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Melasma appears as brownish to blackish stain on the cheeks, upper lip, chin and forehead.These commonly appear during times of hormonal changes, such as menopause, endocrine illness, through the use of contraceptives, in aging and during pregnancy. The typical dark stain in the form of a butterfly that appears on the front of the face during pregnancy, receives the special name of chloasma or gravidic melasma. Most difficult condition to treat as the pigmentation can be deep. Most effective treatment has been combination of special lightening creams with chemical peels such as Obagi or Cosmelan. Beware IPL can worsen melasma.
  
Moles are larger spots of hyperpigmentations. Removal is mostly through CO2 laser.
Freckles or Ephelides are innocuous pale hyperpigmentations of variable colour. They are common in exposed areas, in people with fairer complexion and are stimulated by sun exposure. Excellent clearance with an IPL.
 
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