained, so longevity depends greatly on adherence.
Aftercare and precautions
Temporary redness, peeling, or sensitivity may occur. Adherence to home-care and sun-protection instructions is essential. It may not be appropriate during certain periods of hormonal change; suitability is assessed individually.
Who is it suitable for?
- People with melasma and persistent, widespread pigmentation
- People who are not suitable for, or have not responded to, laser or light-based treatments
- People who can consistently follow a home-care program
How does the process progress?
After the mask is applied in the clinic, treatment continues for several weeks with home-care creams. Redness and peeling may occur during the first few weeks, and improvement in skin-tone uniformity usually becomes noticeable within 4–8 weeks. The success of the program is directly related to adherence to home care and sun protection.
Frequently asked questions
How long does the peeling phase last? It is generally most noticeable during the first 1–2 weeks; moisturizer and sun protection should be used regularly during this period.
Does melasma completely disappear? Melasma is a chronic condition; the goal is to significantly lighten the pigmentation and keep it under control with ongoing protection.
Why is the home-care program important?
Dermamelan and Cosmelan should not be considered single-step masks applied only in the clinic. The home-care protocol that continues after the initial application is an important part of treatment for suppressing pigment production and maintaining the improvement achieved. Using the products more often or in larger amounts than recommended does not produce faster results; instead, it can cause redness, burning, and disruption of the skin barrier.
What can be expected during the first few weeks?
Dryness, tightness, mild burning, and controlled peeling may occur during the initial phase. During this period, the skin should not be stressed with harsh cleansers, granular scrubs, or unnecessary active ingredients. Moisturizer and regular sun protection help the skin barrier recover in a balanced way. Changes in pigmentation are gradual and should not be judged based on how the skin looks on a single day.
During breastfeeding
In general, these treatments can be considered during breastfeeding. The professional products and home-care ingredients to be used are reviewed by the physician before treatment, and a program is created according to the skin’s needs.
↑ Back to listRed and Brown Marks After Acne
Marks that remain on the skin after acne are often not permanent “scars” (depressed scars), but color changes that develop during the healing process. There are two main types: the red-pink marks (vascular in origin, post-inflammatory erythema) and brown marks (pigment-related, post-inflammatory hyperpigmentation). Because this distinction directly determines treatment, the type of mark is evaluated first.
Most of these marks tend to fade over time, but the process may take longer depending on sun exposure, skin type, and whether active acne is still present. Therefore, the two most important steps are bringing active acne under control and consistent sun protection. For brown marks, pigmentation treatments such as appropriate skin care, peels, and light/laser procedures may be considered; for red marks, vascular-targeted laser or light treatments can be planned individually.
What is it used for?
- Brown marks after acne (hyperpigmentation)
- Red-pink marks after acne (persistent redness)
- General uneven skin tone and a dull appearance
How is it performed?
Depending on the type of mark, suitable skin-care products, chemical peels, pigment/light-based procedures for brown marks, and vascular-targeted laser/light treatments for red marks may be combined on an individual basis. The process is planned together with active acne treatment and sun protection.
Results and longevity
Improvement is gradual, and many marks fade significantly over time. Brown marks may darken or recur if sun protection is not maintained. This is different from depressed acne scars.
Aftercare and precautions
Active acne should be brought under control first. Sun protection is essential, and acne lesions should not be squeezed or picked, as this increases the risk of both discoloration and scarring. During periods of hormonal change, certain products and procedures may not be appropriate; suitability should be discussed with a physician.
Who is it suitable for?
- People bothered by persistent red-pink marks after acne
- People whose brown post-acne marks have not faded
- People whose acne is under control and who are ready for pigmentation treatment
How many sessions are needed?
This varies according to whether the marks are red or brown and how extensive they are. Vascular-targeted treatments and pigmentation protocols are often planned as a series of several sessions. If active acne is ongoing, it should be controlled first; otherwise, new marks will continue to develop.
Frequently asked questions
How long do the marks take to fade? Depending on skin type and sun protection, they may fade over weeks to months; treatment can accelerate this process.
Does using concealer cause harm? Non-comedogenic products are generally acceptable; the important points are to avoid irritating the skin and to cleanse it thoroughly in the evening.
Are red and brown marks the same?
Not every color change that remains after acne develops through the same mechanism. A red or pink appearance is usually related to visible blood vessels and post-inflammatory redness, whereas a brown appearance is more closely associated with increased melanin and pigmentation. This distinction is important because vascular lasers that target redness and skin-care products or pigmentation treatments that target brown pigment serve different purposes.
Can pigmentation treatment be performed before acne is controlled?
If new acne lesions continue to appear, targeting only old marks is often not sufficient. The priority is to bring active acne under control and reduce the development of new marks and scars. Pigmentation, redness, and texture concerns can then be addressed separately according to the skin’s characteristics. This approach aims both to reduce existing marks and to help prevent new ones from forming.
During breastfeeding
In general, these treatments can be considered during breastfeeding. Products used for acne and ingredients used for pigmentation treatment are evaluated together; device-based or skin-care treatments are selected according to the dermatologic examination.
How can pigmentation be distinguished from a true acne scar?
Color changes are usually level with the skin surface, whereas true acne scars involve depressions, uneven texture, or, less commonly, raised areas. If the skin surface remains smooth once a brown or red mark fades, the main issue is color. For depressed scars, tissue-remodeling treatments such as fractional laser, microneedling, or radiofrequency may be considered separately. Making this distinction helps prevent unnecessary or inappropriate procedures.
↑ Back to listMelasma
Melasma is a chronic pigmentation disorder that tends to recur and typically appears as symmetrical, poorly defined brown or gray-brown patches on both sides of the face. It most commonly affects the forehead, cheeks, nose, upper lip, and chin. Sunlight and visible light, hormonal changes (including certain hormone treatments), and genetic predisposition are among the main triggers.
Melasma treatment is not a “one-session removal” process, but a long-term strategy for control. Because light and heat can increase pigment production, aggressive laser or light treatments may worsen melasma; therefore, a gentle, personalized, combined approach is required. Consistent and appropriate sun protection is always the foundation of treatment.
What is it used for?
- Symmetrical, hormone-related melasma on the face
- Pigmentation that persists after hormonal changes
- Chronic uneven skin tone and a dull appearance
How is it performed?
Sun and visible-light protection, pigment-regulating skin-care products such as azelaic acid, tranexamic acid, or hydroquinone in suitable patients, gentle chemical peels, and, when needed, depigmentation programs such as Dermamelan/Cosmelan are combined on an individual basis. Light or laser treatments are considered only in appropriate cases and with controlled parameters.
Results and longevity
Because melasma is chronic, results are gradual and must be maintained with protective care. Recurrence is common when sun protection is stopped, making long-term maintenance important after treatment.
Aftercare and precautions
Regular broad-spectrum sunscreen, preferably tinted/mineral when appropriate, is essential. Aggressive procedures should be avoided. During periods of hormonal change, retinoids and certain potent ingredients may not be suitable; suitability should be discussed with a physician.
Who is it suitable for?
- People with symmetrical, poorly defined brown patches on the face
- People with pigmentation that has persisted after hormonal changes
- People who have previously experienced darkening after laser treatment and require a gentler approach
Treatment strategy for melasma
The strategy for melasma is not a “single powerful intervention” but “gentle, continuous control”: strict sun and visible-light protection forms the foundation, pigment-regulating home care is added, and gentle peels or depigmentation programs may be incorporated when needed. Because aggressive heat and light treatments can darken melasma, method selection must be made carefully.
Frequently asked questions
Why does melasma recur? Because hormonal predisposition and light exposure can persist; if protection is stopped, pigment production may become active again.
Why is tinted sunscreen recommended? Tinted sunscreens containing iron oxides also help protect against visible light, which can trigger melasma.
Why is melasma considered chronic?
In melasma, pigment-producing cells may be more sensitive to light, heat, hormonal changes, and inflammation. Therefore, significant lightening does not mean the condition will never recur. The aim of treatment is not only to reduce existing pigmentation but also to control new pigment production as much as possible and establish a long-term protective routine.
Difference between superficial and deeper pigment
The layer of the skin in which pigment is concentrated affects treatment response. More superficial pigment may respond more quickly to topical products and controlled peels, whereas deeper or mixed-type melasma may require a longer process. Strong laser treatment is not appropriate for every dark patch; in some types of melasma, excessive heat and inflammation may paradoxically worsen pigmentation. For this reason, lower-risk, gradual, and monitorable protocols are preferred.
During breastfeeding
In general, these treatments can be considered during breastfeeding. Pigmentation products, peeling ingredients, and device-based treatments are planned individually. Consistent protection from sunlight and visible light remains one of the most important parts of treatment during this period.
Why should follow-up be long term?
After melasma treatment, it is often more appropriate to continue a maintenance program rather than stop all care completely. Sun protection, skin-barrier-supporting care, and maintenance pigmentation products when needed can help reduce new episodes of darkening. The plan may be adjusted during seasonal changes or periods of intense light exposure.
↑ Back to listLet’s Determine the Right Diagnosis and Plan for Your Pigmentation Together
Correctly identifying the type of pigmentation directly affects treatment success. Contact us for a personalized treatment plan.