Melasma, sun spots and age spots — why they are not the same mark
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Three kinds of pigmentation that look alike and behave completely differently. What helps one can make another worse, which is why the analysis comes before the method.
A spot is not a spot
When a woman tells me "I have spots", she usually means one thing: something dark on her face that she wants gone.
But under that heading sit several entirely different conditions. Melasma, sun spots and age spots can look similar and behave completely differently — in the depth they sit at, in what triggers them, and in how they respond to treatment. This is not an academic distinction: a method that helps one type can make another worse.
That is why pigmentation treatment here never starts with the device.
Melasma
Melasma tends to appear as broader patches rather than isolated dots, usually more or less symmetrical across both sides of the face, and it is influenced by hormones, by heat and by sun.
It is also the most sensitive of the three. Melasma can react to heat itself, which means an aggressive thermal method may be exactly the wrong thing. Melasma is worked patiently, in layers, with strict sun protection alongside — without that last part, any improvement is temporary.
If someone offers to clear melasma in a single session, it is worth asking one more question.
Sun spots
Sun spots are the cumulative result of exposure over years. They tend to have more defined borders, and they appear where the most sun lands — forehead, cheeks, the bridge of the nose, and on the body the décolleté and the backs of the hands.
They usually respond better than melasma, but the same principle applies: without sun protection after the treatment, the raw material that created them is still there.
Age spots
Age spots appear as part of a cumulative change in the skin over time, often together with a change in texture and in the evenness of tone — not only in colour. So treating them is often not about the spot alone but about the texture around it, and that is where combining with texture work comes in.
The same mark, two different methods, two opposite outcomes. The difference is decided before anything is touched.
What decides the method
At the analysis I photograph and analyse the skin, and among other things I see the depth the pigmentation sits at — including pigmentation that has not yet surfaced. That is exactly what the camera is good at, and the eye is not.
Only then is the method chosen. The clinic has several pigmentation routes, among them a gold pigmentation treatment and a pigmentation treatment combined with exosomes, and sometimes a combination with work on the texture. Choosing between those routes is precisely the decision the analysis exists for.
Three things I say to everyone
It does not end in one session. Pigmentation is almost always a process, not an event.
Sun is part of the treatment. Not as general advice — as part of the protocol. Without it, the improvement does not hold.
A tendency to hyperpigmentation changes the rules. If you have a history of marks appearing after inflammation, after a wound or after a previous treatment, tell me at the consultation — it affects suitability, and sometimes postpones a treatment to another time.
Still have a question this did not answer?
Every process starts with a skin analysis and a conversation. Tell me what is bothering you, and we will start there.