What exactly are the large brown spots on the skin? Simply put, they can be divided into melasma, coffee spots, nevus of Ota, and dark circles under the eyes. Melasma Stretch marks mostly appear as symmetrical brown patches on both cheeks, medically known as chloasma. Some of them will fade away naturally after having children, while others will worsen during breastfeeding. This is because of the unstable hormone level during pregnancy and breastfeeding, plus many people dare not use any skin care products or apply sunscreen during pregnancy, resulting in the appearance or aggravation of melasma. Melasma is difficult to recover after sun exposure, so you should still apply sunscreen during pregnancy and breastfeeding, and do a good job of sun protection under the premise of ensuring the safety of your child. There are several mild lasers with low energy and large light spots that can be used to treat melasma, but only some patients are effective. Some patients will have aggravation or recurrence after treatment and need to be cautious. The current safe and effective treatment option is to alternate between fruit acid peels and vitamin C introduction. For those who cannot be strictly protected from the sun, vitamin C introduction alone is recommended in summer. Melasma treatment is a long term process, usually it takes at least 10 to 20 times to see the ideal effect, so do not believe in the “fast spot removal” on the market. Melasma may not disappear completely after treatment, but it will be significantly reduced, so it is very important to establish the right goal and full confidence. Melasma can also be treated with topical hydroquinone, but it needs to be used under the guidance of a doctor. The main ingredients of the very hot whitening injections on the market are tranexamic acid, vitamin C and reduced glutathione, which can improve the yellowish and dull skin tone of some patients, but the efficacy for melasma is not certain. Coffee spots Coffee spots can be treated by laser. Coffee spot is a kind of light brown patch, which is usually found at birth and is a kind of birthmark. However, it should be noted that the efficiency of laser treatment is only about 30%, so before treatment, coffee spots first choose a small piece of relatively hidden area for treatment, if the effect is obvious then a large area for treatment. It is difficult to achieve the effect in one treatment, about once every 3 months, and it may take several treatments for the discoloration to fade gradually. Nevus of Ota – unilateral patchy brownish-blue birthmark on the face. Nevus of Ota is a birthmark that appears mostly after birth, but may also appear during adolescence or even in adulthood, and is usually unilaterally distributed as a greenish patch. It is most commonly found around the eyes and ipsilateral to the forehead, temporal area, cheekbone area and nose, so it is also called oculo-palatal nevus. Nevus of Ota is best treated with Q-switched laser and can be cured in 3 to 5 times. Dark circles under the eyes The causes of dark circles under the eyes can be roughly divided into pigmented dark circles, vascular dark circles, and mixed dark circles. In addition to strengthening daily care, paying attention to rest and not staying up late, pigmented dark circles can be treated with different wavelengths of intense pulsed light according to the color of the dark circles to break up the pigment particles and expel them from the body. If the dark circles are of vascular type, laser can be used to remove the closed blood vessels and improve the local color. The photothermal effect can improve the blood circulation around the eyes and increase the local metabolism, thus getting rid of the dark circles. And some types of dark circles are because the local skin is too thin to cover the color of deep skin tissues and blood vessels. Only by filling the local area with soft tissues can the dark circles be effectively removed. In short, the effect of laser treatment for dark circles is not certain, so you need to identify the cause before making a choice.