Pigmentation and Melasma: An Assessment-First Guide

Pigmentation is one of the most common concerns I see in the clinic. It can show up as sun spots, patchy brown areas on the cheeks, or dark marks after a breakout. These can look similar but need different care, so the most important first step is finding out what you're dealing with.

Get New or Changing Spots Checked First

Before any cosmetic treatment, see your GP or a skin cancer clinic about any spot that is new, changing, raised, itchy or bleeding. Your health always comes first. I focus on the appearance of the skin, and I'll always refer you if something needs medical attention.

Common Types of Pigmentation

• Sun spots: flat brown spots linked to sun exposure, often on the face, hands and décolletage. My sun damage guide covers these in more detail.
• Melasma: patchy brown or grey-brown areas, often on the cheeks, forehead and upper lip. Melasma is a medical condition, so it should be assessed by a GP or dermatologist, who can talk to you about medical options.
• Marks after irritation or breakouts: darker marks that can linger after a breakout, a rash or skin irritation.
• Changes during or after pregnancy: some people notice new pigmentation during or after pregnancy. Ask your GP about any new marks.

Because these can look alike, please don't rely on a photo or an online checklist to work out which you have.

Everyday Care That Helps

Whatever the type, the basics are the same:

• Broad-spectrum SPF 50+ every day, reapplied when you're outdoors. Sun exposure can make most pigmentation look darker.
• A hat and shade when you're outside for long periods.
• A gentle routine. Irritated skin can lead to more dark marks, so avoid harsh scrubs and don't layer lots of new products at once.
• Brightening skincare. Some cosmetic ingredients, such as vitamin C and niacinamide, may help improve the look of uneven tone. I can suggest options that suit your skin.

Choosing Skincare Products

"Brightening" describes how a product is meant to make skin look. It doesn't guarantee it will suit you. Before you buy, ask:

• Is this suitable for my skin and my current routine?
• How should I introduce it, and what should I do if it irritates my skin?
• Does it clash with anything else I'm using?

Bring your products to your consultation, and introduce one new product at a time. Prescription medicines for pigmentation are a decision for your doctor. Don't start, stop or change a prescribed product without their advice.

What Cosmetic Treatments Can and Can't Do

Some in-clinic treatments, such as chemical peels and IPL photo rejuvenation, may help improve the look of some types of uneven tone. But they're not right for everyone:

• Not every type of pigmentation suits every treatment. A treatment that may help sun spots could be unsuitable for melasma.
• Peels and light treatments can cause irritation, and sometimes leave unwanted darker or lighter patches, especially on darker skin tones or skin that marks easily.
• IPL isn't a laser, and it isn't suitable for every skin type or every pigmentation concern.

At your consultation, we'll talk through your skin tone, your history, the risks, your other options, and whether waiting or doing no treatment is the better choice. Sometimes it is.

You can see our Larimedical peels, IPL guide and prices on our pricing page.

If You're Pregnant or Breastfeeding

Please tell me at your consultation. Some treatments and skincare ingredients aren't suitable during pregnancy or breastfeeding, so we'll keep things gentle and check with your doctor where needed.

Setting Realistic Expectations

Pigmentation often takes patience, and it can come back, especially with sun exposure. Everyone's skin responds differently, and there's no guaranteed result or timeline.

If you'd like a personalised plan, book a consultation online.

This article is general information only and isn't personal medical advice. Individual responses vary, and we don't promise a particular result.