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Skin Condition · Kensington, London
Hyperpigmentation: Telling the Types Apart Before Treating Them
Hyperpigmentation is darkening of the skin caused by pigment cells making excess melanin. It takes several forms — sun spots, melasma and the marks left behind by inflammation — which look alike but respond to quite different treatment. Dr Prasad establishes which type you have before treating it, at Faciem Dermatology & Medical Clinic in Kensington, London.
- Type identified first
- Every skin tone
- Doctor-led, Kensington
- Medically reviewed by Dr Prasad
This page sets out how the different types of hyperpigmentation are told apart and treated at Faciem, and is checked for clinical accuracy.
Last reviewed: 12 September 2026.
Patient information only. Pigmentation has several distinct causes that respond differently, and any treatment plan follows a face-to-face consultation with Dr Prasad.
Patients since 2019
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TL;DR
Hyperpigmentation is skin darkened by excess melanin, usually triggered by ultraviolet light, inflammation or hormonal change. Sun spots, melasma and post-inflammatory marks look similar and behave differently, so the type is identified before treatment starts. Pigment is more persistent in deeper skin tones and returns readily without daily sun protection. Most people notice improvement in about four to six weeks once a prescribed plan is under way. Assessment at Faciem is by Dr Prasad, a GMC-registered doctor.
- Excess melanin, not surface staining
- Look-alike types, different plans
- Improvement usually from 4–6 weeks
About the Condition
What Is Hyperpigmentation?
Hyperpigmentation is any darkening of the skin caused by increased melanin. Melanocytes, the pigment-producing cells in the upper layer of the skin, respond to ultraviolet light, inflammation and hormones by making extra melanin and depositing it into the skin cells around them. What you see is a flat patch or spot darker than the skin surrounding it, with the texture unchanged.
What does hyperpigmentation look like?
Hyperpigmentation is flat. Run a finger across it and the texture is unchanged, which is what separates it from a raised lesion or a scar. Colour ranges from light tan through deep brown to grey-blue, and the shade hints at how deep the pigment sits: superficial pigment in the epidermis looks brown and well defined, while deeper dermal pigment appears greyer and more diffuse. Distribution is often the most useful clue of all. Sun spots cluster on the face, chest, shoulders and the backs of the hands, where pigment can be treated directly as part of hand rejuvenation. Melasma forms symmetrical patches across the cheeks, forehead and upper lip. Post-inflammatory marks appear exactly where something happened — a spot, a scratch, an insect bite, a patch of eczema — and trace its outline.
Who gets hyperpigmentation?
Anyone can develop hyperpigmentation, but the type varies with skin tone. In fair skin it usually presents as sun spots and freckling after years of cumulative ultraviolet exposure. In Black, South Asian, East Asian, Hispanic and Middle Eastern skin, melanocytes are more reactive, so inflammation of almost any kind is more likely to leave a lasting mark — and those marks stay far longer. Melasma is considerably more common in women, particularly during pregnancy or while taking hormonal contraception, and more common in deeper skin tones. Sun exposure is the single strongest factor across every group, which is why pigmentation becomes more visible from the thirties onwards.
How do sun spots, melasma and post-inflammatory marks differ?
Sun spots, melasma and post-inflammatory hyperpigmentation can look almost identical, and treating one as though it were another is the commonest reason pigmentation treatment fails. Sun spots are localised clusters of pigment cells and often respond well to targeted treatment. Melasma carries a broader hormonal and vascular component, recurs readily, and can be aggravated by heat and by treatments that suit sun spots perfectly well. Post-inflammatory marks generally fade on their own given time and sun protection. A few conditions are darker without being hyperpigmentation at all, among them acanthosis nigricans, where the skin thickens as well as darkens.
Causes & Contributing Factors
What Causes Hyperpigmentation?
Hyperpigmentation is caused by melanocytes producing excess melanin in response to a trigger. Ultraviolet light is the most common trigger, but inflammation, hormones, friction and certain medicines all stimulate the same cells. Genetics and skin tone then determine how readily an individual pigments and how long that pigment lingers.
Ultraviolet exposure
Sunlight stimulates melanin production directly, and cumulative exposure over years produces sun spots and a diffuse unevenness of tone. Ultraviolet light also darkens pigmentation that is already there, which is why unprotected sun undoes treatment faster than anything else does.
Inflammation
Acne, eczema, insect bites, cuts and even vigorous scrubbing can all leave pigment behind once the skin has healed. This is post-inflammatory hyperpigmentation, and it is markedly more common and more persistent in deeper skin tones. Bringing active spots under control with acne treatment stops new marks forming while the existing ones are cleared.
Hormonal change
Pregnancy, hormonal contraception and hormone replacement therapy may trigger melasma, typically as symmetrical patches across the cheeks and upper lip. Hormonal pigmentation often persists long after the trigger itself has been removed.
Friction and pressure
Repeated rubbing from clothing, footwear or scratching darkens skin over time, particularly at the neck, underarms, waistband and ankles. Removing the source of the friction is part of any treatment plan, since pigment returns while the rubbing continues.
Medicines and heat
Some medicines increase pigmentation or make skin more sensitive to light, and prolonged heat exposure may aggravate melasma independently of ultraviolet light. Tell Dr Prasad if your pigmentation changed after starting something new, including a supplement.
Treatments We Offer
How Hyperpigmentation Is Treated at Faciem
Hyperpigmentation is treated on three fronts at once: suppressing melanin production, clearing pigment already deposited in the skin, and protecting the skin so that pigment does not come back. Prescription-strength skincare does most of the first job and peels most of the second. Which combination suits you depends on the type of pigmentation, how deep it sits and your skin tone. Skin tone is graded on the Fitzpatrick scale, I to VI, and it is assessed before any peel strength or laser setting is chosen. Deeper skin tones, Fitzpatrick IV to VI, are treatable, but the concentration, the depth and the intervals between sessions are all adjusted, the skin is prepared for longer beforehand, and a test patch matters more — because the risk being managed is post-inflammatory pigmentation from the treatment itself, on skin that already pigments readily.
01
Medical-Grade Skincare
Prescription-strength actives suppress melanin production inside the pigment cell, and they are the foundation of pigmentation treatment. Faciem uses both hydroquinone and non-hydroquinone routes at strengths not sold over the counter, and the maintenance products that follow are what stop pigmentation returning.
Best for: every type of pigmentation, and maintenance
Read about Medical-Grade Skincare
02
Chemical Peels
Medium-depth peels reach the pigment already deposited in the skin, which superficial peels brighten around without clearing. Peels work best alongside skincare that suppresses further melanin production, so the two are usually planned together.
Best for: established patches, alongside skincare
Read about Chemical Peels
03
TCA Peel
A trichloroacetic acid peel works deeper still, for pigmentation that has not shifted with skincare alone. The skin is prepared with an active programme beforehand so the peel can be used safely, and suitability depends heavily on skin tone.
Best for: resistant pigment, after skin preparation
Read about TCA Peel
Laser is used at Faciem for a handful of isolated sun spots, where the right device can work well; scattered pigmentation over a wider area usually does better with melanin suppression first, then peels. Which options are used, and in what order, is decided once Dr Prasad has examined your skin, and how much any plan achieves differs from person to person.
When to Seek Medical Advice
When Should You See a Doctor About Pigmentation?
See a doctor about pigmentation before you start treating it, not after a product has failed, because the types look alike and behave differently. Get advice promptly about any single patch that is changing, growing or looks unlike the others around it — that needs examining, not a cosmetic plan.
Worth getting checked
- A single spot that is changing in size, shape, colour or outline
- Pigmentation that has not shifted after several months of over-the-counter products
- Symmetrical patches across the cheeks or upper lip, which may be melasma
- Darkening that is thickened or velvety to the touch instead of flat
Conditions that can look similar
- Acanthosis nigricans, seborrhoeic keratoses and pigmented moles are all mistaken for simple hyperpigmentation, and several of them are raised rather than flat. Any lesion that changes, itches, bleeds or stands out from the ones around it should be examined in person. Separating harmless pigmentation from something that needs investigating is one of the main reasons to have it looked at by a doctor.
Self-Care & Prevention
Managing Hyperpigmentation Between Appointments
Daily sun protection does more for pigmentation than any other single measure, both by preventing new marks and by stopping treatment being undone. The second priority is avoiding inflammation, because irritated skin — especially in a deeper skin tone — frequently pigments in response.
Do
- Wear broad-spectrum SPF 50 daily, year round, including indoors near windows
- Reapply sunscreen every two hours outdoors, and keep to the shade between 11am and 3pm
- Treat spots, eczema and insect bites within the first week — inflammation left running is what leaves the marks
- Give a prescribed plan four to six weeks before judging it; some skin responds within two
Avoid
- Picking or scratching — ten seconds of it can leave a mark that takes months to fade
- Harsh scrubs and strong acids without advice; introduce one new active at a time, two weeks apart
- Unregulated skin-lightening creams bought online, some of which contain ingredients banned in the UK
- Stopping the moment pigmentation clears — maintenance runs for months, and it is what prevents recurrence
This is general guidance and does not replace individual assessment. What suits your skin depends on the type and depth of your pigmentation and on your skin tone.
Why Patients Choose Faciem
Why Have Pigmentation Assessed at Faciem?
Pigmentation is where a wrong diagnosis costs the most. Sun spots, melasma and post-inflammatory marks look alike but respond to different treatment, and an approach that clears one can inflame another, so Faciem settles the type and depth before anything is applied to your skin.
- The type and depth of pigmentation established before treatment begins
- Examined by Dr Prasad, a GMC-registered doctor, with dermoscopy where a lesion needs checking
- Extra caution in deeper skin tones, where treatment itself can trigger pigment
- Maintenance planned from day one, because cleared pigmentation comes back without it
Experience & Expertise
Why a Doctor Should Diagnose Pigmentation First
Pigmentation is the area where treating without diagnosing does the most damage. Melasma handled with an approach designed for sun spots can darken further, and in deeper skin tones the treatment meant to clear pigment can trigger more of it: too aggressive a peel or laser setting causes inflammation, and inflammation makes melanin. Then there is the question of what is not benign — one changing patch among many stable ones needs examining, not covering up. Dr Prasad, who has 20 years’ experience in dermatology, establishes the type and depth of the pigment, checks anything atypical, and plans maintenance from the outset, because pigmentation that clears will return without it.
- Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
- Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
- Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
- Face-to-face medical consultation, examination and dermoscopy where a lesion needs checking
- 20 years’ experience in dermatology, with a particular interest in pigmentation across every skin tone
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Hyperpigmentation FAQs
Your Questions, Answered
Pigmentation brings the same handful of questions to clinic, so here are the answers. Anything specific to your own skin is covered at your consultation.
What causes hyperpigmentation?
Hyperpigmentation is caused by melanocytes producing excess melanin after a trigger. Ultraviolet light is the commonest, followed by inflammation from acne, eczema or injury, then hormonal change during pregnancy or on hormonal contraception. Friction from clothing and footwear, prolonged heat and certain medicines also drive it. Skin tone strongly influences how readily the pigment forms and how long it stays.
How long does hyperpigmentation take to fade?
Most people notice hyperpigmentation improving in about four to six weeks on a prescribed plan, and some see a change within two weeks. Post-inflammatory marks left to settle on their own usually take several months to a year, with consistent sun protection throughout. Deeper dermal pigment is slower to shift than superficial pigment, and melasma tends to need continuing maintenance.
Can hyperpigmentation be treated during pregnancy or breastfeeding?
Some pigmentation treatment can continue in pregnancy and while breastfeeding, but the strongest options are paused. Hydroquinone, retinoids and medium-depth peels are set aside until after you have finished breastfeeding; daily broad-spectrum SPF 50, gentle brightening ingredients and treating any inflammation early are all still used. Melasma often appears during pregnancy and frequently settles on its own in the six to twelve months after delivery, so the usual plan is to protect the skin, hold the correcting phase, and reassess afterwards. Tell Dr Prasad at the consultation if you are pregnant, trying to conceive or breastfeeding.
Is hyperpigmentation permanent?
Most hyperpigmentation improves considerably with treatment, though deep dermal pigment is more stubborn and how much clears differs from person to person. Melasma is better described as controlled than cured, because it recurs readily. What keeps pigmentation from coming back once it has cleared is maintenance treatment and daily sun protection, indoors near windows as well as outside.
Can I have pigmentation treatment before a sunny holiday?
Pigmentation treatment and a sunny holiday do not sit well together, so the timing is planned around it. A peel is best kept at least two weeks clear of strong sun in either direction, since freshly treated skin pigments easily. Prescription actives are usually continued with SPF 50 reapplied every two hours, a hat and shade in the middle of the day; where real sun exposure is likely, the correcting phase is paused and picked up on your return. Tell us your travel dates at the consultation.
What is the difference between melasma and sun spots?
Melasma forms symmetrical patches across the cheeks, forehead and upper lip, carries a hormonal and vascular component, and recurs readily; heat alone can aggravate it. Sun spots are discrete clusters of pigment cells on sun-exposed skin — face, chest, shoulders and the backs of the hands — and often respond well to targeted treatment. Treating melasma as though it were sun damage is a common reason pigmentation treatment fails.
What determines the cost of pigmentation treatment?
The cost of pigmentation treatment depends on which prescription products your skin needs, whether peels are added and how many, and how long the correcting phase runs before maintenance begins. Pigmentation is treated as a course over months, so it is best budgeted across a year. Individual treatment prices are published on our chemical peels page, and your own plan is priced and agreed before anything begins.
Sources & Further Reading
- Disorders of skin pigmentation — DermNet NZ
- Post-inflammatory hyperpigmentation — DermNet NZ
- Melasma patient information leaflet — British Association of Dermatologists
These are general sources of patient information and do not replace individual medical assessment. Your own diagnosis and treatment plan are established at consultation.
Hyperpigmentation in Kensington, London
A Doctor-Led Clinic in the Heart of Kensington
Pigmentation is diagnosed and treated at Faciem Dermatology & Medical Clinic on Kensington Church St, London, by Dr Prasad. Appointments run Monday to Saturday, 10am to 7pm, with High Street Kensington station a few minutes’ walk away and Notting Hill Gate about ten. Because pigmentation is corrected over months, expect a first consultation followed by review appointments that adjust the plan as your skin responds, at intervals set when your plan is agreed. Most people see improvement at around four to six weeks, and some within two.
Plan Your Visit
- Faciem Dermatology & Medical Clinic
- Phone: +44 20 7131 3539
- 7 Kensington Church St, London W8 4LF, United Kingdom
- Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
- Parking: Kensington council underground car park nearby
- Open Monday–Saturday, 10am–7pm · Sunday closed
- Pigmentation consultations bookable online; the plan follows the examination
- Consultation-first — no treatment without medical assessment
- Serving Kensington, Chelsea, Notting Hill & Central London
Continue Exploring
Related Conditions & Treatments
Melasma
The hormonal form of pigmentation, which behaves differently from sun damage and recurs more readily.
Read more →
Brown Spots & Freckles
Sun-related pigmentation, how freckles differ from sun spots, and when a single spot needs checking.
Read more →
Loss of Pigment in Skin
The opposite problem: pale patches from vitiligo, or pigment lost after inflammation, and when they need examining.
Read more →
Faciem Dermatology & Medical Clinic · Kensington
Find Out Which Type of Pigmentation You Have
Book a consultation with Dr Prasad to have the type and depth of your pigmentation established, hear what is realistic for your skin tone, and leave with a plan that includes keeping it from coming back.
Prefer to talk? +44 20 7131 3539