Melasma or (Chloasma) is patterned pigmentation on the face particularly over cheeks, and forehead especially in women. Melasma can be idiopathic (no cause) or it can be a result of taking birth control pills or during pregnancy. In the latter case, the pigmentation will fade gradually once you stop taking the pill or after pregnancy, but it could take many years. An idiopathic cause is more common. Chloasma looks light to dark brown and ends abruptly forming a line along the forehead or cheek. It is more often seen in darker races. Sometimes the upper lip and chin can be affected. Melasma is aggravated by sun exposure and perfume, therefore it is a good idea to wear sunscreen.

Phyto-photo dermatitis occurs after coming in contact with a plant or plant derivative (phyto) to which you are allergic, followed by exposure to the sun (photo). Dermatitis refers to the redness or swelling of the skin which occurs almost immediately after sun exposure. After inflammation settles the skin is left dark brown.

Perfume dermatitis or Berloque dermatitis are other names for phyto-photo dermatitis. In perfume dermatitis the effects of using perfumes, colognes and aftershave containing oil of bergamot, or furocoumarin related substances can be mild and pigmentation is the only sign which occurs.  No inflammation of the skin occurs. 

Many plants like limes and lime oil from the rind can cause the same symptoms if you are allergic to them. Common sites are the wrists, behind the ears, and the sides of the neck. In men, the beard area is a common site because of aftershave. Phyto-photo dermatitis usually subsides after a year, but in darker skinned people it could take longer.

Ochronosis is severe hyperpigmentation caused by hydroquinone. It is an ingredient found in many skin-lightening creams. Hydroquinone does not allow (blocks) the production of melanin in melanocytes of the epidermis. Because less melanin is produced, there is less protection from UV light and deeper penetration into the skin structures. This form of hyperpigmentation is permanent and irreversible. Some of the symptoms are coarse black skin and large black papules. The chin, forehead, cheeks and upper lip are the most common sites. Ochronosis is often seen in black populations in countries that use a lot of skin-lightening creams.

Malignant melanoma is skin cancer. Three percent of all Malignant skin tumors are Malignant melanoma. Most often the lesions appear flat and pigmented or can be raised. These nodules are grey-brown or blue-black and ulcerate or extend into an irregular outline. They grow downward into the dermis and become attached to the underlying tissue.

People with many naevi are more at risk of developing Malignant melanoma. Fair complexion and light hair and eyes are more common as well. People who were severely sunburned in their past, or have it run in their families are more likely to experience the illness. It is most common between the ages of 40 and 50 or any time after puberty.

Malignant melanoma can occur anywhere on the body where there are melanocytes. The eyes and mucous membranes are possible sites. It is common on the backs of men and on the legs of women.  Other common places are lower limb, nail bed, sole of foot, neck, and head (especially for people who have no hair or are balding).

It is fair to say that age spots, sun spots and melanin abnormalities are not always permanent. At Nell Laser Clinic there are solutions for age spots, sun spots and brown spots. We access your problem and make educated and helpful suggestions to solve your problems. Make an appointment today.

Fortunately, these days there are many solutions for all hyperpigmentation disorders such as age spots, sun spots, melasma.  These include: Laser; micro-needling; microdermabrasion; chemical peel; and cosmetic acupuncture.  These treatments, with the aid of proper skin care products, will resolve hyperpigmentation.  Patience and persistency, however, are key.

For a complementary consultation call us at 416-228-0011

Sun Spots Removal Toronto

As we now know, hyperpigmentation comes in many forms that are usually called age spots, sun spots, brown spots and melasma. But common to all is the presence of melanin in the body. Ephelides, Lentigo, and Pigmented naevi are all similar in nature.  Dysplastic naevi, and Malignant melanoma have much in common. Melasma or (Chloasma), Phyto-photo dermatitis, and Ochronosis also share common characteristics.

Ephelides is another word for what we know as freckles. They are small, evenly pigmented macules which are more obvious after sun exposure. They are caused by an increase in the melanin in a normal number of melanocytes(producers of melanin). Ephelides often occur on the face, arms, legs and nose, and in fair skinned or red-haired people.

Lentigo is the Latin word for lentil. As such, lentigo resembles lentils in its appearance and form. The lesions of lentigo are called lentigines and they are more defined and darker than freckles. Also, they are slightly raised and distributed in no particular order. They are the result of an increase in the number of melanocytes found in the basal layer of the epidermis.

Pigmented naevi, otherwise known as moles, are tumours of melanocyte cells and usually appear in early adulthood and throughout life.  They are usually small (less than 1cm in diameter) and can be skin coloured to light brown to blue black.  There are three types of pigmented naevi: intradermal,

junctional, and compound.

It is important to note that intradermal naevi are usually never malignant.  They occur in adults and are dome-shaped, papillomatous, or pedunculated.  They may or may not have hairs and they can appear anywhere on the body especially the head and neck.  Intradermal naevi are not, however, usually found on the palms, soles, or genetalia.  They are shades of brown or even skintone in colour, and are found completely within the dermis of the skin.

Junctional naevi, on the other hand, are found mainly on the soles, palms, and genetalia. They can be flat or slightly raised.  Actually, they can be found anywhere on the body and they are hairless.  A small percentage of the naevi can go on to become Malignant melanomas.  The junctional naevi are found where the dermis and the epidermis meet (ie.,dermo-epidermal junction).

Compound naevi have both intradermal and junctional components because they are located in both the intradermal part of the dermis and dermo-epidermal junction. They are raised and papillomatous even though they are like intradermal naevi. They have coarse dark hairs and a small percentage can become malignant(junctionalcompnent).

How can you tell if a naevus is malignant? Many are benign, but the small percentage that change in appearance and behaviour (eg., inflammation) are likely to become malignant. If there is any pain, itching, bleeding, enlargement, darkening, or ulceration it should be checked out by a pathologist.

Hairs on the naevi do not always lead to malignancy. Intradermal moles generally have hairs and compound moles may have hairs because of their intradermal component. It is the junctional component of compound moles that can lead to malignancy. Only through a biopsy under dermatologist supervision (ie., under a microscope) can you be 100% certain of malignancy.

Dysplastic naevi have an irregular colour and shape (greater than 7mm in diameter) with an indistinct border both on biopsy and to the naked eye. They are considered atypical. Dysplastic naevi have a variegated appearance and must be monitored carefully because of their high risk to become Malignant melonoma.

Fortunately, these days there are many solutions for all hyperpigmentation disorders such as age spots, sun spots, melasma.  These at Nell Laser Clinic include: Laser; micro-needling; microdermabrasion; chemical peel; electro-cauterization and cosmetic acupuncture.  These treatments, with the aid of proper skin care products, will resolve hyperpigmentation.  Patience and persistency, however, are key.

For more information and a complementary consultation call us at 416-228-0011 

Sun Spots Removal Toronto

What is age spot or brown spot?  How does the body make brown spots?  How does melanin determine our skin type?  There are many disorders of pigmentation, but for now we will focus on hyperpigmentation and lightly touch on an unfortunate condition called Vitiligo, the opposite of hyperpigmentation.  We will also look at the causes of hyperpigmentation or brown spot and hopefully provide some answers on how to treat it.  Let’s get into it!

Age spots, liver spots, sun spots and melasma are unpleasant phenomena known as hyperpigmentation which is caused by the amount of melanin produced by the melanocytes in the body.  Melanocytes look like an octopus with long arms or dendrites.  They are found in the basal layer of the epidermis and hair follicle, and extend upward into the stratum spinosum layer.  Everyone has 800-1000 melanocytes per square millimeter of epidermis.

Melanocytes contain melanosomes which are granules containing the enzyme tyrosinase.  Tyrosinase helps change tyrosine to melanin which is then taken up by the prickle cells in the epidermis of the skin.  This multistage chemical process is called melanogenesis.

The colour of our hair, eyes, and skin are all determined by the amount of melanin in the special cell melanocytes.  They are not determined by the number of melanocytes (one for every 36 keratinocytes) which is the same in everyone.  The skin’s colour and intensity (how dark or how light) depends also on the type of melanin (eumelanin or yellow-red pheomelanin).  It also depends on the size and number of the melanosomes and their distribution in the epidermis. In darker skinned people, the melanosomes are larger and carry more melanin than in lighter skinned people.

Melanin can be both good and bad.  It protects, but it can also do harm.  Melanin blocks UV radiation from damaging DNA, but it also has the potential to cause skin cancer like melanoma.

There are three main forms of abnormalities in pigmentation of the skin.  First, hyperpigmentation or brown spot (increase in pigmentation or melanin).  Second, hypopigmentation (decrease in pigmentation or melanin).  Thirdly, achromia (no colour, pigmentation or melanin).  These conditions can be either localized in one area or generalized (the whole body).

Hyperpigmentation occurs when the melanocytes are more active or there is an increased number of melanosomes, thus producing more melanin. an example of the opposite of hyperpigmentation is a condition called Vitiligo which occurs when there is a loss of pigment or melanin. 

Vitiligo is the result of melanocytes being destroyed.  It is cosmetic and affects all races equally, but it is more noticeable in dark skinned people.

Treating abnormal pigmentation can be simple most of the time, because usually it is cosmetic.  There is anecdotal evidence, for example, that vitamin C can increase melanin.  Eating foods like green leafy vegetables, berries, and citrus fruits as well as taking vitamin C supplements will increase melanin. 

There are many factors that can cause hyperpigmentation.  Drugs like oral contraceptives, physical or chemical (burns, chronic scratching), endocrine (eg., hypothyroidism), pregnancy(chloasma), tumors (malignant melanoma), genetic (ephelides ie., freckles), and nutritional (Pellagra).

Hyperpigmentation, on the other hand, responds well to laser Therapy if it is localized.

In short, melanin is responsible for causing age spots, sun spots, liver spots and even melasma.  This brown spots or reddish pigment produced by melanocytes, and how much of it is present, will determine your skin type.  Laser Therapy, such as that offered at Nell Laser Clinic, is a good option for someone trying to treat hyperpigmentation, as is the moderate use of lightening creams.  Adding vitamin C to your diet and getting a little more sun will increase the amount of melanin in your body.  Whether you have too much melanin or too little, never give up.  There is always hope.

In Part 2 of this blog we will take an in depth look at some disorders of pigmentation.  These include Ephelides, Lentigo, Chloasma, Phyto-photo dermatitis, Pigmented naevus, Malignant melanoma, and Ochronosis.

Fortunately, these days there are many solutions for all hyperpigmentation disorders such as age spots, sun spots, melasma.  These at Nell Laser Clinic include: Laser; micro-needling; microdermabrasion; chemical peel; electro-cauterization and cosmetic acupuncture.  These treatments, with the aid of proper skin care products, will resolve hyperpigmentation.  Patience and persistency, however, are key.

For a complementary consultation call us at 416-228-0011

Sun Spots Removal Toronto

There are 5 main factors that cause hyper-pigmentation or brown spots, age spots, dark spots.


The sun is the major cause of hyper-pigmentation or dark spots. UV directly stimulates the protection of melanin. Melanin is your body’s way of protecting itself from UV. Excess sun exposure causes age spots or brown spots.

2- Irritation, Inflammation & Trauma

Have you noticed a dark spot after a healing pimple or discoloration from a scar? This is post-inflammatory hyper-pigmentation. Irritation to the skin can cause inflamation. DNA damage caused by inflammation activates the genes for melanin production. The injury causes an increase in pigmentation and scarring.

Irritation can come from many sources – too much pressure (from massage or incorrect extraction technique),  skin trauma or wounds, unprofessional laser treatments , over-exfoliation, even spicy foods and inflammatory diseases such as eczema.

3- Hormones

Changes in the balance of reproductive hormones (estrogen, progesterone) and stress hormones can cause hyper-pigmentation. This is the hardest kind to treat, because there is a ‘hidden’ factor behind the hyper-pigmentation or brown spots.

4- Chemicals

Certain chemicals can trigger a melanocyte to produce melanin. Artificial fragrance is a big one. Oxidized ingredients also cause brown spots. Pure Vitamin C is a perfect example – it oxidizes extremely fast, unless it has been correctly formulated (hard to find).

5. Medications

Certain drugs (anti-malarial, cancer, others) as well as heavy metals may cause dark spots too.

If melanin is produced in high concentrations or becomes “clumped”, they form age spots or brown spots.  These dark spots are not dangerous and can be removed.

Methods of removal at Nell Clinic:

  • Laser
  • Cauterization (electrocoagulation)

Call for a complimentary consultation: 416-228-0011.

Dark Spots Removal Toronto