Skin Pigmentation Guide

Pigmentation & Melasma Explained

A comprehensive guide to understanding skin discolouration — what causes dark patches, how melasma differs from other pigmentation, and the most effective treatments for an even, radiant complexion.

What Is Skin Pigmentation?

Skin pigmentation refers to the colouring of the skin, determined by a pigment called melanin — produced by cells called melanocytes in the basal layer of the epidermis. Melanin is the body's natural defence against ultraviolet (UV) radiation, absorbing and dissipating UV energy to protect the DNA in skin cells.

Hyperpigmentation occurs when melanocytes are overactivated — producing excess melanin in localised areas, leading to patches or spots that appear darker than the surrounding skin. This can affect any skin tone but is particularly prevalent and persistent in medium to deep skin tones, where melanocytes are naturally more active and reactive.

Pigmentation is one of the most complex skin concerns to treat because it has multiple possible root causes — and treatment must address the specific cause to be effective. Sun protection is the foundation of every pigmentation treatment plan, without exception.

Understanding Pigmentation

90%

Of adults experience pigmentation by age 50

5-6 M

People in the UK affected by melasma

SPF

The single most important treatment step

Skin discolouration is always a sign of something else — sun damage, hormonal influence, post-inflammatory response, or ageing. Identifying the root cause of your pigmentation is the essential first step to choosing the right treatment approach.

Pigmentation is a symptom, not a disease

UV exposure is the primary trigger and aggravator of virtually all forms of hyperpigmentation. Without daily broad-spectrum SPF 50, no topical treatment or clinical procedure will produce lasting results — pigmentation will return within weeks of sun exposure.

SPF is non-negotiable

Melasma in Depth

Adults with dark, coarse hair on any skin tone (with appropriate laser technology) · Those with PCOS or hormonal hair growth · People who wax or shave regularly and want a long-term solution · Anyone with ingrown hair problems · Patients willing to complete the full course of sessions · Those who can avoid sun exposure between sessions.

Understanding Melasma Specifically

Ideal for laser

Consider carefully

Blonde, red, grey, or white hair (lacks melanin — laser is ineffective) · Active tan or very recent sun exposure · Pregnancy (safety not established) · Certain medications increasing photosensitivity (Roaccutane, some antibiotics) · Active skin infections or open wounds in the treatment area · History of keloid scarring.

Melasma deserves special attention because it is the most prevalent, the most misunderstood, and the most challenging pigmentation condition to treat. It affects up to 6 million people in the UK alone — predominantly women — and has a significant impact on confidence and quality of life.

Melasma occurs in three layers of the skin — epidermal (surface), dermal (deeper), and mixed — which is why it is notoriously difficult to treat completely. Dermal melasma in particular does not respond well to topical treatments and requires more targeted clinical interventions. A Wood's lamp or dermatoscope examination can identify which depth your melasma sits at.

Types of Pigmentation

Not all pigmentation is the same — and the treatment approach differs significantly depending on the type. Understanding which type you have is critical before starting any treatment.

Different Types of Skin Discolouration

Hormonal (Melasma)

Sun-induced (Sun spots / Age spots)

Post-inflammator(Post-inflammatory hyperpigmentation (PIH)

Vascular (Post-inflammatory erythema (PIE)

Epidermal (Freckles (Ephelides)

Drug-induced (Drug & chemical-induced pigmentation

Session by Session

Avoid sun exposure, fake tan, and sunbeds for 4 weeks before treatment — tanned skin increases the risk of burns and hyperpigmentation. Shave the treatment area 24 hours before each session (do not wax, thread, or use depilatory creams for 4 weeks prior — the root must be intact). Avoid retinoids on the treatment area for 5–7 days before.

What to Expect — Before, During & After

Preparation (2–4 weeks before)

On the day of your session

Arrive with clean, dry skin — no moisturiser, deodorant, or perfume on the treatment area. A cooling gel is applied before treatment. The technician will use a handheld device that emits pulses of laser light. You will feel a sensation described as a rubber band snap or mild heat — modern diode lasers are significantly more comfortable than older technologies. A session takes 10–90 minutes depending on the area.

Immediately after (24–48 hours)

Mild redness and a sensation like mild sunburn is normal and usually resolves within a few hours. Apply aloe vera gel or a soothing post-laser cream. Avoid heat — no hot showers, saunas, steam rooms, or exercise for 24–48 hours. Keep the area out of direct sunlight and apply SPF 50 daily.

Hair shedding phase

Treated hairs appear to grow for 1–3 weeks post-session before shedding — this is normal. The hair shaft is dead but takes time to be pushed out. Gently exfoliating after 1 week helps the shedding process. Do not wax or tweeze during the course — shaving between sessions is fine.

Next session

Sessions are spaced 4–6 weeks apart for the face, and 6–8 weeks apart for the body, to align with the hair growth cycle. With each session, you should notice progressively less regrowth — hair becomes finer, patchier, and sparser. Significant reduction is typically visible from session 3–4 onwards.

After completing your course

After 6–8 sessions, most patients achieve 80–90% permanent hair reduction. Remaining hair is typically fine and light. Annual or bi-annual maintenance sessions help manage any hormonal regrowth. Results are permanent for the treated follicles — but new follicles can be activated by hormonal changes (pregnancy, PCOS, menopause).

FAQ

Is laser hair removal painful?

Pain levels vary by area, laser type, and individual sensitivity. Most patients describe the sensation as a mild rubber band snap or brief heat — far more tolerable than waxing. Modern diode and Soprano-type lasers use continuous cooling and gentle gliding techniques that are virtually painless for most patients. The upper lip and bikini area tend to be the most sensitive zones.

How many sessions will I need?

Most people need 6–8 sessions for optimal results, spaced 4–8 weeks apart depending on the treatment area. Hormonal areas like the face, chin, and bikini may require more sessions (8–12) due to ongoing hormonal influence on hair growth. Fair, fine hair may also require additional sessions as it contains less melanin to absorb laser energy.

Is laser hair removal safe for dark skin?

Yes — with the correct laser. The Nd:YAG 1064nm laser is specifically designed for darker skin tones (Fitzpatrick IV–VI) and has an excellent safety profile when used by a trained professional. The risk comes from clinics using the wrong laser (e.g. IPL or Alexandrite) on dark skin, which can cause burns, blistering, and permanent pigmentation changes. Always confirm the technology and your technician's experience with your skin type.

Does laser hair removal work on blonde, grey, or red hair?

Unfortunately, no. Laser hair removal works by targeting melanin in the hair shaft. Blonde, white, grey, and very light red hair contains insufficient melanin to absorb the laser energy effectively. For these hair colours, electrolysis — which destroys individual follicles using electrical current — is the only proven permanent option, though it is significantly more time-consuming.

Can hair grow back after laser treatment?

Treated follicles are permanently destroyed and will not regrow. However, laser does not prevent new follicles from being activated by hormonal changes. Conditions like PCOS, pregnancy, menopause, or starting/stopping hormonal medications can stimulate new hair growth in previously treated areas. This is why patients with hormonal hair concerns may need periodic maintenance sessions over the years.

Can I have laser hair removal while pregnant?

No. Laser hair removal is not recommended during pregnancy as its safety for the developing foetus has not been established in clinical studies. Most reputable clinics will decline to treat pregnant patients. It is safe to resume or begin treatment after giving birth and finishing breastfeeding — a good time to start is around 3–6 months post-delivery when hormones have stabilised.

What is the difference between laser and IPL?

Laser uses a single, precise wavelength of light focused on the follicle — making it more targeted and effective. IPL (Intense Pulsed Light) emits a broad spectrum of light wavelengths, which is less precise and generally less effective — particularly on fine or light hair. IPL is cheaper and widely available in salons and as at-home devices, but clinical laser consistently produces better, faster, and longer-lasting results.

How do I choose a laser hair removal clinic?

Look for a clinic that conducts a thorough consultation including Fitzpatrick skin typing, uses medical-grade laser technology (not just IPL), employs qualified laser technicians or practitioners with Level 4 laser certification, offers a patch test before the first session, and is transparent about the technology they use. Be cautious of very low-cost deals — these often use inferior equipment or under-qualified staff.

Frequently Asked Questions