Treatment for Hyperpigmentation

Frequently Asked Questions

• What is hyperpigmentation?
  Hyperpigmentation is a common condition in which excess melanin production makes patches of skin darker than the surrounding area. Common types include sun spots, also called age spots; post-inflammatory hyperpigmentation after acne or injury; and melasma associated with hormonal changes. It is usually harmless but can be cosmetically concerning.
• What causes dark spots on the skin?
  Dark spots develop when skin cells produce excess melanin. Common causes include sun exposure, which creates age spots; skin injury or inflammation such as acne, which can cause post-inflammatory hyperpigmentation; hormonal changes associated with melasma; certain medications; and genetic factors. The cause determines which treatment approach fits the condition.
• When should I see a dermatologist about dark spots?
  See a dermatologist if dark spots concern you cosmetically, if you notice new or changing pigmented areas, if spots developed after acne or a skin injury, or if you want professional treatment options. A clinical evaluation can determine the type of hyperpigmentation and guide treatment selection.
• How is hyperpigmentation treated?
  Treatment starts with daily sunscreen to prevent the pigment from worsening. Options include topical lightening agents such as hydroquinone, vitamin C, azelaic acid, and retinoids, as well as chemical peels and laser treatments. Noticeable improvement may take months, and the underlying cause must also be addressed.
• Will dark spots fade on their own?
  Some dark spots, particularly post-inflammatory hyperpigmentation caused by acne or injury, may fade after the underlying cause is treated. That process can take months to years. Sun spots often do not fade without treatment. Consistent sun protection helps prevent new spots and speeds fading.
• How can I prevent dark spots from forming?
  Prevention centers on sun protection. Use broad-spectrum SPF 30+ sunscreen daily, reapply it every two hours outdoors, wear protective clothing and hats, and avoid tanning beds. Prompt treatment of inflammatory conditions such as acne or rashes helps prevent post-inflammatory hyperpigmentation. Avoid injuring or picking at the skin.
• Why does melasma come back after laser treatment?
  Melasma can return because its triggers remain present. It is driven by hormones and light, and pigment cells in affected skin respond to heat as readily as they respond to ultraviolet exposure. An aggressive device can clear surface pigment and then provoke a rebound weeks later that is darker than the starting point. Melasma is therefore managed conservatively and continuously with strict daily photoprotection, topical treatment, and gentler settings than would be used on sun spots. It is treated as a condition requiring ongoing control. If you have been told to expect permanent clearance in a fixed number of sessions, ask whether the condition being described is actually melasma.
• Which pigment treatments are safe for deeper skin tones?
  Skin with more melanin absorbs more energy from light-based devices. A setting that lifts a sun spot on fair skin can injure the surrounding tissue in a deeper skin tone and cause post-inflammatory darkening that lasts longer than the original spot. Broadband light and intense pulsed light are the riskiest in this respect. The available device classes matter more than a brand name: for deeper phototypes, the usual route is topical therapy, chemical exfoliation, microneedling, and non-pigment-selective wavelengths used at conservative settings. Aesthetx carries several device classes and has a dermatologist on the team, so the plan for your phototype can be chosen on its merits.