Best treatment for pigmentation and flat moles on the back?

Question

I am 51 and have flat moles and lighter pigmentation spots on back. I also have some residual red marks from a session of Morpheus8 on my back. What would be the best way to fade these on my back?

Anna Chacon, MD, FAAD · Answer

Thank you for your question. Treating flat moles, pigmentation, and post-procedural erythema (redness) on the back requires a tailored approach depending on the exact nature of the lesions and your skin type.

For pigmentation spots and residual redness (such as those from Morpheus8), here are a few effective options:

Topical Agents: Prescription-strength creams containing hydroquinone, tretinoin, azelaic acid, or tranexamic acid can help fade hyperpigmentation and improve overall tone.

Chemical Peels: Medium-depth peels, such as TCA or salicylic acid, can exfoliate and lighten pigmentation over time.

Laser Therapy: Devices like intense pulsed light (IPL) or fractional lasers can reduce pigmentation and residual redness effectively—particularly when redness is vascular in nature.

Microneedling with PRP: Can be useful for improving texture and diffused pigmentation, especially in areas with post-inflammatory discoloration.

As for flat moles, it’s important to distinguish them from pigmented lesions like lentigines or seborrheic keratoses. If they are true melanocytic nevi (moles), they are typically not treated unless for cosmetic reasons or concern for atypia. Options may include:

Laser removal (e.g., Q-switched lasers)

Radiofrequency ablation

Excision, if clinically indicated

A proper dermatological evaluation, ideally including dermoscopy, would help confirm whether the flat lesions are safe to treat cosmetically or need monitoring or biopsy.

Hope this information is helpful in guiding your decision!

Diyanah Bani Hani, MD · Answer

Based on your description, I’d go with BBL HERO. It’s totally noninvasive and targets brown pigmentation as well as red skin/vessels. It does require an evaluation to make sure that it’s safe for your skin type. Great treatment for a more even skin tone

Best treatment for pigmentation and flat moles on the back?

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Best treatment for pigmentation and flat moles on the back?

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