Concerns · Face
Facial dark spots and melasma: types, causes and treatments
Facial dark spots have different causes: sun spots and freckles appear from sun exposure over the years; melasma is a chronic condition linked to hormones, sun and visible light; and post-inflammatory marks appear after pimples, injuries or irritation. Each type requires a different treatment, combining sun protection, lightening creams and procedures such as laser, intense pulsed light and peels. At Yamagata Dermatologia, in Ipanema, Rio de Janeiro, the type is identified by a dermatologist at the appointment.
Why it happens
Dark spots result from an increase in melanin, the skin's pigment, in a specific area. The most common types on the face are:
- Sun spots and freckles: caused by sun exposure accumulated over the years, they appear on the most exposed areas.
- Melasma: brownish, symmetrical patches on the cheeks, forehead and above the lip, linked to hormonal factors (pregnancy, contraceptives), genetics, sun, heat and visible light.
- Post-inflammatory marks: appear after pimples, bites, burns or irritation, especially in darker skin.
How the evaluation is done
The dermatologist examines the spots, with dermoscopy and Wood's light when necessary, to identify the type and depth of the pigment and rule out lesions that require investigation. The evaluation also covers sun exposure habits, hormone use and the skin care routine.
Recommended treatments
Treatment always includes daily sun protection and lightening creams. Procedures complement and speed up lightening.
- Acroma® laserSun spots and low-energy support in melasma treatment.
- Intense pulsed lightSun spots and freckles (with caution when melasma is present).
- Chemical peelLightening and evening out of skin tone.
- Facial MMPLightening agents delivered to the skin with microneedles.
- MicroneedlingWith delivery of lightening agents, as support in treatment.
Combined treatments
In melasma, combining medical treatment (creams and, in some cases, oral medications), sun protection and low-intensity procedures is usually more effective and safer than a single procedure.
All procedures are recommended and performed after an individual medical evaluation. Results vary from person to person.
Questions
Frequently asked questions
Can melasma be cured?
Melasma is a chronic condition that can be controlled, but it tends to come back with sun exposure, heat and hormonal changes. Ongoing treatment and strict sun protection keep the patch light for long periods.
Does laser make melasma worse?
Some lasers and intense pulsed light, used with inappropriate settings, can worsen melasma. For this reason, treatment is done with specific technologies and energy levels and always combined with medical treatment.
Which sunscreen should I use for dark spots?
For dark spots and melasma, a tinted sunscreen is recommended, which also protects against visible light, reapplied throughout the day. The dermatologist recommends the best option for your skin type.
Is every dark spot on the face benign?
No. Spots that change color, size or shape, or have irregular borders, should be evaluated with dermoscopy to rule out malignant lesions, such as lentigo maligna melanoma.
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