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Medical dermatology
Melasma and dark spot treatment in Richardson, TX
Care for melasma, sun spots and the dark marks left by acne or irritation, tailored to your skin tone by a board-certified dermatologist.
Dr. Kelsie Riemenschneider
MD, FAAD · Board-certified dermatologist. You will see her at every visit.
Overview
What causes melasma and dark spots
Dark spots form when the skin makes extra pigment, called melanin, in one area. Melasma causes brown or gray-brown patches on the cheeks, forehead, upper lip and jawline. It is driven by sunlight and visible light, by hormones such as pregnancy and birth control, and by family history. Other dark spots build up after years of sun, or appear after acne, eczema, a bug bite or an injury heals.
Pigment concerns are especially common in skin of color, and they call for a careful approach, because treatment that is too harsh can irritate the skin and make dark spots worse. A dermatologist can tell which kind of discoloration you have, since each is treated differently, and can check that a dark spot is not something that needs a biopsy.
When to see a dermatologist
Dark patches are spreading, or have not faded after several months
Brightening products have not helped, or have irritated your skin
Dark marks keep appearing after breakouts or rashes
A spot is new, changing, uneven in color or unlike your others
Types of discoloration we treat
Melasma.Symmetrical brown or gray-brown patches on the face, often linked to hormones and sun.
Post-inflammatory dark marks.Spots left behind after acne, eczema, ingrown hairs or injury.
Sun spots. Flat brown spots on the face, hands, chest and shoulders from years of sun exposure.
Uneven skin tone. Blotchy or dull areas from a mix of sun damage and past inflammation.
Dark patches in skin folds.Velvety darkening of the neck or underarms, which can be linked to other health conditions.
Treatment
How we treat melasma and dark spots
Fading pigment takes patience and daily sun protection. Dr. Riemenschneider builds a plan around the type of discoloration, how deep the pigment sits and your skin tone, starting with the gentlest options that are likely to work.
Sun and light protection. A tinted, broad-spectrum mineral sunscreen worn every day, which is the foundation of every plan.
Prescription lightening creams. Ingredients such as hydroquinone, tretinoin and azelaic acid, alone or combined, used on a schedule we set.
Oral medication. Tranexamic acid for melasma in selected patients when creams are not enough.
Chemical peels. A series of gentle peels, chosen for your skin tone, to lift surface pigment. About chemical peels
Your visit
What to expect at your visit
Tell us your history. When the spots appeared, any pregnancy or hormone changes, your sun exposure and the products you have tried.
Dr. Riemenschneider examines your skin. She identifies the type of discoloration and takes a closer look at any spot that stands out.
You leave with a plan. A written routine, any prescriptions sent to your pharmacy and a realistic timeline.
In network with most major health plans. See every plan we accept
Questions
Common questions about melasma and dark spots
Have a question that is not here? Call 214-833-5300.
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Melasma appears as larger, blotchy patches, usually on both sides of the face, and is tied to hormones as well as light. Sun spots are smaller, well-defined spots caused by sun exposure over time. They respond to different treatments.
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Melasma that starts in pregnancy or with birth control sometimes fades once hormones settle. Often it lingers and returns with sun exposure, so most people need treatment plus ongoing sun protection.
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With a consistent plan, it usually takes 3 to 12 months to see results. Consistent sunscreen use makes the biggest difference in how quickly spots fade.
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Yes, when it is chosen carefully. Darker skin is more prone to dark marks from irritation, so we use lower strengths, gentler peels and a slower schedule.
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Yes. Visible light as well as ultraviolet light can worsen melasma, so protect your skin every day, including days spent mostly inside. A tinted sunscreen with iron oxides and SPF 30 or higher covers both and helps keep treated pigment from returning.
Related care Chemical peels Personalized skincare consult Acne Vitiligo All medical dermatology
Reviewed by Dr. Kelsie Riemenschneider, MD, FAAD, board-certified dermatologist. Last reviewed October 2026. Source: American Academy of Dermatology.
Plan your visit
See a dermatologist for melasma and dark spots in Richardson
Address 702 W Arapaho Rd, Suite 104, Richardson, TX 75080
Hours Monday to Friday, 8 AM to 5 PM
Phone 214-833-5300