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Melasma, Dark Spots, and Acne Marks: Care by Pigmentation Type

Published: 2025-04-25 · 3 min read

Summary: Pigmentation is the excessive accumulation of melanin pigment in specific skin areas. It needs completely different approaches depending on cause and depth,…

Pigmentation is the excessive accumulation of melanin pigment in specific skin areas. It needs completely different approaches depending on cause and depth, yet it's often lumped together as "melasma," leading to incorrect care.

Characteristics by pigmentation type

1. Melasma

  • Brown to gray-brown patches appearing symmetrically on cheeks, forehead, upper lip
  • Main causes: UV, female hormones (estrogen), pregnancy
  • Hard to treat when located deep in the dermis
  • Recurs often, so consistent management is essential

2. Solar lentigo (sun spots)

  • Small, well-defined brown spots from cumulative UV
  • Mainly under the eyes, temples, backs of hands
  • Tends to respond better to treatment than melasma

3. Post-inflammatory hyperpigmentation (PIH)

  • Brown marks left after acne, wounds, allergic reactions
  • Tends to remain more prominent on darker skin
  • Melanin concentrated in the epidermis → responds well to epidermis-targeting ingredients
  • Fades naturally over time but can take 3–24 months

4. Post-inflammatory erythema (PIE)

  • The red-colored acne marks → due to vascular dilation, not melanin
  • Vascular-constricting/anti-inflammatory ingredients are more effective than brightening ones
  • Responds well to laser (IPL, VDL) treatment

Effective ingredients for pigmentation

Niacinamide 4–10%

Blocks the melanin transfer pathway. Low irritation, usable for most pigmentation types.

Alpha-arbutin

Inhibits tyrosinase (the melanin synthesis enzyme). The alpha form is stronger than the beta form.

Vitamin C (L-ascorbic acid) 10–20%

Inhibits melanin oxidation + promotes collagen synthesis. Especially effective for photoaging/spots.

Unstable and prone to oxidation → can be replaced with derivatives (ascorbyl glucoside, MAP, etc.).

Tranexamic acid

Suppresses melanin production via the plasmin pathway. Especially effective for melasma, with low irritation.

Kojic acid

Inhibits tyrosinase. Effective but can irritate skin.

Retinoids (retinol/Retin-A)

Promotes cell turnover to quickly shed pigmented keratin. Prescription Retin-A has the strongest evidence for pigmentation improvement.

AHA (glycolic, lactic)

Sheds pigmented areas via surface exfoliation. Effective for PIH improvement.

The most important thing: sun protection

No matter which brightening ingredient you use, its effect is halved without sun protection. During pigmentation care, applying SPF50+ PA++++ sunscreen daily in sufficient amounts and reapplying every 2–3 hours is the baseline. UV worsens existing pigmentation and stimulates new pigment.

Dermatology treatment options

When home care struggles to improve it, especially dermal melasma, consider dermatology treatment.

  • Laser toning (Q-switched Nd:YAG): melasma, spots
  • IPL: spots, redness
  • Laser resurfacing (CO2/erbium): epidermal pigmentation
  • Prescription creams (hydroquinone 4–6%, tretinoin): standard melasma care

Pigmentation is a concern that's hard to eliminate completely in the short term. The combination of consistent sun protection and functional ingredients, plus realistic expectations, is the key to managing it.

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Medical Disclaimer

SKINROUTE is not a medical device. All content is provided for general skincare information purposes only and does not replace medical diagnosis or treatment. If you suspect a skin disease, please consult a board-certified dermatologist.