DARK SPOTS, MELASMA & SUN DAMAGE: WHAT'S THE DIFFERENCE?
Pigmentation is one of the most searched skincare concerns, and also one of the most misunderstood.
"People come to me having spent months using brightening products that aren't working. Often it's because they're treating the wrong thing. Different types of pigmentation have different causes, so they need different treatment approaches." - Dr. Laura
Brown or grey-brown patches
Symmetrical, on cheeks/forehead/upper lip.
Strongly linked to hormonal shifts (the pill, pregnancy, perimenopause).
Sits deeper in the skin and is very sensitive to UV and heat. Treat as long-term management, not a quick fix.
Flat, defined brown spots
Caused by cumulative UV.
Appears on face, hands, chest, shoulders from mid-30s on.
The most straightforward type to treat responds well to topicals, peels, and laser.
Marks left after inflammation
Darkening after acne, eczema, or skin trauma.
More pronounced in medium-to-deep skin tones.
Not scarring; purely colour change. Can fade alone over 6–12+ months.
Shifts with your hormones
Overlaps with melasma but triggered by any significant hormonal change ( starting/stopping the pill, pregnancy, perimenopause, HRT).
Oestrogen and progesterone make skin more reactive to UV.
Genetically determined
Uneven melanin distribution, not overproduction.
More common in lighter skin tones and red/fair hair.
Darken with sun, fade in winter.
A normal skin varian; brightening ingredients reduce their appearance over time but rarely eliminate them entirely.
HOW PIGMENTATION WORKS
All pigmentation comes down to melanin produced by cells called melanocytes.
When stimulated, they produce more melanin, which shows up as darkening on the surface. The trigger varies by type, which is why treatment differs too.
The common thread: UV exposure stimulates melanocytes in almost every case. SPF isn't optional when treating any of these.
INGREDIENTS THAT ACTUALLY WORK
Across all types of pigmentation, there are a handful of ingredients with solid evidence behind them.
HOW IT WORKS
Interrupts melanin transfer to skin cells. Anti-inflammatory, well-tolerated. Pairs well with almost anything.
BEST FOR:
All types, particularly PIH
HOW IT WORKS
Tyrosinase inhibitor and anti-inflammatory. One of the few actives safe in pregnancy. Prescription strength (15%) significantly more effective.
BEST FOR:
PIH, melasma, hormonal
HOW IT WORKS
Antioxidant protection and melanin inhibition. Works well in the morning alongside SPF.
BEST FOR:
Sun damage, general brightening
HOW IT WORKS
Gentle tyrosinase inhibitor. More suitable for longer-term use than hydroquinone.
BEST FOR:
All types
HOW IT WORKS
Accelerates cell turnover: pigmented cells shed faster. Improves penetration of other actives.
BEST FOR:
All types, particularly PIH
HOW IT WORKS
Most evidence-backed prescription-only treatment. Inhibits tyrosinase more potently than any OTC alternative.
BEST FOR:
Melasma, hormonal
THE IMPORTANCE OF SPF
Every brightening ingredient you use is working against UV exposure if you're not protecting the skin daily.
For pigmentation specifically, a layered approach works best: a non-tinted SPF first, then a tinted SPF on top.
Tinted formulas with mineral filters provide better protection against visible light, which can trigger melasma in addition to UV.
The Heliocare 360° Pigment Solution Fluid SPF50+ combines niacinamide and ellagic acid alongside broad-spectrum SPF50+.
IN CLINIC TREATMENTS
Topical products make a real difference for pigmentation, but they have limits — and in-clinic treatments can achieve results that skincare alone can't, particularly for established or deeper pigmentation.
Prescription topicals: Tretinoin, prescription-strength azelaic acid, and hydroquinone in supervised burst cycles. Significantly more potent than OTC.
Chemical peels: Glycolic, lactic, and TCA peels accelerate turnover and break down existing pigmentation. A course combined with a home routine delivers significant improvement.
Laser: Highly effective for established sun damage. Melasma requires more caution; some lasers can trigger rebound, so we assess carefully case by case. We use LaseMD Ultra & BBL HEROic at Dr. Laura Clinic.
Combination protocols: The best results come from combining a well-designed home routine with in-clinic treatments, adjusted as skin responds.
If you've been dealing with pigmentation for a while and feel like you're not making progress, come in. It's often a case of identifying exactly what type of pigmentation you have and building the right protocol around it.
