Skin pigmentation is a natural process determined by melanin, a pigment produced by cells called melanocytes. Melanin production is influenced by various factors, and dysfunctions in this process can lead to the appearance of pigment spots, which can be aesthetically bothersome.
Indeed, a bright and even-toned skin without spots is a frequent request.
In most cases, skin pigmentation is harmless.
However, when brown spots appear, it is essential to consult a doctor for an accurate diagnosis.
Apart from nevi (moles), pigment lesions may include :
• Age spots (lentigos).
• Melasma.
• Freckles.
• Hyperpigmentation spots : due to increased activity of melanocytes, the cells responsible for melanin synthesis, following stimulation (trauma, blemish, medical procedure, application of chemical agents…).
• Spots secondary to fungal infection.
Skin spots, whether brown spots, melasma, sun spots or hyperpigmentation, are a common aesthetic concern that affects the clarity and uniformity of the complexion. In aesthetic medicine, several treatments are available to correct
these skin imperfections and restore smooth, radiant skin. Pigment laser, chemical peels and depigmenting treatments effectively reduce pigment spots for an even skin tone.
Spots result from excessive or irregular melanin production by melanocytes. Melanin is the pigment that gives skin its color, and melanocytes are the cells responsible for producing it.
Pigmentation issues are caused by factors that influence melanin production :
• Sun exposure : UV rays stimulate melanin production, which causes tanning, but excessive production leads to persistent spots.
• Hormones : hormonal changes, especially during pregnancy or with oral contraceptives, play a major role in the appearance of melasma.
• Aging : with age, cell renewal slows down and melanocyte activity changes.
• Genetic factors.
• Skin inflammation : infections, acne, skin trauma and even some aesthetic procedures can cause local inflammation that results in post-inflammatory pigmentation.
The main depigmenting ingredients used in aesthetic medicine and creams include :
• Hydroquinone : a powerful inhibitor of melanin production, very effective but regulated to avoid irritation risks. It is found in onions, fruits, seeds, tea, coffee, beer, and wine. Its use is limited to compounded formulations like Kligman’s trio and is banned in over-the-counter cosmetics.
• Arbutin : a hydroquinone derivative found in cranberry and blueberry leaves.
• Kojic acid : derived from rice fermentation, it has natural brightening and antioxidant properties, acting gently on spots.
• Vitamin C : known for its antioxidant effects, it brightens spots while boosting collagen production and giving a more radiant complexion.
• Retinoids (vitamin A derivatives) : promote cell renewal, exfoliate the skin’s surface and reduce pigmentation spots.
• Azelaic acid : a gentle ingredient suitable for sensitive skin, it reduces hyperpigmentation and has anti-inflammatory properties.
• Tranexamic acid : an effective depigmenting agent ideal for melasma-prone skin, acting on pigmentation and inflammation.
• Phytic acid : found in cereal grain husks.
• Citric acid : derived from lemon.
• Niacinamide or vitamin B3 : found in plant roots and mushrooms.
These ingredients are often combined to maximize efficacy, providing personalized solutions for a more even and radiant complexion.
To determine appropriate treatments, it is essential to distinguish the different types of pigment spots.
Aesthetic treatments for spots offer effective solutions to reduce their appearance and even out the complexion. Depending on the type of spot (sunspots, melasma, freckles, or post-inflammatory pigmentation) and skin type, laser and chemical peels are the most effective methods.
It is important to understand that treatments eliminate the pigment but do not correct the malfunction of melanocytes. The results are therefore temporary, and pigmentation may reappear one or more years later depending on the patient's lifestyle, particularly sun exposure.
The depigmenting peel is an effective, non-invasive method for treating pigment spots and evening the skin tone.
Suited to pigmentation issues such as melasma, solar lentigos, and post-inflammatory pigmentation, this treatment is based on the application of powerful exfoliating agents such as glycolic acid, trichloroacetic acid, or kojic acid.
These substances eliminate the skin's superficial layers, encouraging cell renewal and visibly reducing spots.
The combination of these active ingredients yields visible results, with a clear improvement in skin uniformity in 84 % of cases after 2 treatments, a significant reduction (72 %) in melasma, and smoother skin with fewer fine lines after several sessions for 83 % of patients.
Sun exposure is contraindicated for two months. Peels cannot be performed on tanned skin.
The choice of laser depends on the type of spot and the depth of pigmentation.
Two types of lasers may be used :
• Depigmenting laser.
• Ablative laser.
Depigmenting lasers work by emitting a beam of light with an extremely short pulse duration, in the nanosecond range, which fragments the pigment.
Depending on pigment depth, either a Q-switched KTP laser (epidermal pigment) or Nd:YAG Q-switched laser (dermal pigment) is used.
A small scab may appear at the treatment site, which must be kept moisturized daily. One or more sessions may be necessary.
Doctor Romano prefers to use the ablative laser. Its mechanism of action is pigment vaporization. This treatment is more complex to perform but can treat all types of pigmentation (depigmenting lasers are not suitable, for example, for treating melasma). ablative laser does not cause post-inflammatory pigmentation.
In fact, although used to remove spots, depigmenting lasers can trigger local inflammation that worsens pigmentation.
It is possible to effectively prevent the appearance of pigment spots and maintain the skin’s natural radiance by adopting certain daily habits :
• Use daily sun protection : apply broad-spectrum sunscreen (minimum SPF 30) every day, even on cloudy days. This protects the skin from UV rays, the primary cause of pigmentation spots.
• Choose antioxidant-rich skincare : creams and serums containing vitamin C, vitamin E, or ferulic acid help neutralize free radicals that damage the skin and stimulate melanin production.
• Keep the skin well hydrated : proper hydration is essential for maintaining a healthy skin barrier, reducing inflammation and the risk of post-inflammatory pigmentation.
• Limit sun exposure : reduce time spent in the sun, especially between 10 a.m. and 4 p.m., and wear wide-brimmed hats and protective clothing to reduce the risk of brown spots.
• Use gentle skincare : avoid harsh products or treatments, as repeated inflammation or irritation can lead to post-inflammatory pigmentation.
• Use brightening ingredients preventively : ingredients such as vitamin C or azelaic acid help prevent melanin imbalance, even out the skin tone and reduce early pigmentation.
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In Geneva, medical treatments aimed at reducing pigmentation spots are offered starting at 300 CHF per session. This base rate applies regardless of the method used — whether laser or peel — with the choice of technique depending on the depth and origin of the pigmentation. The price per session may vary depending on the size of the areas to be treated and the skin’s observed response.
A quote is provided during the initial consultation, during which Dr. Romano explains the expected results, the cost of each session, and the number of sessions required.
It is difficult to completely eliminate pigmentation spots in just 3 days using natural methods. However, some remedies can help fade them :
• Lemon mask (rich in vitamin C) to brighten the skin, to be applied with caution (and never before sun exposure).
• Aloe vera gel to soothe and regenerate the skin.
• Honey and turmeric masks, with brightening properties.
However, these methods offer gradual results and require regular use.
Most pigmentation spots, such as solar lentigines or age spots, are benign and harmless. However, if a spot changes rapidly in shape, size or color, it is recommended to consult a dermatologist to rule out any precancerous lesion.
The main factors are :
• Excessive sun exposure without protection.
• Hormonal changes (pregnancy, contraception).
• Certain photosensitizing medications.
• Natural skin aging.
• Lack of proper skincare, such as not using sun protection.
Yes, pigmentation spots can reappear, especially if sun protection is not strictly followed. After a treatment such as a peel or laser, it is essential to adopt an appropriate skincare routine and limit sun exposure to prevent recurrence.
Common pigmentation spots, such as solar lentigines, are benign and do not turn into cancer. However, regular monitoring is essential, as some precancerous skin lesions can resemble spots. In case of doubt, a dermatological consultation is recommended.
Pigmentation spots are melanin deposits, often flat and related to sun exposure or age. Moles (or nevi) are clusters of pigment cells that can be flat or raised, with a uniform color, and usually appear in childhood or adolescence. Any suspicious change in a mole requires medical advice.
