Identify the pattern
The location, timing and appearance help distinguish melasma from post-inflammatory marks and other causes. Further examination or testing is selected only if it can clarify the diagnosis.
Service
Pigmentation assessment and treatment
Updated
Understand the dark marks before choosing a treatment.
Pigmentation treatment starts by identifying the cause of a dark patch. Melasma, marks after inflammation and individual pigmented spots can look similar but need different care. At SkinWise in Carmelaram, assessment guides whether sun protection, prescription treatment or a selected procedure belongs in your plan.
About pigmentation care
Tell us when the pigmentation began, whether it followed a rash or procedure, and how it has changed. Bring photographs and the labels of creams you have used, including products sold as fairness or spot-removal creams.
Treatment aims to improve the concern while limiting irritation and further pigment change. Some marks fade gradually; others need ongoing management. Laser is an option for selected diagnoses, not the inevitable next step when a cream has been tried.
When an assessment may help
- Dark marks after acne, eczema or irritation
- Recurring facial patches that may be melasma
- Uneven pigmentation that is persistent or difficult to identify
When to reassess or defer treatment
- A changing, bleeding or otherwise unusual spot needs medical assessment before cosmetic treatment.
- Active irritation, a recent tan or a previous procedure reaction may change which treatment is suitable.
- Tell the dermatologist about pregnancy, breastfeeding and medicines before a prescription or procedure is selected.
How treatment is planned
Discuss the options
Sun protection and treatment of any ongoing inflammation are considered alongside suitable topical medicines. Peels or lasers need a separate discussion of expected benefit, recovery and pigment risk.
Choose a manageable routine
Agree which products to use, which to stop and what irritation should prompt contact. Do not add several brightening products together or copy another person’s prescription.
Review the response
Use comparable photographs and your experience of the routine to decide whether to continue, simplify or change treatment. A poor response may warrant reconsidering the diagnosis.
Preparing, recovering and following up
Before the visit
Bring prior prescriptions, procedure details and photos taken before treatment where available. Mention any burning or new darkening after a product.
During treatment
Ask how to combine medicines with sunscreen, when to pause them around a procedure, and how to reach the clinic if irritation develops. Instructions depend on the actual treatment.
Over time
Fading varies with the cause, depth and continuing triggers. Melasma can recur; a procedure can cause darker or lighter patches. No fixed number of sessions guarantees an even skin tone.
Frequently asked questions
Does every dark spot need laser?
No. Some marks follow inflammation, while other patches may be melasma or a different diagnosis. Identifying the cause helps avoid a procedure that could irritate or worsen the pigment.
How long does pigmentation treatment take?
Response is gradual and variable. Your dermatologist can discuss an initial review point, but the diagnosis, ongoing inflammation and tolerance of treatment matter more than a standard timeline.
Can I keep using my brightening cream?
Bring its packaging or a clear ingredient photo. Some products contain prescription ingredients or combinations that should not be continued without review, especially if the skin burns, thins or becomes darker.
What happens at a pigmentation consultation?
A dermatologist asks when the pigmentation appeared, examines the affected skin and considers possible causes, previous treatments and current skincare. Conditions that look similar can need different care. The assessment helps decide whether home care, a procedure or further investigation is appropriate; a consultation does not automatically mean laser treatment.
Options to discuss
Swipe or scroll to see all columns.
| Concern or option | What may help | What to weigh up |
|---|---|---|
| Melasma | Photoprotection and supervised medical care | Often relapses; procedures are considered cautiously for selected cases. |
| Post-inflammatory marks | Control the original inflammation and discuss suitable topical care | Additional irritation or a procedure may deepen the marks. |
| An individual dark spot | Examination to identify the lesion | Confirm that cosmetic treatment is appropriate before targeting pigment. |
Evidence behind these choices
- Melasma management: international expert consensus (2026)
Supports photoprotection and supervised medical treatment, with lasers reserved for selected resistant cases. Expert consensus does not establish one treatment sequence for everyone.
- Post-inflammatory hyperpigmentation in skin of colour (2024)
This systematic review found varied, limited evidence across treatments. Procedures can also worsen pigmentation; published response rates are not predictions for an individual patient.
- UV and visible-light protection in melasma: randomised trial (2014)
An iron-oxide-containing sunscreen improved outcomes compared with UV-only protection while both groups also used hydroquinone. This supports suitable photoprotection, not sunscreen as a cure.
Related care and reading
Conditions we treat with pigmentation care
Pigmentation care by neighbourhood
Area-specific notes on what we see and how we treat for patients from each part of the south-east Bengaluru corridor:
Ready to start with a consult?
Most plans at SkinWise begin with a focused consultation. We map the concern, talk through what you’ve tried, and only then suggest what comes next — no oversell.
Plan your first visit: appointments, clinic location and what to bring.