Melanin is the skin's own sun protection, and the pigment cells (melanocytes) in the lowest layer of the skin make it to order: when UV light hits the skin, when hormones (oestrogen, progesterone) signal, when the skin is inflamed (spots, eczema, wounds, scrubbing) and when it is exposed to heat and friction. Pigment spots appear when a group of pigment cells has become overactive and keeps delivering melanin to the same place. Sun spots (lentigines, "age spots") are sharply defined, light to dark brown, millimetres to a centimetre in size, on cheekbones, temples, forehead, backs of the hands and décolletage, and they are the sum of the years' sun; they are harmless but a sign that the skin has had more UV than it could handle. Melasma is larger, diffuse, symmetrical grey-brown patches on cheeks, forehead, upper lip and chin, driven by hormones (pregnancy, the pill, hormone therapy) plus sun and heat, most common in women aged 20–50 with darker skin types, and it is the most stubborn of all pigment problems because the cells keep reacting to every ray of sun and every warm day. Post-inflammatory hyperpigmentation (PIH) is brown or grey-brown marks where the skin has been inflamed: after spots, eczema, insect bites, grazes, waxing, laser or acid treatment that was too strong; more common and longer-lasting the darker the skin. Freckles are hereditary and sun-dependent, harmless. Moles (naevi) are clusters of pigment cells; the vast majority are harmless, but they are the ones to watch. Treatment follows the type, and sun protection is the foundation for all: without it nothing helps, with it most things do.
Which type of spot? And which should be examined
| Type | What it looks like | Cause | What helps |
|---|---|---|---|
| Sun spots (lentigo) | Sharply defined brown spots, flat, on sun-exposed areas; more with the years | Accumulated UV | SPF, retinoid, vitamin C, acids, laser/IPL (good effect), cryotherapy at a dermatologist |
| Melasma | Diffuse, symmetrical grey-brown patches on cheeks, forehead, upper lip, chin; worse in summer | Hormones + UV + heat + visible light; hereditary | SPF with iron oxide, triple cream on prescription, azelaic acid, tranexamic acid, chemical peels; laser cautiously (can worsen) |
| Marks after spots and wounds (PIH) | Brown or grey-brown, exactly where the inflammation was, flat | Inflammation; worsened by sun and picking | Time (3–12 months), SPF, azelaic acid, niacinamide, retinoid; treat the cause (the acne) |
| Red marks after spots (PIE) | Pink-red, blanch when you press | Dilated vessels, not pigment | Time, niacinamide, vascular laser; not pigment treatment |
| Freckles | Small, light brown, many, darker in summer | Hereditary + UV | No treatment needed; SPF |
| Mole (naevus) | Brown, may be slightly raised, has been there a long time, looks the same | Pigment cell cluster | Leave; watch according to ABCDE below; lightening products should not be used on moles |
| Seborrhoeic keratosis ("age wart") | Brown to black, waxy, "stuck on", a little rough | Harmless skin growth with age | None; can be removed by a dermatologist if it bothers you |
Show a doctor (ABCDE): a spot that is Asymmetrical, has an irregular or blurred Border, several Colours (brown, black, red, white, blue), a Diameter over 6 mm, or that Evolves (changes shape, colour, size, starts to itch, bleed or crust). Also: a new spot after 40 that differs from your others (the "ugly duckling"), a sore that doesn't heal in four weeks, a shiny, pearly bump. Skin cancer is treatable when found early; never lighten a spot you don't know the nature of.
Causes, and what makes it worse
- Sun, including cloudy days, winter, car windows and the window seat at the office (UVA passes through glass). The biggest cause of all types and the one that makes treated spots come back.
- Visible light and heat, especially with melasma: blue light from the sun (not screens at normal doses) and infrared heat from sun, sauna, the stove and hot facial treatments trigger the pigment cells independently of UV. That is why tinted sunscreen with iron oxide helps with melasma, and why melasma gets worse from sauna and hot yoga sessions.
- Hormones: pregnancy ("mask of pregnancy", often fades after delivery but not always), the pill and hormonal IUDs with oestrogen, hormone therapy in menopause, thyroid disorder.
- Inflammation and friction: spots, eczema, shaving, waxing, rubbing with a towel, cleansing brushes, harsh scrubs, and acids and retinoids that are too strong and cause irritation: the skin responds to irritation with pigment, especially darker skin types. The same applies to vigorous facial massage, gua sha and cupping with too strong suction.
- Fragrance and certain substances (bergamot, citrus oils, some essential oils) that make the skin light-sensitive and give spots where the product was when the sun hits.
- Medicines: some antibiotics (tetracyclines), antiepileptics, chemotherapy, amiodarone; ask the pharmacy.
- Picking at spots and scabs: PIH forms in the inflamed area and lingers for months.
What helps, in the right order
- Sun protection every day, all year: SPF 30–50, broad spectrum, half a teaspoon for the face, reapply every two hours outdoors. With melasma: tinted mineral sunscreen with iron oxide (also protects against visible light), a hat and shade. Without this everything else is wasted. It is also the only thing that prevents new spots.
- Niacinamide 4–5% morning and evening: reduces the transfer of pigment to the skin cells, calms inflammation, tolerated by all. The base of every routine.
- Vitamin C 10–15% in the morning under the sunscreen: inhibits pigment formation and boosts the sun protection. Sensitive skin: lower strength or a derivative.
- Azelaic acid 10–20%: inhibits overactive pigment cells, anti-inflammatory, safe in pregnancy and breastfeeding, good for melasma and PIH, gentle on sensitive skin. The best choice when you are pregnant or have rosacea or acne at the same time.
- Retinoid (retinal, retinol, adapalene, tretinoin on prescription) in the evening: speeds up skin renewal so pigmented cells are shed, and prevents. Start every other evening, build up; irritation causes pigment, so gently. Not in pregnancy.
- Acids: glycolic or lactic acid 5–10% a couple of evenings a week (not the same evening as a retinoid), or a chemical peel at a skin therapist. With melasma and dark skin: mild acids, never strong peels.
- Tranexamic acid in cream (2–5%) or tablets via a doctor: specifically effective for melasma, inhibits the signal from the vessels to the pigment cells.
- Triple cream (hydroquinone, tretinoin, cortisone) on prescription for two to three months: standard for melasma, effective, must not be used longer than that.
- Laser and IPL at a dermatologist: excellent for sun spots (often one to two treatments), cautiously and with low energy for melasma (the wrong laser makes melasma worse), never on spots that haven't been assessed.
- Patience: pigment is replaced at the pace of the skin, so expect eight to twelve weeks before you see a difference in sun spots and PIH, and three to six months with melasma. Photograph in the same light every four weeks.
A routine for pigment: morning: mild cleanser, vitamin C or niacinamide, moisturiser, sunscreen. Evening: cleanser, azelaic acid or retinoid (alternating if the skin is sensitive), moisturiser. See skincare routine. Face oil: works as the moisture step in the evening, choose one without fragrance and citrus (photosensitising); see face oil.
What doesn't work, or makes it worse
- Lemon juice, apple cider vinegar, baking soda: irritate, photosensitise and give more pigment.
- Scrubs and brushes "to polish the spot away": the pigment sits deeper than you reach, and the friction creates new.
- Lightening creams bought online without an ingredient list: may contain mercury or illegally high doses of hydroquinone or cortisone.
- Sunbeds "to even things out": make all spots darker and give new ones.
- Stopping sunscreen once the spot has faded: it comes back in one summer.
Face cupping and pigment spots: how to do it right
Face cupping doesn't affect the pigment itself, in either direction, when done right: the suction acts on circulation, lymph and muscles, not on the pigment cells. It can however give the skin a more even glow and better blood flow that makes the complexion look clearer, and many with pigment spots also have dull or puffy skin that cupping helps with. There are two situations to be aware of. Melasma: the pigment cells in melasma react to heat and friction, and vigorous facial massage, gua sha with pressure and cupping with strong suction or fast strokes increase both heat and friction in the skin. Therefore: the lightest possible suction, so the skin barely lifts, slow strokes, never back and forth over the same spot, cool skin (not after a hot shower, not in the sun), plenty of oil so the cup glides without resistance, and short sessions, three to five minutes. If the skin is clearly red or warm afterwards, it was too much. Stop completely during a period when melasma has flared, and during treatment with triple cream or acid peels when the skin is sensitive. Darker skin types prone to PIH: the same rules, since any irritation can leave a mark; never cup over active spots, wounds or eczema. Sun spots and harmless moles are not affected by light cupping, but don't glide the cup over raised moles or seborrhoeic keratoses (they can be irritated and bleed), and don't cup at all over a spot that should be assessed. After laser, IPL or a chemical peel: wait until the skin is fully healed, usually two to four weeks, and ask the practitioner. This is what a suitable session looks like: cleansed, cool skin, a drop of fragrance-free face oil, the mini cup with the lightest suction from the middle of the chin outwards along the jawline, from the side of the nose outwards over the cheek towards the ear, from the eyebrow outwards towards the temple, and down along the neck, three to five strokes per path, three minutes, then sunscreen in the morning. The full technique in face cupping and lymphatic massage for the face.
Read more
Skincare routine, spots and marks after spots, rosacea, dark circles under the eyes, wrinkles, face oil, menopause and face cupping.
Frequently asked questions
Why do you get pigment spots on the face?
Because the pigment cells have been irritated and produced too much melanin in one place. The most common cause is sun over the years (sun spots on cheekbones, temples and forehead), then hormones combined with sun and heat (melasma: diffuse symmetrical patches on cheeks, forehead and upper lip, with pregnancy, the pill, hormone therapy), and inflammation (marks after spots, eczema, wounds and treatments that were too strong). Certain medicines and fragrances make the skin light-sensitive and cause spots.
How do you get rid of pigment spots?
Sunscreen SPF 30–50 every day all year round is the foundation; without it everything comes back. Then: niacinamide and vitamin C in the morning, azelaic acid or a retinoid in the evening, mild acids a couple of times a week, and for melasma tranexamic acid or triple cream on prescription. Laser and IPL are effective for sun spots at a dermatologist. Expect eight to twelve weeks for sun spots and marks after spots, three to six months for melasma.
What is melasma and does it go away?
Melasma is hormone-driven pigmentation: larger, diffuse, symmetrical grey-brown patches on cheeks, forehead, upper lip and chin, driven by oestrogen and progesterone together with sun, heat and visible light. The kind that follows pregnancy often fades within a year; other melasma can be lightened with tinted sunscreen with iron oxide, azelaic acid, tranexamic acid and triple cream, but it returns with sun, sauna and heat and requires lifelong sun protection. The wrong laser can make it worse.
When should a pigment spot be examined?
When it is asymmetrical, has an irregular or blurred edge, several colours, is larger than 6 mm, or changes (grows, changes colour, itches, bleeds, crusts); when a new spot after 40 differs from your others; when a sore doesn't heal in four weeks; or when a bump is shiny and pearly. Book your doctor or a dermatologist, and never lighten a spot you don't know the nature of.
Can I do face cupping if I have pigment spots or melasma?
Yes, with the right technique: cupping doesn't affect the pigment itself, but with melasma the pigment cells react to heat and friction, so use the lightest suction, slow strokes outwards, plenty of oil, cool skin, short sessions and stop if the skin gets red and warm. Never cup over active spots, raised moles or spots that should be assessed, and wait two to four weeks after laser or a peel. Sunscreen afterwards in the morning.
Written by Curam. Last updated 17 October 2026. This is general self-care information and does not replace medical care. For sudden, severe or unusual symptoms, contact your doctor. Talk to your doctor before cupping if you are pregnant, take blood thinners or have a condition affecting skin, blood vessels or blood.
