Hyperpigmentation & Dark Spots: Professional Treatments That Actually Work — Côte Saint-Luc

Understanding Hyperpigmentation: It's Not Just One Condition

Hyperpigmentation is one of the most common skincare concerns we treat at Réhabital's aesthetic clinic in Côte Saint-Luc — and also one of the most misunderstood. The dark patches you see in the mirror are not all the same condition and treating them with the wrong approach can actually make them worse. Effective treatment requires identifying the exact type of pigmentation, understanding its trigger and selecting the right combination of clinical interventions.

At its biological core, hyperpigmentation occurs when melanocytes — the pigment-producing cells in the lower epidermis — overproduce melanin in response to a trigger. The trigger could be UV radiation, hormonal changes, inflammation, injury, or even visible light. Once the melanin is produced, it can settle at different depths in the skin, which dramatically affects how easy or difficult it is to treat.

The Four Main Types of Hyperpigmentation

1. Sun Spots (Solar Lentigines)

These flat, round, brown spots appear on sun-exposed areas — face, hands, chest, forearms — typically after age 40, though they can appear earlier with significant sun exposure. They are localized clusters of melanin caused by years of cumulative UV damage. Sun spots are typically epidermal (sitting in the upper layers of skin), which makes them among the most responsive types of pigmentation to professional treatment.

2. Melasma

Melasma appears as larger, symmetrical patches on the cheeks, forehead, upper lip and chin. It's strongly linked to hormonal triggers (pregnancy, birth control, hormone therapy) combined with UV and visible-light exposure. Melasma sits in both the epidermis and dermis and it is notoriously difficult to treat because it tends to recur with sun or hormonal triggers. It requires a maintenance approach rather than a one-time fix.

3. Post-Inflammatory Hyperpigmentation (PIH)

PIH appears after any inflammatory skin event — acne breakouts, eczema flare-ups, cuts, burns, even aggressive cosmetic procedures. The dark marks left behind after acne is the most common form. PIH is more common and more persistent in medium and deep skin tones (Fitzpatrick III–VI). The good news: with the right protocol, PIH typically resolves over 3–12 months.

4. Freckles (Ephelides)

Freckles are small, genetically determined pigmented spots that darken with sun exposure and lighten in winter. While they're typically considered a feature rather than a flaw, some people seek to lighten them — and the same treatments used for sun spots are effective.

Why Many At-Home Treatments Fail

The skincare market is flooded with “brightening” creams promising dramatic results. The reality is that most over-the-counter formulations contain active ingredients at concentrations far too low to penetrate deeply enough to affect melanin production. Hydroquinone — long the gold standard — is now restricted in Canada at OTC strength. Vitamin C, niacinamide, alpha arbutin and tranexamic acid all work, but at OTC concentrations they take 6–12 months to show modest results.

Worse, many people aggravate their pigmentation by using harsh scrubs or DIY acid treatments that cause inflammation, which paradoxically triggers more melanin production. This is why a professional approach is essential, especially for melasma and PIH.

Professional Treatment 1: Chemical Peels

Clinical-grade chemical peels remain one of the most effective treatments for hyperpigmentation. Our Dermalogica Pro Power Peel uses a customized layering system of glycolic, lactic, salicylic, mandelic and phytic acids to accelerate cell turnover, dissolve pigmented cells and prevent new melanin from settling. Mandelic and phytic acid in particular are excellent for melasma and PIH because they brighten without causing the inflammation that can worsen pigmentation.

For epidermal pigmentation like sun spots, a series of 3–6 peels spaced 2–4 weeks apart typically delivers dramatic results. For melasma and deeper PIH, peels are most effective when combined with maintenance home care and other modalities.

Professional Treatment 2: Microneedling with Brightening Serums

Microneedling creates microscopic channels in the skin that simultaneously trigger collagen production and allow brightening serums (vitamin C, tranexamic acid, niacinamide, growth factors) to penetrate to the dermal level — where most pigmentation actually lives. This combination is particularly effective for melasma and deep PIH that doesn't respond fully to peels alone. A series of 4–6 sessions spaced 4–6 weeks apart is standard.

Professional Treatment 3: IPL & SharpLight DPC

For sun spots and freckles, intense pulsed light (IPL) and our SharpLight DPC technology are exceptionally effective. The light energy is selectively absorbed by melanin in the pigmented cells, heating and destroying them while leaving surrounding tissue untouched. The treated spots typically darken slightly for 5–7 days, then flake off, revealing clearer skin underneath. Most patients see dramatic results in 2–4 sessions.

Important note: IPL is generally not recommended for melasma or for darker skin tones (Fitzpatrick V–VI), where it can paradoxically worsen pigmentation. A professional consultation is essential to determine candidacy.

Professional Treatment 4: Green LED Therapy

Green LED light (520–530 nm) targets melanocytes and helps modulate melanin production. As an add-on to peels and microneedling, green LED therapy enhances brightening results and helps prevent recurrence. Read our complete LED light therapy guide for details on how each color works.

The Non-Negotiable Foundation: SPF and Antioxidants

No professional treatment will deliver lasting results without daily, year-round broad-spectrum sun protection. SPF 30+ minimum, with mineral filters (zinc oxide, titanium dioxide) preferred for melasma because they also block visible light. Combine with a morning vitamin C serum to neutralize free radicals and support brightening between sessions. Without these two steps, pigmentation will return within months — even after the most aggressive clinical protocol.

Realistic Timelines and Expectations

Sun spots: visible improvement in 2–4 sessions, full clearing in 6–8 weeks. PIH: 3–6 months of combined clinical and home care. Melasma: ongoing management — expect significant improvement in 3–4 months, with maintenance treatments needed every 6–8 weeks long-term. Anyone promising “permanent” melasma removal in a single session is misrepresenting the condition.

Book a Pigmentation Consultation at Réhabital

Effective hyperpigmentation treatment requires accurate diagnosis. During your consultation at our Côte Saint-Luc clinic, our medical aestheticians will identify the exact type of pigmentation you have, assess your skin tone, evaluate any contributing triggers and design a customized multi-modal protocol. We serve clients from Côte Saint-Luc, Hampstead, Westmount, NDG and across Montreal. Book online via Jane App or call (438) 842-3550.