Sun Spots and Melasma in Tel Aviv: Which Laser Treatment

A brown spot on the face doesn't always have the same origin, and, more importantly, isn't always treated the same way. Confusing a sun spot with melasma is common, and can lead to an unsuitable treatment. Here's how to tell them apart, and what the laser can really do for each.

Sun spots and melasma: two different mechanisms

Sun spots, or solar lentigines, are well-defined brown spots that appear on the areas most exposed to the sun over the years: face, hands, décolleté. They result from a local build-up of melanin linked to cumulative UV exposure.

Melasma is different: it is a more diffuse pigmentation disorder, often with blurred edges, that typically affects the forehead, cheeks and upper lip. It is strongly linked to hormonal fluctuations (pregnancy, birth control pills) as much as to sun exposure, and mostly affects women and darker to deeper skin tones.

This distinction isn't just a medical detail: it genuinely changes the approach and the expected results. Find the full details on the site's sun spots and melasma page.

Recognising a sun spot

A sun spot typically appears as a small, well-defined brown area, regular in size and shape, often isolated or in a small cluster on an area heavily exposed to the sun over the years. It doesn't change much over time, aside from possibly darkening with repeated sun exposure.

Recognising melasma

Melasma tends to appear as larger patches, with blurred and sometimes symmetrical edges on the face (both cheeks, for example). It often appears or worsens with a hormonal change (pregnancy, contraception) or intense sun exposure, and can fluctuate in intensity with the seasons, unlike an isolated sun spot, which remains more stable.

Why melasma is trickier to treat

Melasma has a particular feature that complicates its laser treatment: it can be worsened by excessive stimulation of the skin, particularly through heat. This is why its treatment often requires a more cautious, gradual approach than a simple sun spot, sometimes combined with complementary medical care (depigmenting treatments, a personalised protocol).

An isolated sun spot, by contrast, generally responds more predictably and directly to laser treatment.

The risk specific to melasma: pigmentation that can worsen

In some people, excessive skin stimulation (excessive heat, unprotected sun exposure) can paradoxically worsen melasma instead of lightening it, a rare but well-documented phenomenon specific to this disorder. It is this particular sensitivity of melasma that justifies more cautious settings and a more gradual session schedule than for a simple sun spot.

Care that often combines several approaches

Melasma rarely responds to laser alone in a lasting way: comprehensive care most often combines laser treatment with at-home depigmenting products and rigorous, ongoing sun protection, not just in the weeks following a session. It is this combination, more than the session itself, that determines how stable the result remains over time.

Key takeaway: not all brown spots are treated the same way. An accurate diagnosis before treatment avoids unpleasant surprises, particularly for melasma.

The areas most frequently affected

• Face: forehead, cheeks, upper lip, the areas most exposed to UV and hormonal changes.
• Neck and décolleté: frequently affected by sun-related brown spots.
• Hands: what are commonly called "age spots," solar lentigines linked to cumulative sun exposure over the years.

How many sessions, and why sun protection is non-negotiable

A protocol of 2 to 4 sessions is generally enough for sun spots, depending on skin phototype and response to treatment. Melasma, being more complex, may require a longer protocol.

The most important point to remember concerns the aftercare: SPF 50+ sun protection is mandatory for 4 to 6 weeks after each session. This is not just a comfort recommendation. Skin that has just been treated is particularly reactive to UV, and unprotected exposure can worsen pigmentation instead of improving it, especially for melasma.

What to expect during treatment

The treatment is performed with eye protection, with a sensation of quick, generally well-tolerated tingling. It is not unusual for the spots to darken slightly in the days following the session, before gradually lightening: this is a normal sign that the treatment is working, not a failure. For skin that instead lacks firmness and overall radiance, laser skin rejuvenation addresses a different, complementary need.

In short

• Sun spots (localised, UV-related) and melasma (diffuse, often hormonal) are two different issues, which don't respond to treatment in the same way.
• A standard protocol involves 2 to 4 sessions for sun spots; melasma often requires longer, more cautious care.
• SPF 50+ sun protection after each session is essential, especially for melasma.
• Without this protection, new spots can reappear: annual maintenance is recommended.

Have brown spots and aren't sure whether they're sun spots or melasma? Book an appointment at Dr Mergui's clinic, 8A Frishman, for an accurate diagnosis.

This article is for informational purposes and does not replace a medical consultation. Only a clinical examination can precisely distinguish a sun spot from melasma.