Pigmentation
Bellevue Pigmentation Treatment: Melasma, Sun Spots & Dark Spots
Ready to clear your dark spots and achieve even skin tone? Book a Consultation
Clear dark spots and melasma with dermatologist-led pigmentation treatments in Bellevue. Our board-certified team uses FDA-cleared IPL, pico and Q-switched lasers, chemical peels, and RF microneedling—customized for all Fitzpatrick skin types I-VI, including skin of color. See real before-and-afters, transparent pricing, and a personalized plan based on digital skin analysis. Free consultation—book today to find the safest, most effective option for your skin.
Hyperpigmentation Explained: Causes & Types
Melanocytes and Melanin Production
Your skin contains special cells called melanocytes that produce melanin—the pigment that gives your skin its color. When these cells become overactive or damaged, they create excess melanin, leading to dark patches on your skin.
Triggers: Sun Exposure, Hormones, Heat, Acne
Several factors can trigger hyperpigmentation. UV exposure from the sun is the most common cause. Hormonal changes during pregnancy or from birth control pills (OCPs) can trigger melasma. Heat and inflammation from acne can also leave dark marks behind.
Sun Spots (Solar Lentigines)
These flat, brown spots appear on sun-exposed areas like your face, hands, and shoulders. They develop after years of UV exposure and become more common as you age.
Age Spots
Similar to sun spots, age spots are flat brown patches that appear later in life. They're harmless but can make your skin look older than you feel.
Melasma
Melasma creates brown or gray-brown patches, usually on the face. It's often triggered by hormonal changes and sun exposure. This condition requires special care as it can be stubborn to treat.
Post-Inflammatory Hyperpigmentation (PIH)
PIH occurs when your skin produces extra melanin after injury or inflammation. Acne, cuts, or burns can all leave behind dark marks that last for months.
Freckles (Ephelides) vs Sun Spots (Lentigines)
Freckles are small, light brown spots that appear in childhood and fade in winter. Sun spots are larger, darker, and don't fade without treatment.
Post-Inflammatory Erythema (PIE) vs PIH: What's the Difference?
PIE appears as red or purple marks from damaged capillaries, while PIH shows as brown spots from excess melanin. Different treatments work best for each type. PIE (red/pink marks) often responds better to vascular lasers (e.g., 595 nm pulsed dye) than pigment-targeting lasers.
Who's a Candidate? Fitzpatrick Skin Types I-VI, Safety & Contraindications
Medical History & Medications
Your medical history matters. We'll review your current medications, especially if you're taking isotretinoin (Accutane) or photosensitizing medications that make your skin more sensitive to light.
Skin Type Considerations
We use the Fitzpatrick scale to assess your skin type from I (very fair) to VI (very dark). This helps us choose the safest, most effective treatments for your skin. For Fitzpatrick IV-VI, we favor longer wavelengths (1064 nm Nd:YAG) and conservative parameters; for lighter skin, IPL or 755 nm alexandrite can target sun spots efficiently.
Contraindications
Some conditions make certain treatments unsafe. Active skin disease, photosensitivity disorders, or recent sun exposure may mean we need to wait or choose different options.
Fitzpatrick Scale and Device Settings
Your Fitzpatrick skin type determines our laser and IPL settings. Darker skin requires special protocols to prevent post-inflammatory hyperpigmentation.
Pregnancy & Breastfeeding Considerations
If you're pregnant or breastfeeding, we'll recommend safe alternatives like azelaic acid or vitamin C instead of certain lasers or hydroquinone. Avoid hydroquinone and retinoids during pregnancy/breastfeeding; azelaic acid, vitamin C, niacinamide, and strict SPF are preferred.
Isotretinoin and Photosensitizing Medications
Recent isotretinoin use requires a 6-month wait before certain treatments. Other medications may need adjustment before procedures.
Pigmentation Treatment Options in Bellevue: IPL, Lasers, Peels & RF Microneedling
Our treatment options include:
IPL (Intense Pulsed Light)
Q-switched Nd:YAG (1064 nm)
Picosecond lasers
Fractional/CO2 lasers
Chemical peels
Microneedling/RF microneedling
Medical-grade topicals
IPL (Intense Pulsed Light)
IPL uses broad-spectrum light to target pigment in your skin. It's excellent for sun spots and freckles on lighter skin types.
Fractional & CO2 Lasers: Texture, Collagen, and Pigment
Both ablative and non-ablative fractional lasers, including CO2 laser treatments, can improve pigmentation while stimulating collagen production.
Q-Switched Nd:YAG (1064 nm) for Skin of Color
This laser uses specific wavelengths (532 nm and 1064 nm) to break up pigment particles. It's safe for darker skin when used correctly.
Picosecond Lasers for Melasma and Stubborn Spots
Pico lasers deliver ultra-short pulses that shatter pigment with less heat, reducing risks for all skin types.
Chemical Peels
Professional peels remove damaged skin layers, revealing brighter skin underneath. We offer various strengths for different skin types.
Microneedling & RF Microneedling
These treatments create controlled micro-injuries that trigger healing and reduce pigmentation. RF microneedling adds heat for enhanced results.
Topicals That Work: Hydroquinone, Tranexamic Acid, Azelaic Acid, Vitamin C, Retinoids, Niacinamide
We use medical-grade ingredients including hydroquinone, tranexamic acid (topical and oral, off-label), azelaic acid, kojic acid, arbutin, vitamin C (ascorbic acid), retinoids (tretinoin), and niacinamide. These tyrosinase inhibitors block melanin production. Oral tranexamic acid is off-label and not suitable for patients with clotting disorders, on estrogen-containing OCPs, or with thrombotic risk—requires medical clearance.
Medical-Grade Skincare
Professional lines like Epionce and Biojuve offer potent formulations that outperform over-the-counter products.
Glutathione IV Therapy
This antioxidant treatment may help lighten overall skin tone, though more research is needed on its effectiveness.
Combination Therapy Protocols
We often combine treatments—laser plus chemical peels plus skincare—for optimal results.
Find out which treatment is right for your skin type and concerns. Book a Consultation
How Pigmentation Treatments Work (532/755/1064 nm, Tyrosinase Inhibitors)
Technology Explained
Each device uses different technology to target pigment. Lasers use single wavelengths while IPL uses multiple wavelengths of light.
Wavelengths for Pigment
Different wavelengths target different depths: 532 nm for superficial pigment, 755 nm for medium depth, and 1064 nm for deeper pigment.
Tyrosinase Inhibition and Melanogenesis
Topical treatments work by blocking tyrosinase, the enzyme needed for melanin production, interrupting melanogenesis at its source.
Step-by-Step Process
During treatment, we clean your skin, apply protective eyewear, and deliver precise energy to targeted areas. Most sessions take 20-45 minutes.
Comfort Measures & Session Length
We use cooling devices and numbing cream when needed. Most patients describe treatments as feeling like a rubber band snap.
Consultation & Same-Day Treatment Availability
Assessment & Diagnosis
Our board-certified providers examine your skin to identify your specific type of pigmentation and contributing factors.
Digital Imaging & Skin Analysis
Advanced imaging shows pigment below the surface, helping us track progress and plan treatments.
Setting Realistic Goals
We'll discuss what's achievable for your skin type and condition, creating a timeline for expected results.
Sequencing and Combination Therapies
Your personalized plan may include multiple treatments in a specific order for best results.
Same-Day Treatment Availability
For many procedures, we can begin treatment during your consultation visit if you're ready.
Before-and-After Expectations
We'll show you real patient photos so you know what to expect from your treatments.
Sessions Needed & Timeline
Typical Number of Sessions
Most patients need 3-6 sessions for significant improvement, though some see results after just one treatment.
Frequency and Spacing
Treatments are typically spaced 3-4 weeks apart to allow proper healing between sessions.
When to Expect Visible Results
Initial improvement appears within 1-2 weeks, with continued improvement over several months as collagen remodels.
Seasonality and Sun Exposure Planning
Fall and winter are ideal for treatment when sun exposure is minimal, though we can treat year-round with proper precautions.
Downtime, Recovery & Aftercare: What to Expect
Immediate After-Effects
Expect mild redness, swelling, and eventual flaking or peeling as damaged pigment sheds.
Downtime by Treatment
IPL: 3-5 days of bronzed appearance
Lasers: 5-7 days recovery
Chemical peels: 3-10 days depending on depth
RF microneedling: 2-3 days downtime
PIH Prevention for Darker Skin Tones
We use specific protocols for Fitzpatrick IV-VI skin, including pre-treatment prep and conservative settings.
At-Home Care Essentials
Gentle cleansing, moisturizing, and strict sun protection with broad-spectrum SPF 30-50 are crucial.
When You Can Resume Normal Activities
Most patients return to work the next day with makeup, avoiding strenuous exercise for 24-48 hours.
Risks, Safety & Contraindications
Temporary Side Effects
Common effects include redness, swelling, and temporary darkening before pigment sheds.
Potential Complications
Rare risks include burns, scarring, or paradoxical darkening (PIH), especially without proper protocols.
Skin Type Safety
We adjust parameters based on your Fitzpatrick type to minimize risks.
Test Spots & Patch Testing for Safety
For higher-risk patients, we perform test spots to ensure safe response before full treatment.
Skin of Color Protocols
Special protocols for Fitzpatrick IV-VI include lower energy, longer wavelengths, and pre-treatment preparation.
Results, Collagen & Longevity
Collagen and Elastin Stimulation
Many treatments trigger collagen stimulation and elastin remodeling, improving texture alongside pigmentation.
How Long Results Last
With proper sun protection, results can last years. Melasma requires ongoing maintenance.
Maintenance Treatments
Annual touch-ups help maintain results, with medical-grade skincare between sessions.
Melasma Recurrence Management
Melasma often returns with triggers. We create long-term management plans including topical treatments.
Pre-Procedure Prep & Aftercare
Sunscreen Strategy: Broad-Spectrum (UVA/UVB) Mineral SPF 30-50
Start using broad-spectrum sunscreen with zinc oxide or titanium dioxide daily, SPF 30-50 minimum. Use a broad-spectrum (UVA/UVB) mineral sunscreen SPF 30-50 daily; reapply every 2 hours outdoors.
Pre-Treatment Preparation
Stop retinoids and acids 3-5 days prior
Avoid sun exposure and self-tanner for 2 weeks
Arrive makeup-free
Post-Treatment Care
Use gentle cleanser and emollient moisturizer
Apply mineral SPF 30-50 daily
Avoid heat and exercise for 24-48 hours
When to Call Your Provider
Contact us for excessive pain, signs of infection, or unexpected reactions.
In-Office vs. At-Home Options
Efficacy Differences
Professional treatments deliver faster, more dramatic results than at-home options.
Safety Considerations
Medical supervision ensures proper diagnosis and safe treatment parameters.
When At-Home Care Is Appropriate
Mild pigmentation may respond to prescription topicals alone.
Hydroquinone vs Non-HQ Regimens
We offer both hydroquinone-based and hydroquinone-free options based on your needs and preferences.
FDA Status & Technology
FDA-Cleared/Approved Devices
We use only FDA-cleared or FDA-approved devices for pigmentation treatment.
Picosecond and Q-Switched Categories
Both laser categories have specific FDA indications for pigmented lesions.
Glutathione IV Notes
While used off-label for skin lightening, glutathione IV therapy lacks FDA approval for this indication.
Cost of Pigmentation Treatment in Bellevue
Per-Session Pricing Ranges
Individual sessions range from $200-800 depending on treatment type and area size.
What Affects Cost
Treatment modality and energy settings
Area size being treated
Number of sessions needed
Add-ons (topicals, numbing)
Provider level and expertise
Packages and Multi-Session Planning
Package deals offer 15-20% savings when purchasing multiple sessions upfront.
Financing, Memberships, and Promotions
We offer payment plans, membership programs, and seasonal promotions to make treatment accessible.
Insurance Coverage
Cosmetic pigmentation treatment isn't covered by insurance. Medical conditions may qualify for coverage.
Why Choose Our Bellevue Clinic: Board-Certified, FDA-Cleared, Skin of Color Expertise
Board-certified providers with extensive pigmentation training
Dermatology-led protocols for optimal results
FDA-cleared technology and devices
Specialized expertise with skin of color (Fitzpatrick IV-VI)
Transparent pricing with no hidden fees
Convenient Eastside locations
Personalized, Evidence-Based Plans
Every treatment plan is customized to your specific needs using proven methods.
Serving the Eastside
We proudly serve Bellevue, Redmond, Kirkland, Issaquah, and surrounding Eastside communities.
Take the first step toward clearer, more even skin tone. Book a Consultation
Frequently Asked Questions
What types of pigmentation can be treated in Bellevue clinics?
We treat melasma, sun spots, age spots, freckles, post-inflammatory hyperpigmentation from acne, and other forms of hyperpigmentation using various technologies.
How much does pigmentation treatment cost in Bellevue?
Costs range from $200-800 per session depending on the treatment. Packages offer savings for multiple sessions.
How many sessions are usually required for visible results?
Most patients need 3-6 sessions, though some see improvement after one treatment. Melasma often requires ongoing maintenance.
Which pigmentation treatments are FDA-approved or cleared?
IPL, Q-switched lasers, picosecond lasers, and fractional lasers have FDA clearance for treating pigmented lesions.
What are the most common risks or side effects?
Temporary redness, swelling, and darkening before pigment sheds are common. PIH is a risk, especially for darker skin without proper protocols.
How soon will I see results from pigmentation procedures?
Initial improvement appears within 1-2 weeks, with continued improvement over 2-3 months.
What should I avoid before and after treatment?
Avoid sun exposure, retinoids, and acids before treatment. After treatment, avoid heat, exercise, and sun for specified periods.
Are laser and chemical peel treatments safe for all skin types?
With proper protocols and settings, most treatments can be adapted for all Fitzpatrick skin types I-VI.
Who qualifies for pigmentation treatment? Most adults with pigmentation concerns qualify, except those with active skin disease, recent isotretinoin use, or photosensitivity.
Are there alternatives to in-office treatments?
Prescription topicals like hydroquinone, tretinoin, and tranexamic acid can help mild pigmentation.
Is pico laser better than IPL for melasma and dark spots? Pico laser may be safer for darker skin and melasma, while IPL works well for sun spots on lighter skin.
How do you treat darker skin tones safely?
We use longer wavelengths, conservative settings, test spots, and pre-treatment preparation for Fitzpatrick IV-VI skin.
Can I treat pigmentation in summer?
Fall and winter are ideal, but summer treatment is possible with strict sun protection and adjusted protocols.
Is oral tranexamic acid safe for melasma, and who should avoid it?
Oral tranexamic acid can be effective for melasma but is off-label. It's not suitable for patients with clotting disorders, those on estrogen-containing birth control pills, or with thrombotic risk. Medical clearance is required before starting this treatment.
IPL vs 755 nm alexandrite vs 1064 nm Nd:YAG: which is best for my sun spots and skin type?
IPL works best for sun spots on lighter skin (Fitzpatrick I-III). The 755 nm alexandrite laser is effective for medium-toned skin. The 1064 nm Nd:YAG is safest for darker skin types (IV-VI) due to its longer wavelength that bypasses surface melanin.
Do you offer free consultations and patch testing for Fitzpatrick IV-VI skin?
Yes, we offer free consultations for all patients. For Fitzpatrick IV-VI skin, we provide complimentary patch testing to ensure safe treatment parameters before proceeding with full treatment.
Ready to start your journey to clearer skin? Our experts are here to help. Book a Consultation