Pigmentation & sun damage

Close-up of a middle-aged woman with red hair, brown eyes, and numerous freckles on her face and neck, looking directly at the camera with a neutral expression.
Close-up of a middle-aged woman with red hair, brown eyes, and numerous freckles on her face and neck, looking directly at the camera with a neutral expression.

Pigmentation is one of the most commonly mistreated concerns in aesthetic medicine. The reason is simple — it looks like one problem, but it’s almost never just one thing.

Sunspots respond differently to melasma. Post-inflammatory pigmentation triggered by acne needs a completely different approach to UV-driven sun damage. And melasma — which is hormonal, chronic, and stubborn — will return after laser treatment if the hormonal driver hasn’t been addressed first. Treating it without that conversation isn’t just ineffective. It’s expensive and demoralising for the patient.

Diagram showing three stages of skin: normal skin, pigmentation, and sun damage. Normal skin has balanced melanin production; pigmentation shows dark spots from excess melanin; sun damage depicts hyperpigmentation, age spots, and weakened collagen.

Assessment here looks at pigmentation type and depth, triggers and history, skin type, and UV exposure patterns before any treatment is planned.

Management may include targeted light or laser therapies, combination approaches for mixed pigment and vascular change, strict photoprotection, and medical-grade skincare. For melasma specifically, long-term management and expectation-setting are part of every plan from the beginning.

Recurrence is common. Maintenance is essential. Anyone who tells you otherwise isn’t being straight with you.