Derma Clinic IndexBy treatmentMelasma & pigmentation

Melasma & pigmentation dermatology clinics compared by area

Updated 2026-11-08

Brown patches on the face tend to be lumped together as melasma, but in reality several conditions are mixed. Typical ones are melasma, which spreads symmetrically over the cheekbones and forehead; freckles, scattered like small dots; solar lentigines caused by sun exposure; acquired dermal pigmentation, which lies as a bluish layer over the cheekbones; and pigmentation left after inflammation. The right treatment depends on how deep in the skin the pigment sits.

Melasma arises from sunlight, female hormones and skin irritation acting together, and behaves like a chronic condition that can darken again after seeming to fade. Treatment combines topical brightening medication, oral medication and low-power laser, built on a foundation of sun protection. Freckles and lentigines often fade after a few laser sessions, but melasma can actually darken with strong stimulation, so the approach differs.

Checklist for choosing a clinic for Melasma & pigmentation

1. Start with diagnosing the pigment type Melasma, freckles, lentigines and acquired dermal pigmentation look alike but call for different treatment plans. When you consult a clinic in your area, have them explain which pigments are mixed in which areas of your face before treatment begins.
2. Check your sun protection habits Even with laser, pigment returns quickly if you don't block the sun. You need sunscreen even on cloudy days or by a window indoors, reapplied every two to three hours. Before starting treatment in your area, have your current sun protection routine reviewed.
3. Precautions with oral and topical medication Oral medications such as tranexamic acid need caution in people with a history of blood clots or who also take oral contraceptives, and topical brightening agents can cause redness or stinging. When you get a prescription in your area, tell the doctor about every medication you take and your full medical history.
4. Laser intensity and intervals Melasma can darken or fade unevenly under strong laser stimulation, so low-intensity sessions spaced apart are common. When a clinic in your area explains the treatment plan, ask about intensity, number of sessions and alternatives if it doesn't work.
5. A plan for preventing relapse Even after treatment ends, melasma commonly darkens again in summer or during hormonal changes. When wrapping up treatment in your area, decide in advance how much longer to use maintenance topical medication and in which season to come back for a check.

Warning signs to watch for

1. One spot that turns unusually dark A single spot among widespread patches that turns unusually dark, develops blurring borders, grows or bleeds may not be simple pigmentation. Before having it lasered away, check with a doctor in your area whether a biopsy is needed.
2. Pigment that darkens after treatment If the color has deepened a few weeks after a procedure, it may be post-inflammatory pigmentation or worsening melasma. Rather than repeating the same procedure right away, have the cause checked in your area and adjust the interval and method.
3. Scattered white spots Small white spots appearing here and there after many pigment laser sessions at short intervals may be hypopigmentation, which can be slow to recover or may remain. If you notice such changes, stop the procedures and see a doctor in your area first.
4. Brightening creams with unknown ingredients Brightening creams of unclear origin that promise fast results may contain high-concentration ingredients or steroids, and long-term use can thin the skin or make blood vessels show. Bring the products you've been using to a clinic in your area to have them checked.

Melasma & pigmentation clinics by area

Choose an area to see its dermatology clinic ranking along with what to check when consulting about Melasma & pigmentation.

Frequently asked questions

Final notes

With melasma and pigmentation, diagnosis, treatment and maintenance go together. Distinguishing pigment types first, then sustaining gentle treatment and sun protection over time, is what delays the next darkening. Once you've chosen a clinic in your area that you can visit regularly, decide treatment intensity, medication and the maintenance plan with your doctor before starting.

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