Dark marks on the skin have different causes, including melasma, post-inflammatory hyperpigmentation and sun-related pigment changes.
A new, changing or atypical pigmented lesion should not simply be treated as a cosmetic spot. Suspicious lesions require in-person assessment and often dermoscopy.
Melasma commonly causes symmetrical brown facial pigmentation and is influenced by sun exposure, hormones and individual susceptibility. Consistent photoprotection is an important part of management.
Pigment after acne, eczema or irritation is particularly visible in darker skin types. Treating the underlying inflammation and avoiding further irritation can be as important as using a pigment-targeted product.
Depending on the diagnosis, options can include sunscreen, retinoids, azelaic acid and other depigmenting treatments.