Skin Pigmentation in Cagliari
Solar lentigines, melasma and hyperpigmentation: diagnosis first, then treatment
Skin spots are not all the same. At Centro Eudermia in Cagliari, every spot is first identified with a dermoscopic assessment, then treated with a protocol tailored to the type of pigmentation, your skin type and your individual response.
- Dermoscopic assessment to distinguish benign from suspicious lesions
- Tailored protocols: laser, chemical peels, topical therapies
- Dedicated management of melasma and post-inflammatory pigmentation
- Strict sun protection as the foundation of every treatment
The Main Types of Spots
The word "spot" is a generic term that covers very different conditions. The main categories:
Solar Lentigines (Lentigo Solaris)
Solar lentigines are flat, brown spots, with sharp borders, that appear on areas chronically exposed to the sun — face, backs of the hands, décolletage, forearms, shoulders. They are caused by the build-up of melanin produced by melanocytes in response to UV rays. They are benign, but they are the visible sign of chronic sun damage. They are sometimes confused with moles and always deserve a dermoscopic assessment.
Melasma (or Chloasma)
Melasma is a symmetrical hyperpigmentation, with irregular borders, typically located on the forehead, cheekbones, upper lip and chin. It mainly affects women and is influenced by hormonal factors (pregnancy, the contraceptive pill, hormone therapies) and by sun exposure. It is particularly difficult to treat because it tends to recur with every new exposure to the sun.
Post-Inflammatory Hyperpigmentation (PIH)
These are dark spots left behind after an inflammatory skin event: resolved acne, eczema, psoriasis, burns, trauma, aggressive medical procedures. They are more common in darker skin types (III-VI). They tend to fade spontaneously over time, but the process can take months or years.
Seborrhoeic Keratoses
These are raised lesions, ranging in colour from beige to black, with a waxy or "stuck-on" surface. They are benign and very common after the age of 40. They must nonetheless be distinguished from suspicious pigmented lesions, which is why a dermoscopic assessment is always indicated.
Actinic Keratoses
Actinic keratoses are pre-cancerous lesions caused by chronic sun exposure. They appear as rough, scaly spots, pinkish or brownish in colour, on sun-exposed areas. They must be treated because they can progress to squamous cell carcinoma. They require specific treatments such as photodynamic therapy and cryotherapy, or topical treatments, which also have good response rates.
Suspicious Pigmented Lesions
Some spots can be pre-cancerous or cancerous lesions: lentigo maligna, melanoma in situ, melanoma. Every new spot, every spot that changes, every spot with an irregular appearance deserves a dermoscopic assessment. See the mole mapping and skin cancer pages for the diagnostic pathways.
Diagnosis is the First Step
Before treating a spot, it is essential to establish what it actually is. A dermatological assessment includes:
- Clinical examination of the spots and the surrounding skin
- VIDIX digital dermoscopy — examination under the dermatoscope makes it possible to distinguish benign lesions from suspicious ones
- History of risk factors (sun exposure, skin type, hormonal factors, medications, family history)
- Photographic documentation for monitoring over time
A skin biopsy if the lesion is suspicious. Only after this assessment can the appropriate treatment be chosen.
The Available Treatments
Fractional CO2 Laser
Indicated for solar lentigines, photoageing and some forms of hyperpigmentation. The fractional laser creates micro-areas of treatment that stimulate skin renewal and help clear excess pigment. It generally requires 1-3 sessions spaced 4-6 weeks apart.
Intense Pulsed Light and Q-Switched Lasers
For isolated solar lentigines and some forms of hyperpigmentation, pigment-specific lasers are effective, selectively targeting the melanin without damaging the surrounding skin.
Chemical Peels
Chemical peels (glycolic acid, mandelic acid, low-to-medium concentration TCA, Jessner's peel, modified phenol) are indicated for melasma, post-inflammatory hyperpigmentation and diffuse photoageing. They require courses of sessions and strict sun protection.
Topical Therapies
For melasma and hyperpigmentation in general, there are topical therapies based on depigmenting substances such as retinoids, azelaic acid, kojic acid, high-concentration vitamin C and niacinamide.
What Does NOT Work
Over-the-counter "brightening" cosmetic products have a modest, slow effect on true hyperpigmentation. Home remedies (lemon, toothpaste, etc.) are ineffective and sometimes make the situation worse by causing irritation and post-inflammatory hyperpigmentation.
The Crucial Role of Sun Protection
No treatment for skin spots works without strict sun protection. Photoprotection is the foundation of any protocol:
- SPF 50+ on the treated areas, every day, even in winter and on cloudy days
- Reapplication every 2-3 hours on days of sun exposure
- Physical protection (wide-brimmed hat, sunglasses) during the middle of the day
- Avoiding direct exposure during the hours of peak radiation (10:00-16:00)
Without photoprotection, treated spots come back quickly, melasma in particular. Photoprotection is not optional: it is part of the treatment.
What to Expect: Timeframes and Results
Solar lentigines: often completely eliminated after 1-3 laser sessions. They can reappear with new sun exposure.
Melasma: a difficult, partial, long-term treatment. The realistic goal is control, not a definitive cure.
Post-inflammatory hyperpigmentation: tends to fade over time; treatment can speed up the process.
Seborrhoeic keratoses: easily removed with curettage, cryotherapy or diathermocoagulation, generally in a single session.
Actinic keratoses: require specific treatments (photodynamic therapy, cryotherapy), with good response rates.
Frequently Asked Questions about Skin Pigmentation
Related Services
The treatment of skin spots at Centro Eudermia combines several approaches: fractional CO2 laser for lentigines and photoageing, chemical peels for melasma and hyperpigmentation, anti-wrinkle treatment for overall rejuvenation, photodynamic therapy for actinic keratoses, mole mapping for differential diagnosis, and skin cancer care for lesions that require an oncological pathway.
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The information on this page is for general information purposes only and does not replace specialist medical advice. The results of skin pigmentation treatments may vary depending on the type, skin type and individual response.