Pigmentation
Sun damage, melasma, dark spots & uneven skin tone
Pigmentation is one of the most common skin concerns, but not all pigmentation is the same.
Brown spots caused by sun exposure, hormonal pigmentation, marks left behind by acne and patches of uneven skin tone can look similar, yet respond very differently to treatment.
At Peau Skin Health, I take an individual approach to pigmentation. Understanding what type of pigmentation you have and what's causing it is the first step towards choosing the most appropriate treatment.
What is pigmentation?
Our skin naturally produces a pigment called melanin, which determines much of our skin colour and helps protect against UV radiation.
Melanin is produced by specialised cells called melanocytes. When these cells produce excess pigment, or pigment is distributed unevenly, darker patches or marks can appear. This is known as hyperpigmentation.
Pigmentation can affect different layers of the skin. Some pigment is concentrated within the epidermis (the outermost layer), while other forms involve the deeper dermis.
This matters because the depth, cause and type of pigmentation can significantly influence how well it responds to treatment.
Different Types of Pigmentation
Sun Damage & Age Spots
Also known as solar lentigines, these typically appear as well-defined brown spots on areas frequently exposed to sunlight, such as the face, hands and décolletage.
They develop following cumulative UV exposure, which can cause localised increases in melanin production.
Superficial sun damage can often respond well to professional treatments and targeted skincare, although ongoing sun protection is essential.
Melasma (Hormonal Pigmentation)
Melasma commonly appears as larger, symmetrical patches of brown or grey-brown pigmentation, particularly across the forehead, cheeks and upper lip.
It's influenced by a combination of factors, including genetics, hormones, UV radiation and visible light.
Melasma is often more complicated to treat than ordinary sun damage because the pigment-producing cells remain particularly reactive to certain triggers.
Melasma can be managed and significantly improved, but recurrence is common. Overly aggressive treatments can sometimes make it worse, so a cautious, long-term approach is important.
Post-Inflammatory Hyperpigmentation (PIH)
These are darker marks left behind after inflammation or injury to the skin.
Common triggers include acne, eczema, irritation, burns and certain skin treatments.
Unlike acne scarring, post-inflammatory hyperpigmentation is a change in skin colour rather than a permanent change in skin texture.
These marks can gradually fade naturally, although targeted skincare and selected professional treatments may help improve their appearance.
Freckles
Freckles are small, flat areas of increased pigmentation, often influenced by genetics and sun exposure.
They tend to become darker or more noticeable following UV exposure and may fade during the winter months.
Freckles are generally harmless and don't require treatment, although sun protection helps prevent further darkening.
What Causes Pigmentation?
Although different types of pigmentation have different underlying mechanisms, several factors can contribute to excess melanin production.
Sun exposure
UV radiation stimulates melanocytes to produce additional pigment. Repeated exposure can contribute to sun spots, uneven skin tone and worsening melasma.
Hormonal changes
Pregnancy, hormonal contraception and other hormonal influences can contribute to melasma in susceptible individuals.
Inflammation
Acne, eczema, skin irritation and injury can trigger increased pigment production during the healing process.
Genetics
Some people are naturally more susceptible to developing certain types of pigmentation, including freckles and melasma.
Visible light
Certain wavelengths of visible light can contribute to pigmentation, particularly melasma. This is especially relevant in darker skin phototypes.
Skin irritation and inappropriate treatments
Aggressive exfoliation, excessive use of active skincare ingredients and poorly selected professional treatments can sometimes worsen pigmentation by triggering inflammation.
Understanding these factors is important because treating existing pigmentation without addressing its triggers can lead to disappointing or short-lived results.
How Can Pigmentation Be Treated?
There isn't one treatment that works for every type of pigmentation.
Superficial sun damage may respond well to controlled exfoliation and pigment-regulating skincare, while melasma often requires a more cautious approach focused on reducing pigment production and preventing recurrence.
Depending on the type of pigmentation, treatment may involve a combination of:
Daily sun protection: Broad-spectrum SPF 50 is one of the most important steps in managing pigmentation. For melasma, tinted sunscreens containing iron oxides can provide additional protection against visible light.
Targeted skincare: Ingredients such as retinoids, azelaic acid, vitamin C and other pigment-regulating ingredients may help improve uneven skin tone.
Professional chemical peels: Carefully selected superficial peels can encourage exfoliation and help improve certain forms of epidermal pigmentation.
Skin rejuvenation treatments: Selected treatments may improve overall skin quality, texture and uneven tone, depending on the cause of pigmentation.
Managing inflammation: Supporting the skin barrier and avoiding unnecessary irritation is particularly important for inflammatory pigmentation and melasma.
Some pigmentation responds relatively quickly, while other forms require several months of consistent treatment.
The aim isn't simply to remove visible pigment, but to understand and manage the processes contributing to its development.
Pigmentation Treatments at Peau Skin Health
The most appropriate treatment depends on your skin type, the cause of your pigmentation and whether other concerns, such as acne, scarring or uneven texture, are also present.
Chemical Peels
For superficial pigmentation, sun damage and post-inflammatory marks.
Professional chemical peels use carefully selected acids to encourage controlled exfoliation, helping to improve uneven skin tone and certain forms of superficial pigmentation.
They can be particularly beneficial for sun-related pigmentation and the darker marks left behind by acne.
At Peau Skin Health, I use professional Medik8 and advanced Korean peel formulations, selected according to your skin type, concerns and tolerance.
Chemical peels aren't suitable for every type of pigmentation, and stronger isn't necessarily better, particularly when treating melasma.
PRX-T33 Skin Biorevitalisation
For uneven skin tone, texture and overall skin quality.
PRX-T33 combines trichloroacetic acid (TCA), hydrogen peroxide and kojic acid in a professional skin revitalisation treatment.
Unlike traditional superficial chemical peels, PRX-T33 is designed to deliver skin biorevitalisation with relatively little visible peeling.
It may help improve the appearance of uneven skin tone alongside skin texture and overall radiance.
However, it isn't a replacement for targeted pigment-regulating skincare, and results for established melasma can be variable.
Microneedling
For uneven skin texture, acne scarring and selected pigmentation concerns.
Microneedling uses fine needles to create controlled micro-injuries in the skin, stimulating a wound-healing response and supporting collagen remodelling.
It's particularly useful when pigmentation is accompanied by uneven skin texture or acne scarring.
Microneedling has also been investigated as an additional treatment for melasma, particularly alongside topical pigment treatments. However, the evidence is still developing, and it isn't appropriate for everyone.
Because inflammation can worsen certain types of pigmentation, careful treatment selection is essential.
At Peau Skin Health, I use professional Dermapen 4 microneedling technology.
Why Pigmentation Needs an Individual Approach
Two people can have pigmentation that looks almost identical but require completely different treatment approaches.
For example, sun-induced pigmentation may respond well to selected professional treatments, whereas aggressive treatment of melasma can sometimes make it worse.
Skin type, hormonal influences, inflammation, skincare habits and previous treatments all need to be considered.
Sometimes the best approach is to focus on skincare and sun protection before introducing professional treatments.
And in some cases, pigmentation may require assessment or prescription treatment from a medical professional.
At Peau Skin Health, my approach is to recommend treatments based on what is most appropriate for your skin, rather than simply offering the most intensive option.
Not Sure What's Right for Your Skin?
You don't need to know whether you have melasma, sun damage or another type of pigmentation before getting in touch.
If you're concerned about pigmentation or uneven skin tone, I'm happy to discuss your skin and help you understand which treatments may be suitable.
Pigmentation Treatments in Oxfordshire & the Cotswolds
Peau Skin Health is a private skin clinic based in Stonesfield, near Woodstock and Chipping Norton, Oxfordshire, welcoming clients from across the Cotswolds and surrounding areas.
Treatments are individually selected following an assessment of your skin concerns, suitability and treatment goals.