Pigmentation and Melasma: Diagnosis First, Then the Device

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Melasma, solar lentigines and post-inflammatory hyperpigmentation are not the same condition — even though all three look like "spots." Treatment depends on the pigment type, its depth and your skin phototype. That is why pigmentation treatment here does not begin with a device; it begins with a diagnosis.

First: what kind of pigment is it?

Solar lentigines (sun spots). Well-defined brown marks on the face, hands and décolleté — the result of accumulated sun exposure. Usually the most rewarding to treat.

Melasma. Symmetrical brown patches, most often on the cheeks, forehead and upper lip; linked to hormones, sun and genetics. Said honestly: melasma is a chronic, relapse-prone condition. It is controlled and faded — not "erased forever." Aggressive laser in the wrong case can even worsen it; anyone promising to remove melasma permanently is not speaking medically.

Post-inflammatory hyperpigmentation (PIH). Dark marks left after acne, eczema or trauma — more common in darker phototypes. Here patience and sun protection are half the treatment.

The rule that comes before any treatment

Not every brown spot is a cosmetic target. Some pigmented lesions require dermoscopic assessment before any laser is discussed — treating an unexamined lesion carries a double risk: ineffectiveness and a missed diagnosis. In our clinic every spot goes through examination (with dermoscopy and 3D skin analysis where needed) before a plan is made.

How we choose the treatment

After examination, the plan may include:

• Daily sun protection — without it no treatment holds; this is not advice "among other things," it is the foundation of the therapy. In melasma, tinted formulations with iron oxides add protection against visible light — a detail most labels never mention

• Topical therapy — depigmenting agents, retinoids, azelaic acid; in melasma this is usually the first step

• Chemical peels — for suitable superficial pigmentation

• BBL photorejuvenation — light absorbed by the pigment itself: excellent for sun spots and photodamage in correctly selected patients. The spot darkens briefly, then flakes away over days — that is the treatment working, not a side effect

• Q-Switch laser — releasing energy in nanosecond pulses that shatter pigment rather than heat it; the specialist tool for well-defined pigmented lesions, after dermatological assessment. Note honestly: melasma is not the classic territory of Q-Switch — there, restraint beats aggression

Which method, in what combination and how many sessions — decided at examination, not from a price list. Different pigments respond differently, and "guaranteed clearance in X sessions" is marketing, not medicine.

Your routine at home matters

In-clinic treatment and home care are teammates: sunscreen that gets reapplied, retinoids and antioxidants (vitamin C) where indicated, no aggressive exfoliation and — in PIH — no squeezing or picking, which deepens exactly the mark you want gone. Specific recommendations come at the consultation, for your skin.

What to expect realistically

Spots fade gradually, over weeks and months — usually across a series of treatments, not overnight. In melasma the goal is control and maintenance; in lentigines the results are often quick and satisfying; in PIH, time and sun discipline make the difference.

A note for patients travelling to Turkey

Pigmentation is the area where medical tourism goes wrong most often, for one reason: the same device produces opposite results depending on phototype and diagnosis. An aggressive setting that clears a sun spot can worsen melasma for a year. The questions that protect you: was the lesion examined, was your phototype assessed, and is the plan built on your pigment type rather than the clinic's newest machine? Our full checklist for choosing a clinic in Turkey.

For international patients

Dr. Kağan Cingöz's clinic is in Kırklareli, Turkey — 2 hours from Istanbul, 1 hour from Edirne, and an easy drive from the Bulgarian and Greek borders. Examination, dermoscopy and the start of a plan fit into a single visit, with photo follow-up via WhatsApp. Autumn and winter — the low-sun months — are the ideal season for pigmentation work. Send photos of the spots (+90 555 209 09 39) for a preliminary assessment and a euro price before you travel; English spoken.

Frequently asked questions

Do spots disappear permanently? — Treated lentigines clear, but the sun makes new ones; melasma is controlled, not cured. Sunscreen is how you keep the result. Can I have treatment in summer? — Topical therapy yes; light-based treatments prefer low-sun months, and tanned skin postpones the session. Why won't you give me a session count over WhatsApp? — Because pigment depth is seen at examination, not in a photograph; an honest estimate requires a consultation. Do over-the-counter brightening creams work? — Some ingredients have evidence, but correct concentrations and combinations are medical territory; aggressive unsupervised products can leave marks worse than the originals. BBL or Q-Switch — which is better? — Wrong question: they target different pigment patterns. The right question is which one your pigment needs — and sometimes the answer is neither.

Appointments

☎ WhatsApp: +90 555 209 09 39 · ✉ info@drkagancingoz.com · İstasyon Mah. Edirne Cad. No:102, Kırklareli, Turkey

⚠️ Results vary between individuals; chronic pigmentation requires maintenance and strict sun protection. A detailed consultation is recommended before any treatment.