There are limited options for treating hyperpigmentation in the NHS. Azelaic acid (Skinoren can be used for acne and hyperpigmentation) and can be prescribed by GPs. However there are many other reasons, so if there is any doubt, a dermatologist opinion should be sought.
What is hyperpigmentation?
Hyperpigmentation is the darkening of an area of skin caused by increased production of melanin and its incorrect distribution.
Melanin gives us our skin colour. Darker skinned people have more eumelanin, lighter skinned people have more phaeomelanin. Melanin is produced by special cells called melanocytes in the basal (bottom) layer of the epidermis.
Melanin helps to protect the skin against the effects of the sun such as skin cancer and premature ageing. It is our natural sunscreen.
The incidence and severity of Post Inflammatory Hyperpigmentation (PIH) is much greater in patients of a darker skin colour. For the darker skin types uneven pigmentation is a tell tale sign of ageing rather than wrinkles.
In all cases exposure to the sun will increase the effects.
What are the different types of hyperpigmentation?
- Brown spots – which vary in size and are usually on the face, hands, shoulder and arms – those areas exposed to the sun. More common in adults over the age of 50
- Melasma – a common skin condition of adults in which light to dark brown or greyish pigmentation develops – mainly on the face
- Freckles – Flat tanned circular spots that may develop on sun exposed skin after repeated exposure to sunlight
The more common are listed here:
- Melasma (exact cause is unknown – but worsened by Ultraviolet light (UV), contraceptive)
- Freckles/lentigenes – UV induced
- Chloasma – hormone changes
- Disease – Addison’s disease, Cushing’s syndrome, haemochromatosis – even cutaneous lymphomas
- Medication – amiodarone, minocycline
- Post inflammatory hyperpigmentation : acne/chemical peels/ lasers – any form of injury
- Even environmental pollution!
How can this clinic help with the cosmetic appearance of pigment problems?
Dealing with uneven pigmentation needs to be treated as a journey, not a single event. A daily home care regime is key as well as the use of sunscreen. For clients undergoing clinic treatments the clinic policy is that sunscreen purchased from this clinic is a non-negotiable. This is to reduce the chances of Post Inflammatory Hyperpigmentation.
The process begins with an online consultation where your skin care options will be discussed.
The possible options for clinic based treatments can also be discussed. The approach taken keeps skin safety in mind first, so particularly in skin of colour certain treatments may not be offered to you.
Professional skin care - the foundation of skin health and pigment concerns
Clinical results begin at home. Bespoke skin health programmes will be agreed with you to prepare your skin for in-clinic treatments:
ZO Skin Health: Stabilization and correction for melanin-rich or sun-damaged skin.
ESK (Evidence Skincare): High-potency vitamins A, B, and C to maintain clarity.
Sente: Specialized inflammation and redness repair (HSA technology).
Intradermology: Advanced internal and external skin nutrition.
Neostrata Enlighten: A targeted range specifically formulated to brighten, illuminate, and prevent new dark spots.
Clinic Treatments
Once a skin health regime has been established, the second phase is Professional Peels and Microneedling. Some treatments have downtime, other’s don’t. Some can be used on the body as well as the face. Some have got a greater track record of safety in skin of colour.
The basis of clinic treatments are: Peels, microneedling and Regenerative Aesthetic treatments.
Peels
Peels are most effective for : Epidermal melasma (especially early stage), Post Inflammatory Hyperpigmentation (PIH) following acne, superficial burns or dermatiis – where inflammation has subsided and pigment remains epidermal; Lentigines (solar lentigines, particularly inlighter skin types), Fine textural irregularities and dull skin (glycolic and lactic acid peels enhance cellular turnover)
- Obagi Blue Peel Radiance
- Neostrata Brightening Peel
- Vi Peel variants
- WOW Brightening Peel
- ZO Stimulator Peel with Brightening
- Zo Stimulator Peel with automated microneedling
Other procedures not offered by this clinic include laser based technologies and radiofrequency microneedling.
Obagi Blue Peel Radiance
Used in melasma
Key ingredients: Salicylic acid 20%, glycolic acid, lactic acid.
Downtime: Mild flaking 1-3 days
Sessions needed: 3-6 sessions
Risks in skin of colour: Moderate. Patch test recommended
Pre-Peel Priming: 2-4 weeks of HQ equivalent and SPF
Post procedure skincare: Hydrating creams, no actives, SPF
Neostrata Pro System Brightening Peel
Key ingredients: Mandelic acid.
Downtime: Minimal Mild flaking
Sessions needed: 4-6 sessions
Risks in skin of colour: Low.
Pre-Peel Priming: Gentle Tyrosinase inhibitor and SPF
Post procedure skincare: Barrier support, SPF 50+
Other considerations: May wish to start with an aestheticians peel.
Vi Peel
Key ingredients: Trichloroacetic Acid (TCA) for deep resurfacing, Retinoic Acid to inhibit melanin, Salicylic Acid for inflammation, Phenol for penetration, and Vitamin C combined with Hydroquinone or Kojic Acid (depending on the specific formula) to lift existing pigment.
Downtime: Moderate (7 Days). You will typically look normal for the first 48 hours. Active peeling usually begins on day 3, starting around the mouth and spreading outward. By day 7, the peeling process is generally complete, revealing fresh, luminous skin.
Sessions needed: While a single peel provides a significant “reset,” a series of 4-6 sessions spaced 4 weeks apart is the clinical recommendation for correcting chronic melasma or heavy solar lentigines (age spots).
Risks in skin of colour: Low. The VI Peel was originally formulated specifically to be safe for all Fitzpatrick skin types (I–VI). Because it contains a numbing agent (Phenol) and a unique blend of acids, it suppresses the inflammatory response that usually triggers PIH in darker skin tones. However, strict adherence to the provided post-peel kit is mandatory to avoid complications.
Pre-Peel Priming: For clients with darker skin tones or stubborn melasma, e 2–4 weeks of priming with pigment controlling products are required. This ensures the melanocytes are “quiet” and stable, allowing the peel to work deeper without triggering a reactive pigment response.
Post procedure skincare: The VI Peel comes with a mandatory take-home kit. This includes specialized towelettes to be used in the first 48 hours, a clinical-grade SPF, and a repair protectant. You must avoid all “active” skincare (Retinols/AHAs) and direct sun exposure for at least 7 days.
Other Considerations: This is a “top-down” treatment. It is highly effective when alternated with “bottom-up” regenerative treatments like Exosome Microneedling or Dermaroller XCellaris Protwist to tackle pigment from every cellular angle. The Cleopatra treatment can also be alternated
WOW Facial Bright Peel
This is offered as part of the WOW facial with different options:
- Mini WOW includes LED and mask and is done monthly. A course of 3 is recommended
- WOW express inclues a peel and mask, can be done every fortnight. A couse of 6 is recommended
- WOW Hydrate and Brigthten option includes the peel, mask, and WOW fusion and can be don monthly. A course of 3 is recommended
- Full WOW fusion (repair sun damage) includes the Peel, LED, mask and wow fusion
- For the body. Taster peel. Price multiplied according to area covered.
Key Ingredients: f Mandelic Acid , Citric Acid, and Phytic Acid.
Downtime: Minimal to none. Most patients experience a “flash” brightening effect immediately. You may have slight redness for 12–24 hours, and very mild, microscopic flaking may occur around day 3 or 4, but “sheets” of peeling skin are not expected with this specific formulation.
Sessions Needed: For significant pigment correction, a course of 4 to 6 sessions spaced 2–4 weeks apart is typically recommended. Results are cumulative as the ingredients progressively regulate melanin activity.
Risks in Skin of Colour: Because the WOW Brightening Peel uses Mandelic Acid (a larger molecule that penetrates the skin more slowly and evenly), the risk of Post-Inflammatory Hyperpigmentation (PIH) is theoretically low, but caution is advised, particularly if the skin is not properly “prepped” or if post-care is ignored, there remains a small risk of temporary darkening or irritation.
Pre-Peel Priming: To ensure an even result and minimize risk, we recommend 2–4 weeks of priming with medical-grade skincare that targets pigment e.g. from the Intradermology /ZO Skin Health/ or Neostrata Enlighten ranges) and a high-factor, broad-spectrum SPF to stabilize melanocytes before the first peel.
Post-Procedure Skincare: Keep it simple for 5–7 days. Use a gentle cleanser, a recovery balm (like Sente Dermal Repair), and strict SPF 50 application. Avoid active “shedding” agents like Retinol or high-strength AHAs until the skin feels completely back to normal.
Other Considerations: The Brightening Peel is an excellent “entry-level” treatment for those new to chemical peels. It can be strategically combined with Dermalux LED to further suppress inflammation or used as a maintenance treatment between more intensive Dermaroller XCellaris Protwist sessions.
Zo Skin Health – Stimulator/Restorative Peel
Zo Skin health Brightening Peel can be started immediately once a week for a month to kick start the process if the issue is primarily pigmentation.
A Brightalive accelerated serum can be added to the package to use at home starting the day after the treatment. Microneedling with the serum is an option.
BRIGHTALIVE® serum accelerated is technologically advanced skin brightener clinically proven to increase luminosity, visibly improve skin clarity and fade the appearance of dark spots for a brighter, more even complexion. Non-hydroquinone and non-retinol. This is an optional extra to use at home after the treatment.
Zo Skin Health – Stimulator/Restorative Peel with automated microneedling
A “Red Carpet” treatment combined with needling to drive brightening ingredients deeper into the dermis.
Microneedling
Microneedling can be started at different stages of the skin journey.
- Automated microneedling with Dermaroller XCellaris ProTwist is a highly versatile option which can be used for a variety of skin concerns on the face and body. It can be combined with Zo Skin Health Peels, exosomes or dermaroller home based skin care.
- WOW fusion which can be combined with WOW facial peel
- Cleopatra – Hydrodermabrasion
Automated microneedling with Dermaroller XCellaris Pro Twist
XCELLARISPRO Pigmentation
Treatment
A treatment that fights pigment disorders, brings the melanocytes into balance and prevent inflammation in the skin.
Suitable for: Uneven skin tone with dark spots which can besolare lentigines (sun damage) melasma (hormonally) and post inflammatory pigmentation.
The skin is often out of balance it is stressed and easily develops inflammation.
Treatment time: I hour – face. 1.5 hours – face, neck, decollettee
Sessions needed: Every 4-6 weeks
Hero ingredient: High Light serum
Main Ingredients
- Sodium Hyaluronate: Small molecular goes deeper into the skin, filling in between collagen fibres improve resilience and increase moisture levels.
- Matrixyl 3000: Has an extensive regenerative effect. Stimulates and activates the fibroblast cells and activates the synthesis of all Matrix. Activates cell growth, cell renewal and communication between cells. Improve texture and skin tone for a smoother skin tone. Protects against harmful UV influences and therefor oxidative stress.
- Copperpeptide: Promotes wound healing, improve scarring, anti-inflammatory efficacy and antioxidant effect prevent oxidative stress. Reinforcing and repairing the barrier. Resets gene expression (methylation). Increases activity and excretion of growth factors, promotes angiogenesis. Accelerate the repair of damaged fibers in Dermis.
- Retinyl palmitate: Increases the number of fibroblasts and activates the fibroblast cells Strong antioxidant. Promotes cell renewal, improves skin tone, makes Epidermis supple, and Dermis thickens. Reduces pigmentation and uneven skin.
- Lactic Acid: has a gentle exfoliation and adds moisture and ensures that the skin can retain moisture. makes the barrier more flexible. Pulls the pigmentations up to the surface.
- Niacinamide/Vitamin B3: slows the transfer of melanin to the skin surface. Increases the skin‘s immunesystem by protecting the Langerhans cell, which is often damaged when exposed to sun exposures and burns from the sun. Improve moisture balance and protect against environmental damage and increase the production of ceramides. The long-term effect of B3 is that the barrier is strengthened, thus reducing redness and irritation in the skin.
- Mandelic acid/Phytic acid/ Salicylic acid/ Licorice root/Morus Alba/ Phyllanthus Emblica: effective antioxidant a mild superficial peel that is great for stressed inflammatory pigmented skin. Very anti-inflammatory, fights damage caused by UV in the skin. Strengthens the skin‘s resilience. Decreases the activity of MSH. Ensures that the skin gets an even glow. Activates collagen synthesis and inhibits MMP
Home care
- Use one High Light serum applied after HC902 dermaroller once a week in the evening for 4 weeks.
- Bright Skin serum daily
Purasome Skin Glow Complex (SGC100+)
Suitable for: dull, pigmented, and damaged skin in mind. The complex
contains exosomes sourced ethically from bovine colostrum, the
structural and functional stability of which supports the repair of
skin damage caused by UV exposure. As a result, it can be an
effective treatment for supporting skin regeneration and hydration. The most common way to apply this product has historically been through microneedling.
Indications:
Skin Age spots, oily skin, young skin, dark spots, post blemish
scarring.
Sessions needed: Once a month for 3 months
Ingredients:
20 billion of exosomes from bovine colostrum 20 Growth factors from
bovine colostrum Synthetic Peptides Glutathione Antioxidant Hyaluronic acid
Amplex +
Niacinamide Copper Acetyl Glycyl Beta-Alanine Glutathione Lysine Melatrepein 5000
WOW fusion microneedling
WOW fusion -with brightening complex
Brightening Complex
- Brightens, lightens and evens skin tone
- Improves pigmentation
- Revitalizes
- Powerful antioxidant
- Inhibits melanin production
- Personalized cocktail applied using WOW fusion device
- PDRN can be added in to focus on cellular repair, barrier strengthening, and anti-inflammatory action.
- 3-6 fortnightly – microneedling only
- Monthly if treatment includes bright peel, LED and WOW mask
Cleopatra Classic facial
Similar in approach to the Hydrafacial TM, this treatment uses microdermabrasion and microchannelling of products tailored to specific concerns including blemish prone skin, dehydrated skin, sun and age spots, ageing skin and sensitive skin.
At least 6 treatments are needed, one treatment every 2-4 weeks. Maintenance every quarter.
The HexBrite solution:
• Decreases melanin formation
• Inhibits tyrosinase
• Decreases melanin transfer from melanocytes to keratinocytes
• Increases skin brightness
• Decreases risk of appearance of age spots
Surface treatments
Dermalux Flex
Hyperpigmentation, sun-induced age spots, uneven skin tone – 30 minutes red and near infra red wavelengths
Hormonal, post inflammatory hyperpigmentation (PIH), medication, photo-sensitivity Red
HydroPeptide Brighten & Glow Jelly Mask
- Key Ingredients: It includes niacinamide, alginate (algae extract), firming peptides, and aloe vera, which help brighten the skin, reduce pore size, bind moisture, and soothe the skin.
- Benefits: After just one use, you can expect a brighter, plumper, and more radiant complexion, along with enhanced skin clarity and hydration.
Most recommended sunscreens for pigment
A common misconception is that we only need protection when it is sunny. However, UVA and High Energy Visible (HEV/Blue) light (from screens and sun rays) are present at high levels 365 days a year even through clouds and windows. These are the specific wavelengths that trigger the pigmentation pathways we are trying to manage.
Why these specific formulas matter:
Traditional sunscreens often only tackle UVB (burning), which is what the SPF refers to. To truly protect your investment, we need to block UVA and High Energy Visible (HEV) light, which are major triggers for pigmentation. Studies show that Iron Oxides found in some of the professional ranges at this clinic are one of the few ingredients proven to physically shield the skin from these specific light frequencies.
- Colorescience: Superior mineral protection with a focus on skin health.
- Intellishade: A 5-in-1 formula that hydrates and corrects while it protects.
- Sente: Medical-grade science that supports the skin’s natural repair journey.
Obagi Sunshield Tint SPF 50
Most sunscreens primarily protect against UV rays—
Sun Shield Tint has added Infra Red Defence technology.
• Provides broad-spectrum SPF 50 protection
• Non-comedogenic, hypoallergenic and dermatologist tested
• Sheer and fragrance free
Physical and Chemical Active Ingredients:
Cool: 10% homosolate, 7.5% octinoxate ,5% zinc, 3.15% titanium
Warm: 10% homosolate, 7.5% octinoxate, 5% Zinc, 3.19% titanium
Other Ingredients:
Algae extract, physalis angulata extract (gooseberry), diatomaceous earth, iron
oxides
The Skin Cancer Foundation recommends this product as
an effective broad-spectrum sunscreen
Obagi Sun Shield Broad Spectrum SPF 50 MATTE Sunscreen Lotion
Protects against UVA and UVB
• High SPF 50 protection includes physical and chemical sunscreen ingredients
• Versatile, elegant sun protection lotion
• Dries with a sheer matte finish
• Non-comedogenic, allergy & dermatologist tested
• Fragrance free for all skin types and made without parabens
Physical and Chemical Active Ingredients:
Homosalate, 10%, Octisalate 5%, Zinc Oxide 16.5%
The Skin Cancer Foundation recommends this product as an effective broad-spectrum sunscreen
Zo Skin Health Broad Spectrum Sunscreen SPF 50
Provides UVA/UVB, HEV and IR-A protection.
Soothes skin and minimizes inflammation
Offers ideal solution for sensitive skin, severe acne and post-procedure care.
Available to buy following a consultation
Zo Skin Health Sunscreen + powder Broad- Spectrum SPF 40 (International SPF 30)
Light-weight, on-the-go powder sunscreen provides buildable,
long-lasting coverage and protection from damage caused by UVA/UVB and HEV light
Contains oil-absorbing properties and light-reflecting particles, reducing unwanted surface oils and providing a luminous, matte finish
Soft, unique brush design allows for a smooth application and effortless air-brushed result.
Available to buy following a consultation in light, medium and deep skin tones.
Zo Skin Health Sunscreen + Primer Broad- Spectrum SPF 30
Provides UVA/UVB, HEV and IR-A protection
Offers firming peptide
Doubles as a makeup primer with a universal tint
Available to buy following a consultation