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What it is, and why it happens
Three patterns account for most of the uneven tone we see, and the first job is to tell them apart.
Sun-induced lentigines — the flat brown spots on cheekbones, hands and decolletage — are collections of pigment in the upper skin caused by cumulative ultraviolet exposure. They have edges, and they respond predictably to targeted laser and good topical care.
Melasma is different. It is a hormonally influenced, heat-sensitive condition producing symmetrical, blotchy patches across the cheeks, upper lip and forehead. It is chronic: managed rather than cured. Aggressive laser can make it flare, and the pattern we see most often is someone who got a fast result elsewhere, rebounded six weeks later, and has been chasing it since.
Post-inflammatory hyperpigmentation is the mark left after acne, an ingrown hair or a cut. It is not a scar, and in most cases it fades on its own — faster with sun protection and a sensible routine.
Deeper skin tones carry a higher risk of both post-inflammatory pigmentation and paradoxical darkening after light-based treatment, so wavelength, settings and preparation matter more rather than less. We take a full history, ask about hormonal contraception and pregnancy, and examine the skin in good light before recommending anything.
A realistic plan usually combines three things: a broad-spectrum SPF 50 you will actually wear — tinted, with iron oxides, if melasma is in the picture, because visible light matters too — a topical routine matched to your skin, and a course of in-clinic treatment. Expect three to five sessions three to four weeks apart for sun damage, and an ongoing plan for melasma.
Toronto summers undo careless work quickly, which is why most of our pigment courses start in the autumn.
We will always tell you when a mark should be assessed by a physician rather than treated cosmetically. Anything new, changing or irregular deserves that assessment first.
How we treat it
Treatments that address this
Each of these is performed here under physician supervision. Which one is right depends on the assessment, and more than one may be combined over a course.
Hyperpigmentation Treatment
Targeted laser treatment for sun spots, melasma and uneven tone.
What to expect
How a course usually runs
The shape of a course is the same whichever treatment your plan settles on. What changes is how many appointments sit inside it and how long the result takes to appear.
Consultation and photographs
About 45 minutesWe take a medical history, assess the concern in good light — at rest and in animation where that matters — and take standardised photographs. You leave with a written plan carrying prices and timelines. Nothing is treated on the day unless you ask, you are medically suitable, and you have had time to read the consent form.
The treatment
45 min–1 hThe appointment itself is usually the shortest part. Treatments for this concern run between 45 min and 1 h. Consent is confirmed again before anything begins, and you can stop at any point.
Who it is for
What we check before treating
Suitability is decided at the consultation, not at booking. These are the things that most often change a plan — or postpone it — and every one of them is asked about before anything is treated.
In their words
From clients treated for this
Quotes are published with permission and shown with a first name and initial only.
Related
Other concerns people ask about
Fine Lines & Wrinkles
The first lines to appear are usually the ones you make on purpose. Softening them is a question of movement, not erasure.
Volume Loss & Facial Contour
Faces do not only sag; they deflate. Working out where volume has actually gone is what separates a refreshed result from an overfilled one.
