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doi: 10.1016/j.bmc.2011.08.042

When melanocytes are hyperactivated by specific triggers UV radiation, post-inflammatory signals from acne or injury, hormonal changes (especially estrogen and progesterone in melasma), or genetic predisposition they produce excess melanin that accumulates in patches, creating dark spots, uneven tone and visible discolouration

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One of the most commonly used modifiers with CPT code 96372 is: Modifier 25 : Used when the injection is performed on the same day as an Evaluation and Management (E/M) service