Skin · tone
Dark spots and melasma: why sun protection comes first
Uneven tone has several different causes. Knowing which one you are dealing with decides what helps — and how patient you need to be.
Three common kinds of dark marks
Sun spots (solar lentigines) are flat brown spots on the areas that get the most sun, and they become more common with age. Post-inflammatory hyperpigmentation is the dark mark left behind by a spot, a scratch or irritation; it is especially common in darker skin. Melasma appears as symmetrical brown or grey-brown patches on the cheeks, forehead, nose or upper lip, is more common in women, and is driven by a mix of sun, hormones and genetics.
Sun protection is the treatment, not an extra
Ultraviolet light darkens all three, and melasma also reacts to visible light. That is why daily broad-spectrum sunscreen is the first measure for every kind of pigmentation. For melasma, many dermatologists recommend a tinted sunscreen with iron oxides, which also blocks part of the visible light. Without consistent protection, even effective treatments lose ground every sunny day.
Ingredients that can help
Azelaic acid reduces pigment production and has been studied in both acne and hyperpigmentation. Niacinamide reduced dark spots in a 12-week controlled trial. Vitamin C and retinoids help even out tone over months. All of them work gradually and best alongside strict sun protection: allow eight to twelve weeks before judging them.
What needs a prescription
Stronger lightening creams are prescription-only in the EU and meant to be used under medical supervision for limited periods. For moderate to severe melasma there are also prescription treatments taken by mouth, with trial evidence and real contraindications. Ask a dermatologist about the options; the decision belongs with them.
Careful with procedures
Chemical peels and lasers can lighten pigment, but in the wrong hands they can also trigger more of it — especially in melasma and in darker skin. If you consider a procedure, choose a practitioner experienced with your skin type, and expect melasma to need ongoing maintenance: it tends to return when protection slips.
Spots that belong with a doctor
A dark spot that is new, changing in size, shape or color, has an irregular border or several colors, itches or bleeds should be checked by a doctor promptly. These can be signs of skin cancer, and no app — MiraSkinLab included — can rule that out from a photo.
Sources
- Melasma: a comprehensive update: part I — Journal of the American Academy of Dermatology (2011)(Opens in a new window)
- Azelaic acid. A review of its pharmacological properties and therapeutic efficacy in acne and hyperpigmentary skin disorders — Drugs (1991)(Opens in a new window)
- Niacinamide: A B vitamin that improves aging facial skin appearance — Dermatologic Surgery (2005)(Opens in a new window)
- The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer — British Journal of Dermatology (2002)(Opens in a new window)
- Chemical peels in aesthetic dermatology: an update 2009 — Journal of the European Academy of Dermatology and Venereology (2010)(Opens in a new window)
