Melasma is the most common cause of facial hyperpigmentation and is characterised by symmetrical, blotchy, brownish pigmentation that becomes more pronounced after sun exposure.

  • The pigmentation is caused by the overproduction of melanin, which is taken up by the keratinocytes (epidermal melanosis) and/or deposited in the dermis (dermal melanosis)
  • The exact cause is unknown
  • There is a genetic predisposition with at least one-third of patients reporting other family members to be affected
  • The most important exacerbating factor is UV radiation. Other factors include pregnancy, and the combined oral contraceptive pill. In the context of pregnancy, melasma is regarded as a normal physiological change, along with darkening of the nipples and linea nigra
  • The rarity of melasma in postmenopausal women on oestrogen‐containing hormone replacement therapy and the fact that men are occasionally affected suggests that oestrogen alone is not the causative agent

Ablative treatment for pigmented nevi

We suggest using pulsed Er:YAG laser ablation of tissue in cases when it is necessary to remove not only the pigment but the plus-tissue as well. In this case, the tissue is removed under excellent visual control and strictly in the pigmented area.

Ablative treatment for pigmented nevi