Not all brown or dark areas on the skin are the same. Sunspots, melasma, freckles, post-inflammatory hyperpigmentation caused by acne or other inflammatory skin conditions, and certain moles develop for different reasons. An accurate diagnosis is therefore essential before planning treatment.
Not every pigmented lesion is suitable for laser treatment. Any lesion that has recently appeared, increased in size, or changed in shape or colour should first be examined by a dermatologist. A dermoscopic examination or additional diagnostic procedures may be required in some cases.
A treatment plan is created by considering:
The type, location, and depth of the pigmentation
The patient’s skin type
Sun exposure
Current medications
Previous treatments
The risk of post-treatment pigmentation changes
For some pigmentation concerns, the first steps may be consistent sun protection and topical medication. In suitable patients, chemical peels, laser treatments, or other light-based procedures may be included in the treatment plan. No single treatment method is appropriate for every type of pigmentation.
Pigment-targeting technologies, including Q-switched and picosecond lasers, may be used for certain pigmented lesions. Fractional lasers or other light-based systems may also be considered in selected cases.
The choice of device and treatment settings depends on the diagnosis, the depth of the pigment within the skin, and the patient’s skin type. A treatment method should not be selected solely based on the visible appearance of a dark spot.
Melasma is a pigmentation condition associated with sun exposure, hormonal factors, and individual predisposition. It also has a tendency to recur. Consistent sun protection and appropriate topical treatments form the foundation of melasma management.
Following a dermatological assessment, laser or light-based treatments may be considered for selected patients as part of a broader treatment plan. However, these procedures may sometimes cause irritation, increased pigmentation, or recurrence. For this reason, laser treatment is not suitable for every patient with melasma.
Brown marks that remain after acne are known as post-inflammatory hyperpigmentation. The first priority is to control active acne and prevent new marks from developing.
For some patients, topical treatments and careful sun protection may be sufficient. If laser treatment is being considered, the patient’s skin type and the depth of the pigmentation must be assessed carefully. Inappropriate treatment may cause the pigmentation to become darker.
The number of sessions varies depending on the type and depth of the pigmentation, the treatment method used, and the skin’s response.
Some superficial sunspots may respond relatively quickly, while melasma and post-inflammatory hyperpigmentation often require longer-term treatment and follow-up.
The exact number of sessions and the final outcome cannot be guaranteed in advance. Pigmentation may return or become more noticeable because of sun exposure, hormonal changes, or the persistence of the underlying cause.
Temporary redness, sensitivity, swelling, crusting, or darkening may occur after laser treatment. Possible complications include:
Post-inflammatory hyperpigmentation
Hypopigmentation or lightening of the skin
Burns
Prolonged irritation
Scarring in rare cases
The risk of pigmentation changes may be higher in patients with darker skin types. Treatment may also need to be postponed if the skin is recently tanned or sunburned.
Consistent sun protection is a fundamental part of treating pigmentation. Sun exposure can darken existing spots, trigger new pigmentation, and cause treated areas to become noticeable again.
Regular use of a suitable broad-spectrum sunscreen and limiting direct sun exposure are essential for maintaining treatment results and reducing the risk of recurrence.
At Dr. Armin Müştak’s dermatology practice in Çankaya, Ankara, pigmented lesions and dark spots are assessed according to their diagnosis, the patient’s skin type, medical history, and individual risk factors.
Following a dermatological examination, the suitability of laser treatment or other methods is determined, and a personalised treatment plan is created for suitable patients.
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