Pigmentation and melasma: diagnosis before laser

Find out what the discoloration is

Uneven color can have different causes. Melasma, marks after inflammation and individual sun-related spots do not necessarily need the same treatment. A dermatologist may examine the skin closely and use additional assessment where needed. Do not assume that every dark area is suitable for cosmetic removal.

Bring a history of when the patches appeared, whether they change with sun exposure, and any previous treatment. Mention pregnancy, hormonal medication and products that caused irritation. Clear photographs taken before treatment can make your history easier to explain.

Expect management rather than a one-visit cure

Melasma may persist or return. The AAD describes treatment as a combination that often includes sun protection and topical medication, with a procedure considered for selected patients. There is no single best approach for everyone. The consultation should distinguish improvement during treatment from the maintenance needed afterward.

Ask whether a laser or peel is needed at all, and why it is appropriate for your diagnosis and skin color. A treatment that irritates the skin can make discoloration more difficult to manage. Discuss previous darkening after injury or procedures before agreeing to an intervention.

Build a plan that survives the flight home

A short visit should leave you with a clear diagnosis and a usable follow-up plan, even if you decide against a procedure. Request the names of recommended medicines and ask how long they should be used before review. Clarify what to stop if your skin becomes irritated, rather than adding several new products at once.

Compare quotes by the areas treated and the proposed number of visits. Ask whether review appointments and care products are included. For ongoing melasma, continuity may matter more than completing a package during a holiday. Arrange photographs or clinical review using the method your clinician recommends.

• What diagnosis explains these patches?
• How does my skin color affect the procedure risk?
• What is the maintenance plan if the pigment returns?

Sources & further reading

• American Academy of Dermatology — Melasma diagnosis and treatment
• American Academy of Dermatology — Skin conditions lasers can treat

Sources checked 26 October 2026. This guide is editorial information, not a personal diagnosis or an independent clinical review.