Pigmentation
What it is
Pigmentation is an uneven distribution of melanin in the skin. The common patterns look similar at a glance but behave quite differently.
Sun-induced pigmentation appears as discrete brown spots on areas with years of exposure. Melasma shows as larger, symmetrical patches, often across the cheeks, forehead or upper lip, and is strongly influenced by hormones as well as light. Post-inflammatory pigmentation is the flat mark left after a spot, a scratch or a treatment.
Melasma in particular is a long-term condition to manage rather than a problem to clear once.
Common causes
- Cumulative sun exposure, including incidental daily exposure
- Hormonal change - pregnancy, some contraceptives, some medications
- Inflammation in the skin from acne, injury or over-treatment
- Heat and visible light, which can drive melasma independently of UV
- Genetic predisposition
When professional assessment helps
An assessment is worth having if you are not certain which type you have, if patches are spreading, or if previous attempts have made things worse - which is common with melasma, where aggressive treatment can rebound.
Any pigmented spot that is changing in size, shape or colour, or that looks different from the others, should be checked by a doctor before any cosmetic treatment. We will not treat a lesion we are unsure about.
Treatment categories worth discussing
- Chemical peels - professionally selected to target surface pigment, usually as a course
- Facial treatments with targeted actives, often used alongside a home routine
- Microneedling - sometimes discussed, though with more caution where melasma is involved
With pigmentation, what you do daily between treatments matters at least as much as the treatments themselves.
Suitability and considerations
Melasma is prone to recurrence and can worsen with heat and aggressive resurfacing. Deeper skin tones carry a higher risk of post-inflammatory pigmentation, which sometimes means a gentler, slower approach. Pregnancy and breastfeeding rule out some options.
Daily broad-spectrum SPF is a condition of treating pigmentation, not an add-on. Without it, results reverse.
What is realistic
Pigmentation usually lightens and evens out rather than disappearing. Surface pigment responds better than deeper pigment, and melasma is managed rather than cured.
Expect a course of treatments over months, not a single appointment, and expect maintenance. Pigmentation can return, especially with sun exposure, so daily SPF is part of every plan.
Questions people ask
Can pigmentation be removed completely?
Rarely, and we would not promise it. The realistic goal is lighter, more even tone, maintained with sun protection.
Why did my pigmentation get worse after a treatment elsewhere?
It happens, particularly with melasma and with deeper skin tones, when treatment is too aggressive. It is one of the reasons we assess before recommending.
Do I really need sunscreen every day?
For pigmentation, yes. It is the single most useful thing you can do, and it protects whatever the treatments achieve.
Related treatments
Talk it through
Every plan starts with a consultation. We look at your skin, listen to your goals and talk through the options that suit you, including when a treatment is not the right choice.