Brown marks on the face can look similar but behave very differently. Melasma, solar lentigines (sun spots) and post-inflammatory hyperpigmentation do not have the same triggers or treatment response. Correct identification is essential before using laser, peels or active skincare.
A cosmetic clinic should not treat an unexplained or changing pigmented lesion until it has been appropriately assessed.
What is melasma?
Melasma usually appears as symmetrical brown or grey-brown patches, commonly on the cheeks, forehead, nose or upper lip. Sunlight is a major aggravating factor. Hormonal influences, pregnancy, some medicines and genetic susceptibility may also contribute.
Melasma can be persistent and may recur. Heat, ultraviolet and visible light can worsen it, so treatment without ongoing light protection is unlikely to be a complete plan.
What are sun spots?
Solar lentigines are flat, well-defined areas of increased pigment associated with cumulative sun exposure. They commonly appear on the face and hands. Although many are benign, a professional should review any mark that is new, changing, irregular or otherwise concerning.
What is post-inflammatory hyperpigmentation?
Post-inflammatory hyperpigmentation, or PIH, develops after inflammation or injury. Acne, eczema, picking, burns and overly aggressive cosmetic procedures can all leave excess pigment behind. PIH is more frequent and can last longer in deeper skin tones.
Why treatment differs
A device that helps a discrete sun spot could aggravate melasma or trigger PIH if the diagnosis, skin type or settings are wrong. Likewise, strong exfoliation may increase inflammation and create more pigment rather than less.
This is why a responsible plan begins with history and examination: onset, pattern, previous inflammation, sun exposure, hormones, medicines, skin type and past reactions.
Where laser may be considered
Laser treatment for selected pigmented lesions uses energy absorbed by pigment. Suitability depends on the type and depth of pigment, the device available and the risk of post-treatment colour change.
Laser is not automatically the first choice for melasma. Conservative skincare, strict photoprotection and medical treatment may be more appropriate. When a device is considered, the clinician should explain the rationale, patch testing, expected sessions and recurrence risk.
A safer consultation checklist
- What is the likely diagnosis, and how confident are you?
- Does this lesion need medical or dermoscopic review first?
- What is my risk of PIH or hypopigmentation?
- Which device or product is proposed and why?
- What should I stop before treatment?
- How will results be photographed and reviewed?
- What happens if pigmentation becomes darker?
Skincare principles that support treatment
Use broad-spectrum sun protection consistently and avoid deliberate tanning. Choose gentle cleansing and moisturising products, and introduce active ingredients gradually. Do not combine multiple acids, retinoids or “brightening” products without guidance; irritation itself can drive pigmentation.
Red flags that need medical assessment
Seek professional medical review for a lesion that changes size, shape or colour; has an irregular border; bleeds, crusts or itches persistently; looks different from your other marks; or appears rapidly. Cosmetic laser should never be used to obscure a lesion that has not been appropriately identified.
Frequently asked questions
Can pigmentation be removed permanently?
Some discrete marks respond well, but recurrence or new pigmentation is possible, especially when the underlying trigger continues.
Is darker skin unsuitable for laser?
Not necessarily, but treatment requires careful selection because epidermal melanin can also absorb energy. Device choice, settings and practitioner experience matter.
Will one session be enough?
It depends on the diagnosis, depth and response. A reputable clinician should avoid promising a fixed result before assessment.
Start with identification
For a personalised pigmentation assessment in Bournemouth, contact Progen Aesthetics. If a mark needs medical review, that should happen before cosmetic treatment.
Medical note: This guide is educational and does not diagnose any skin lesion.
Further reading: British Association of Dermatologists: melasma.