Hyperpigmentation is a category, not a diagnosis
“Dark patches” covers half a dozen different things, and they do not respond to the same treatment. Some fade on their own with time and sun protection. One is chronic and provoked by heat. Some need a doctor. Buying a treatment before knowing which you have is how people spend a year on the wrong thing.
And one that must be said first: not every dark patch is hyperpigmentation. Anything changing, growing, irregular in outline or uneven in colour needs a physician, not a cosmetic appointment.
See a doctor before treating anything if
- A pigmented spot is changing in size, shape or colour.
- It is asymmetric, has an irregular or blurred border, or contains more than one colour.
- It itches, bleeds, crusts or will not heal.
- It looks different from all your other marks.
- It is new after middle age, or growing.
This is not a formality. Cosmetic treatment of a lesion that has not been identified is the wrong order of operations, and we will decline to do it.
The main types, and what each one means
| Type | How it usually looks | What it needs |
|---|---|---|
| Post-inflammatory pigmentation | Flat brown marks where a spot, scratch, burn or treatment was | Time and sun protection. The most common, and the most reversible |
| Post-inflammatory redness | The same story but pink or red rather than brown. Often mistaken for the above | A vascular problem, not a pigment one. Pigment products do little |
| Melasma | Larger symmetrical patches, often cheeks, forehead, upper lip | Chronic and relapsing, and heat is a trigger — see melasma and the order of treatment |
| Sun spots | Discrete brown spots on the face, hands, chest, shoulders | Cumulative UV damage. Treatable, and preventable going forward |
| Freckles | Small, numerous, darkening with sun exposure | Largely genetic. Not a problem unless you want them lighter |
| Drug or plant related | Odd distribution, sometimes streaked or in a pattern | Worth a doctor. Some medications and some plant juices in sunlight cause marked pigmentation |
Depth decides how well it responds
Pigment sitting in the upper layers responds far better than pigment that sits deeper. That is why two people with apparently similar marks get very different results from the same treatment, and why nobody should promise you a percentage before looking properly.
As a rough guide, sharply defined marks tend to be more superficial, and blurred, greyish or bluish tones often indicate something deeper. It is one of several reasons an assessment under a lamp beats a photograph sent by message.
The rule that applies to every type
Sun protection is not an adjunct to pigmentation treatment. It is the treatment. Without it, results fade and marks return, and you will have paid for something the sun undid. Visible light matters here as well as UV, so shade, a hat and a product that addresses visible light do more than a conventional sunscreen alone.
This is also the least profitable advice in the industry, which is roughly how you can tell it is the honest kind.
The trap on pigment-prone skin
Aggressive treatment aimed at pigmentation can cause pigmentation. Inflammation is what triggers it in the first place, so an over-enthusiastic session can leave someone darker than they started — more likely, more visible and longer-lasting on deeper skin tones. The caution is set out in facials for deeper skin tones.
Slow and conservative genuinely is faster here. It is not a sales position; it is what stops the treatment becoming the cause.
Realistic timelines
- Months, not weeks. Existing marks fade gradually even when everything is being done correctly.
- Partial, not complete. Substantial lightening is a good outcome. Erasure is not on offer.
- Maintenance matters, because the tendency does not disappear when the mark does.
- Photograph the start, in the same light. Gradual change is genuinely hard to see day to day.
What we will not do
- Treat a pigmented lesion that has not been identified.
- Promise removal, or a number of sessions before assessing you.
- Treat aggressively on skin that is already inflamed.
- Sell you anything that is not legal to sell — the boundaries are in skin lightening: what we treat and what we do not.
Where to find us
Downtown Montreal — 2365 rue Saint-Patrick, Unit A5
Laval — 1655 boulevard de l'Avenir
Saint-Léonard — 5045 rue Jean-Talon Est
West Island — 45 boulevard Brunswick, Dollard-des-Ormeaux
This page is general information and is not medical advice, and nothing here is a diagnosis. Any pigmented lesion that is changing, asymmetric, irregularly bordered, multi-coloured, itching, bleeding or not healing should be assessed by a physician promptly, before any cosmetic treatment.
