Dark spots form when melanin, the pigment that gives skin its color, is overproduced and builds up in certain areas. The medical term for this is hyperpigmentation. Sun exposure, hormonal changes, genetics and skin inflammation are the main factors that increase melanin production. Hyperpigmentation treatment aims to reduce this uneven color with methods chosen for the type of spot and how deep it sits in the skin.

The goal is not only to lighten the spot, but also to calm the mechanism that keeps producing it. That is why treatment usually combines complementary methods.

Before treatment begins, your examination looks at whether the pigment is superficial or deep. If a spot or mole has changed in shape, color or size, it needs a dermatological assessment first.

Hormonal medicines such as birth control pills, some light-sensitizing medicines, perfumed cosmetics and irritating procedures may also make spots more visible. People with darker skin tones are also more prone to dark marks after skin inflammation.

Spots differ in their cause and in how they respond to treatment. The most common types are:

• Sun spots (lentigines): Well-defined brown spots on the face, the backs of the hands and the chest after years of unprotected sun exposure.
• Age spots (senile lentigines): Sun spots seen later in life, especially on the hands and face. See age spots treatment.
• Melasma: Symmetrical, map-like patches on the cheeks, forehead and upper lip. Hormones, sun and genetics act together, and it tends to come back.
• Pregnancy mask (chloasma): A type of melasma triggered by hormonal changes in pregnancy. Some fade after birth; others remain.
• Freckles: Small dots in fair-skinned people with a genetic tendency, more visible in summer. See freckle treatment.
• Post-acne marks: Dark marks left after pimples or skin irritation.

Treatment starts with a skin analysis and identifying the type of spot. A plan is then built around your skin type and the season. At our clinic in Nişantaşı, these methods are most often combined:

• Peels: A chemical peel, which renews the top layer of the skin in a controlled way, or a gentler enzyme peel reduces superficial pigment.
• Mesotherapy: Ingredients that help even out skin tone and support repair are delivered into the skin with fine needles. Injections containing salmon DNA, such as DNA Işıltısı, may also be added to the plan.
• Laser: For suitable spots, laser systems such as RedTouch Pro target the pigment and help lighten it.
• Home care: Anti-pigment products recommended by your doctor and a broad-spectrum sunscreen are an essential part of treatment.

Clinic treatments usually take 20–45 minutes and are often done as a course, two to three weeks apart. Which method suits you is decided at your consultation.

In what is known as needle-free mesotherapy, ingredients are delivered with devices that increase skin permeability. This may be an option for people who are wary of needles, although the ingredients reach a more limited depth. Combining methods helps treat different layers of a spot during the same period.

Pigment-producing cells are sensitive: doses that are too high or unsuitable treatments can make a spot darker, so correct dosing and aftercare both matter.

• Sun protection: Use a broad-spectrum sunscreen every day, summer and winter, and reapply every two to three hours.
• Don’t peel flakes: Light flaking for three to five days after a peel is normal; pulling off new skin increases the risk of marks and spots.
• Avoid irritation: In the first days, don’t use harsh scrubs, retinol or alcohol-based toners without asking your doctor.
• Avoid heat: Saunas, Turkish baths and tanning beds may trigger spots in the first days after treatment.

Temporary redness, mild sensitivity and flaking are the most common effects and usually settle within a few days. If redness lasts longer, or blistering or intense itching develops, you should come in for a check-up.

The number of sessions varies from person to person, depending on the type and depth of the spot and how your skin responds. Superficial, recent sun spots may lighten noticeably in a few sessions. Deeper spots and melasma treatment need a longer course and regular maintenance sessions.

A treated spot usually doesn’t return, but the skin’s tendency to form spots remains. Unprotected sun, hormonal changes or irritation can cause new spots in the same area. Melasma in particular can be controlled but may recur. Daily sun protection and the home care your doctor recommends are key to keeping results.

After the course, maintenance sessions every few months may be planned depending on your skin. A check-up after the summer months helps catch new spots early.