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The most common pigmentation mistake in Dubai clinics: treating all dark spots the same way. Melasma (hormonal), PIH (inflammatory), and solar lentigines (sun damage) are three different conditions that respond to different treatments. Laser makes melasma worse in many patients. SPF alone cannot treat pigmentation but without it nothing else will work. Here's the honest guide.
Melasma (hormonal pigmentation): Symmetrical brown patches typically on the cheeks, forehead, and upper lip. Triggered or worsened by oestrogen (pregnancy, hormonal contraceptives), sun exposure, and heat. Very common in Dubai's South Asian, Arab, and North African patient population. Melasma is a chronic condition — it is managed, not cured. The melanocytes producing it are permanently sensitised. Any treatment must be combined with absolute sun avoidance and maintained consistently. Aggressive laser or deep peels can trigger a rebound flare that leaves the skin darker than before treatment.
Post-inflammatory hyperpigmentation (PIH): Dark patches following an inflammatory event — acne, a wound, an allergic reaction, or a previous cosmetic treatment. PIH is theoretically temporary (the melanin will break down over time) but in Fitzpatrick III–VI skin, it can persist for 12–18 months without treatment. Consistent SPF 50 + topical brightening agents (azelaic acid, tranexamic acid, vitamin C, niacinamide) form the treatment foundation. Chemical peels and HydraFacial BRITENOL accelerate improvement.
Solar lentigines (sun spots, age spots): Discrete, flat, well-defined brown spots caused by cumulative UV exposure. Unlike melasma, they are not hormonally driven and do not symmetrically cover the face. Most responsive to treatment among the three types. Q-switch Nd:YAG laser or IPL with appropriate settings can clear individual sun spots in 1–2 sessions. For Fitzpatrick I–III skin, laser is the fastest route. For Fitzpatrick IV–VI, chemical peels are safer for this indication.
Mandelic acid or salicylic acid peels (safest for Fitzpatrick III–VI) every 3–4 weeks, combined with prescription topicals (azelaic acid 15–20%, tranexamic acid, low-dose hydroquinone for short courses). HydraFacial with BRITENOL booster adds alpha-arbutin for added suppression. Laser for melasma: Q-switch and Nd:YAG can worsen melasma through the heat stimulus triggering rebound melanin production. Pico laser has a better safety profile for melasma but still requires caution. Any Dubai clinic recommending aggressive laser as a first-line melasma treatment without prior topical preparation is not following best practice.
The home care foundation: vitamin C serum (morning), azelaic acid or niacinamide (morning and evening), SPF 50 (morning). In-clinic: salicylic acid peels every 2–3 weeks speed up the clearance of PIH significantly. HydraFacial GLYSAL or BRITENOL booster complements the peel series. Timeline: mild PIH clears in 2–4 months with treatment; severe or long-standing PIH may take 6–12 months. Key: avoid the triggering cause (treat active acne before treating its PIH sequelae).
Fitzpatrick I–III: Q-switch Nd:YAG laser targets melanin in individual sun spots. 1–3 sessions typically clear individual spots. IPL (Intense Pulsed Light) targets multiple spots in a single session and works well for widespread sun damage on lighter skin. Fitzpatrick IV–VI: laser risks triggering PIH. Chemical peels (salicylic, mandelic) over a series of sessions are safer for spot-clearance in darker tones. Price: Q-switch from AED 800/session; IPL from AED 1,200/session.
HydraFacial with BRITENOL booster (alpha-arbutin + vitamin C) is colour-blind — safe for all Fitzpatrick types, no heat, no UV sensitivity post-treatment, no peeling or downtime. Over 6 monthly sessions combined with daily SPF and topical brighteners, it produces meaningful improvement for melasma, PIH, and general uneven tone. It's not the fastest route but it's the safest consistent option for patients with darker skin who can't tolerate peels or laser. Cost: AED 600–1,000/session with booster.
Last updated · May 2026 · Dubai clinic survey
No — and this is the most important expectation to set correctly. Melasma is a chronic skin condition characterised by permanently sensitised melanocytes that react to UV, heat, and hormonal triggers. Treatments suppress the condition and reduce its visibility; they do not cure it. If SPF is discontinued, if hormonal changes occur (new pregnancy, change in contraceptive), or if significant sun exposure returns, melasma will recur. The goal of treatment in Dubai is effective management — keeping melasma consistently reduced to minimal visibility through a sustainable combination of sun protection, topical maintenance, and periodic in-clinic treatments. Any clinic claiming to "cure" melasma is misleading you.
Melasma is triggered by heat as well as UV. The thermal energy from most laser treatments (Q-switch, Nd:YAG, IPL) stimulates the already-reactive melanocytes in melasma-affected skin, causing a rebound flare that leaves the skin darker than before treatment — sometimes significantly so. This is called post-laser PIH on a background of melasma. Pico laser (ultra-short pulse duration, less heat) has a better safety profile for melasma, but still requires pre-conditioning and careful patient selection. For Fitzpatrick IV–VI patients with melasma specifically, the risk-benefit ratio of laser is unfavourable compared to a consistent chemical peel and HydraFacial series. Always ask your Dubai practitioner what their protocol is if melasma flares after laser treatment.
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