Hyperpigmentation Treatment
What causes pigmentation, which treatments actually shift it, and which ones will not.
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What hyperpigmentation actually is
Hyperpigmentation is any area of skin that has produced more melanin than the skin around it, leaving it darker. That is the whole of the definition, and it is why the word covers several different problems that happen to look similar.
The distinction that matters for treatment is how deep the pigment sits. Pigment near the surface responds well to treatments that speed up how quickly that surface turns over. Pigment sitting deeper in the skin is far more stubborn, and some of it does not respond to surface treatment at all. That is the single biggest reason people are disappointed by pigmentation treatments — the treatment was matched to the wrong depth.
What causes pigmentation on the face
Sun exposure
The most common cause by a wide margin, and cumulative. Melanin is the skin’s response to UV, so years of ordinary exposure produce the flat brown patches most people notice first on the cheeks and forehead.
Inflammation — the mark a spot leaves behind
Any inflammation can leave a darker mark once it heals: a breakout, a scratch, a reaction to a product. This is post-inflammatory hyperpigmentation, and it is the most treatable kind because it is purely a colour change with no structural damage underneath.
Hormones
Pregnancy, oral contraceptives and hormonal shifts drive melasma, which typically appears symmetrically across the cheeks, forehead and upper lip. This is the difficult category, and it is covered separately below.
Age
The flat brown patches usually called age spots or sun spots are really accumulated sun exposure showing up over time, most often on the face, backs of the hands and chest.
Post-inflammatory hyperpigmentation
If your pigmentation is the marks acne left behind, this is the section that applies to you — and it is the best news on this page.
PIH is not a scar. A scar is a structural change in the dermis, which is why scarring needs microneedling to remodel it. PIH is only a colour change in skin that is otherwise intact, which is why resurfacing works on it and why the outlook is genuinely good.
It also fades on its own, given long enough — often many months, sometimes over a year. Treatment shortens that timeline rather than achieving something the skin would never have managed. That is an honest framing and we would rather give it to you than imply the marks are permanent without us.
One caveat that matters: treating PIH while the acne causing it is still active is working against yourself, because each new breakout creates a new mark. We will usually want the breakouts settled first.
How we treat it
Both of the treatments we use for pigmentation work on the same principle: increase how quickly the pigmented surface layer turns over, so the marked skin is replaced by newer skin underneath.
Bio microneedling
Needle-free, using silica spicules massaged into the skin, with the treated surface turning over across about seven days. Because there is no acid and no needling, it is the gentler of the two and the usual choice for reactive skin or for anyone who has had a bad experience with a peel.
Chemical peels
An acid solution loosens the bonds between surface cells so they shed evenly. Peels are the more established option for tone and pigmentation, and the acid and strength are chosen for your skin rather than sold as a fixed grade. Expect a series of four to six, spaced three to four weeks apart.
Which of the two suits you is a consultation question. If your skin is reactive or you are nervous about downtime, bio microneedling is usually where we start.
Laser hair removal is not a pigmentation treatment
This gets confused constantly, so it is worth stating plainly on a laser clinic’s own website.
Laser hair removal works by targeting the pigment inside the hair follicle — the melanin in the hair is what absorbs the light and carries the heat down to disable the follicle. The target is the hair, not the skin. It is not designed to reduce pigmentation in the skin and we do not offer it for that.
If someone has told you a hair removal laser will clear your pigmentation, they have either confused two different treatments or they are selling you the wrong one.
Melasma is different
Melasma deserves its own warning, because it is the form of pigmentation most likely to end in disappointment.
It is hormonally driven, which means the trigger is internal and treating the surface does not address the cause. It is chronic and relapsing rather than curable — it commonly returns with sun exposure, pregnancy or a change in medication. And it responds badly to aggressive treatment: an over-strong peel can leave melasma worse than it started.
None of that means it cannot be improved. It means the honest plan is conservative, gradual, paired with strict daily sun protection, and judged over months. For some people the right answer is dermatological management rather than a course of resurfacing, and we will say so at consultation if that is what we think.
Deeper skin tones, and why the approach changes
Deeper skin tones carry a higher risk of post-inflammatory hyperpigmentation — meaning an aggressive treatment can itself trigger the exact problem you came in to fix. This is not a reason to avoid treatment. It is a reason to be careful about who is doing it.
Every appointment starts with a Fitzpatrick assessment and a medical history review before anything is chosen. We build conservatively across a series rather than taking a treatment deep in one session, because on pigmentation-prone skin the aggressive route is not the faster route — it is the one that backfires.
What to expect, honestly
It is a course. Four to six sessions spaced three to four weeks apart is typical. A single appointment gives you a glow, not a change in pigmentation.
SPF is not optional. Daily sun protection during and after the course is the difference between holding your result and replacing the pigment you have just treated. This is the step people skip and then conclude the treatment did not work.
Managed, not cured. For sun-related pigmentation and PIH, a course produces a real and lasting improvement. For melasma, think in terms of management rather than a finish line.
Questions we hear
What is hyperpigmentation?
Hyperpigmentation is any patch of skin that has produced more melanin than the skin around it, leaving it darker. It is not a single condition — sun damage, the mark left behind by a spot, and hormonal melasma all look similar on the surface but start in different ways, and they respond differently to treatment.
What causes pigmentation on the face?
Four causes account for most of it. Sun exposure, which drives melanin production and is cumulative over years. Inflammation — a spot, a scratch, a reaction — which leaves a mark behind after it heals. Hormones, including pregnancy and oral contraceptives, which is the usual driver of melasma. And age, which brings the flat brown patches often called age spots or sun spots.
What is post-inflammatory hyperpigmentation?
PIH is the flat brown or grey mark left after the skin has been inflamed — most commonly after acne. It is not a scar: there is no change to the skin’s structure, only to its colour, which is why it responds to resurfacing when a true scar does not. It also fades on its own eventually, though that can take many months.
Which treatment do you use for pigmentation?
Bio microneedling and chemical peels. Both work by accelerating how quickly the pigmented surface layer turns over, which is the mechanism that suits pigment sitting near the surface. Which one suits you depends on your skin and how reactive it is, and that is decided at consultation rather than in advance.
Does laser hair removal help hyperpigmentation?
No, and it is worth being clear about this because the two get confused. Laser hair removal works by targeting the pigment inside the hair follicle in order to disable it. That is a different target from pigment sitting in the skin, and the treatment is not designed to reduce it. If pigmentation is your concern, laser hair removal is not the treatment to book.
Can you treat melasma?
Melasma needs a different conversation. It is hormonally driven, it is chronic rather than something that is cured, and it relapses — particularly with sun exposure or a return of the hormonal trigger. Aggressive resurfacing can make it worse rather than better. We will tell you honestly at consultation whether we think treatment will help, and for some people the answer is that dermatological management is the better route.
Is treatment safe for deeper skin tones?
Yes, with the right approach, and the right approach matters more here than anywhere else. Deeper skin tones carry a higher risk of post-inflammatory hyperpigmentation, which means an over-aggressive treatment can leave you with more pigmentation than you started with. We assess on the Fitzpatrick scale first and build conservatively across a series rather than going deep in one session.
How long does it take to see a difference?
Pigmentation is a course, not a single appointment. Most people are planned for a series of four to six sessions spaced three to four weeks apart, and the change is gradual across that series rather than dramatic after one visit. Daily SPF throughout is not optional — without it, new pigment replaces what you have just treated.
Booking
Pigmentation is worth a consultation before a booking, because the treatment depends on which kind you have. Bring a sense of how long the marks have been there and whether anything has made them worse — that usually tells us more than the marks themselves.
Availability varies by clinic. Chemical peels and bio microneedling each list where they are offered.