Melasma, Sun Spots or Post-Inflammatory Pigmentation?

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.

If acne, eczema or irritation is still active, managing that cause matters alongside addressing the dark marks it leaves. Pigment treatment alone does not address the continuing inflammation. The Primary Care Dermatology Society recommends treating the underlying skin condition promptly and effectively to reduce further post-inflammatory pigmentation. PCDS: facial hyperpigmentation

Is the inflammation still active, or has it left a mark?

A darker patch can remain after an eczema flare has settled. Its continued colour does not, by itself, establish that the eczema is still active. Eczema UK explains that pigmentation can persist after successful eczema treatment. Eczema UK: skin pigmentation and eczema

This makes two questions useful during assessment: “Is there still a skin condition needing treatment?” and “What can reasonably be done about the remaining colour?” They may require different parts of the care plan.

Mention itching, pain and changes after products

Melasma itself does not usually itch or hurt. If a dark patch is uncomfortable, explain those symptoms rather than assuming they are part of melasma. This is a reason for assessment, not a way to diagnose the patch yourself. British Association of Dermatologists: melasma

Describe whether new marks follow breakouts, recurring rashes or irritation after a product. Skincare irritation can itself cause dark spots. If you suspect a prescribed medicine is involved, discuss it with the prescriber before changing it. AAD: causes and management of dark spots

Prepare for the appropriate assessment

Before the appointment, make a short note of:

• Which marks appeared after a breakout or rash, and which appeared without an obvious preceding event.
• Whether the area still itches, hurts or becomes irritated.
• Products and prescribed treatments used, including anything that seemed to precede a reaction.

These prompts organise your observations; they do not identify the condition or establish suitability for laser. Seek GP advice for an ongoing rash or unexplained symptoms. For a general enquiry about appointment options in Bournemouth, ask Progen which appointment is appropriate.

Ask Progen which appointment is appropriate

Sources and further information

• PIH follows inflammatory eruptions or injury; prompt, effective treatment of the primary skin disorder reduces subsequent PIH. Published update 15 February 2023; accessed 25 October 2026.
• Pigmentation can persist after eczema has been successfully treated, so remaining colour alone does not establish continuing active eczema. Accessed 25 October 2026.
• Melasma generally has no physical symptoms: affected skin is not itchy or painful. June 2024 leaflet; accessed 25 October 2026.
• Irritating skincare can cause dark spots; suspected medication-related pigmentation should be discussed with the prescriber rather than prompting independent discontinuation. Accessed 25 October 2026.
• Existing Bournemouth contact page supports general appointment enquiries and advises keeping initial messages general. Opened 25 October 2026.