Melasma appears as brownish to blackish stain on the cheeks, upper lip, chin and forehead.These commonly appear during times of hormonal changes, such as menopause, endocrine illness, through the use of contraceptives, in aging and during pregnancy. The typical dark stain in the form of a butterfly that appears on the front of the face during pregnancy, receives the special name of chloasma or gravidic melasma. Most difficult condition to treat as the pigmentation can be deep. Most effective treatment has been combination of special lightening creams with chemical peels such as Obagi or Cosmelan. Beware of treatments with IPL as it can worsen the melasma. There are refractory forms of melasma that require oral anti oxidants to be taken in addition to existing treatments.


Moles are larger spots of hyperpigmentations. Removal is mostly through CO2 laser.



Freckles or Ephelides are innocuous pale hyperpigmentations of variable colour. They are common in exposed areas, in people with fairer complexion and are stimulated by sun exposure. Excellent clearance with an IPL.Hori’s NaevusHori’s Naevus also known as “Acquired bilateral nevus of Ota-like macule” is a cutaneous condition characterized by multiple brown–gray to brown–blue macules, primarily in the malar region of the face. The pigmentation is in the deeper dermal layer of the skin, making it very difficult to clear. The only effective treatment is by a Q- switch laser. It requires several sessions.