Treating pigmentation spots – Dr. Tremblay answers your questions

Pigmentation spots and skin tone irregularities are common concerns of people who come for a consultation for the improvement of their skin’s appearance.

Hyperpigmentation has multiple causes and can be difficult to treat. People often inquire with us after many unsuccessful attempts at eliminating the pigmentation and can be reluctant to seek a professional treatment. Understanding the underlying causes and predisposition factors to hyperpigmentation will help evaluate each situation and prevent the return of pigmentation spots. The initial consultation will help determine the exact cause of hyperpigmentation in order to establish efficient treatment protocols for each patient.

Treating pigmentation spots – Question 1 : What are the different types of hyperpigmentation?

Dr. Tremblay’s answer: There are 3 main types of hyperpigmentation.

  1. Post-inflammation hyperpigmentation happens when there is inflammation of the skin. This type of hyperpigmentation often occurs with acne, rosacea, and facial swelling conditions.


  1. Melasma, also known as chloasma, is very common and more specifically with darker skins. Melasma appears as a larger ambiguous dark spot and is one of the skin diseases that is most difficult to treat. The symptoms of Melasma include darker and irregular patches often located on the cheekbones, forehead, or upper lip. These patches generally develop progressively over time. People with light brown skin that is exposed to intense sunlight are more susceptible to develop this type of hyperpigmentation. During the treatment of this condition it is important to avoid UV rays which contribute to the development of melasma and can also cause the production of pigment. Melasma is a common skin disease in pregnant women, women taking oral contraceptives, or women undergoing hormonal treatments.


  1. Solar lentigines, also known as sun spots, are light brown to dark brown macules that appear on the face, shoulders, chest, forearms, and hands. Lighter skins are more affected by solar lentigines, but they can be found on all phototypes. Solar lentigines do not disappear on their own. Actinic keratosis and pre-cancerous skin cells caused by ultraviolet rays are other forms of damage caused by the sun. Actinic keratosis appears as scaly lesions on the surface of the skin and can be light, dark, pink or red. They appear and disappear. They generally aren’t life threatening, but it is important that actinic keratosis be diagnosed and treated early on. Certain prescribed topical medications or liquid nitrogen and photodynamic therapy are used to eliminate pre-cancerous lesions.


Treating pigmentation spots – Question 2 : What are the treatment options for hyperpigmentation?

Dr. Tremblay’s answer: For post inflammation hyperpigmentation often found in darker skins, the erbium Pixel laser is most appropriate. Since it is not a pulsed light wavelength laser, it is safe for darker skins. The Pixel creates micro-perforation at the epidermis level which allows the excess pigment to evacuate to the surface of the skin through these channels. The skin naturally eliminates the pigment found on the surface of the skin through cellular regeneration.

Melasma is treated with a combination of Pixel laser and topical application products with anti-inflammatory properties, topical vitamin C, retinol, as well as a large spectrum solar protection.

Solar lentigo is treated with intense pulsed light (IPL) lasers such as the IPL M22, the most recent generation of IPL, much more efficient and that leaves little to no redness after treatment. Often, the YAG Enlighten laser is used in combination with the IPL to treat deeper spots. The combination of the two technologies allows for better results in terms of treatment of solar lentigines by treating the older pigmentation spots that are deposited deeper in the skin as well as the more recent spots on the skin surface.

To even skin tone and treat more recent pigmentation spots, the Pico Genesis is the technology of choice. It unifies the tone, provides a lot of glow and gets rid of skin tone irregularities. We often suggest it for younger patients who wish to find a more uniform skin tone after having abused of the sun a bit too much.


Treating pigmentation spots – Question 3 : Are the treatments painful?

Dr. Tremblay’s answer: Most treatments for pigmentation spots cause little to no pain.  A slight tingle, pinching or a sensation of heat can be felt during treatment. After the session, you can feel as if you have a slight sunburn for the first few hours. It is important to note that the pigmentation spots can darken a bit during the first few days and then gradually exfoliate themselves from the skin over about 1 week.


Treating pigmentation spots – Question 4 : What can we do to prevent dark spots?

Dr. Tremblay’s answer: During the treatment of hyperpigmentation, the best treatment is a preventive approach, using topical antioxidants and a daily use of a large spectrum sunscreen.


All the treatments for dark spots are available at MédIME.

Book an appointment now for a free personalized consultation by calling at 514-739-7444 or by filling out the appointment form.


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