Hyperpigmentation – Consultant Diagnosis & Advanced Skin Treatment in London

What is hyperpigmentation?

Hyperpigmentation describes darker areas of skin caused by overproduction of melanin, the natural pigment in skin, hair and eyes. It is a descriptive term rather than a single condition, with common types including melasma, sunspots, freckles and post-inflammatory pigmentation after acne or eczema.

Causes and how it develops

Melanin is produced by melanocytes in response to sun exposure, hormones, inflammation or skin injury. Hyperpigmentation may result from:

• Melasma – triggered by hormones (pregnancy, contraception) and sunlight.
• Post-inflammatory hyperpigmentation (PIH) – after acne, eczema, psoriasis, or injury.
• Lentigines (sunspots/age spots) – due to cumulative UV damage.
• Freckles – genetically determined and accentuated by UV.

Hyperpigmentation Symptoms and patterns

Hyperpigmentation presents as flat patches darker than surrounding skin, ranging from light brown to black or grey-brown. It most often occurs on sun-exposed areas (face, chest, hands) but can follow inflammation anywhere. Pigmentation is usually painless but can cause significant cosmetic concern.

Hyperpigmentation Diagnosis and tests

Diagnosis is clinical, with dermoscopy used to assess pigment depth and exclude skin cancer. In uncertain cases, a biopsy may be taken. Blood tests may be recommended for melasma or systemic triggers. Correct diagnosis guides safe treatment.

Hyperpigmentation Treatment options and management

Topical therapies

Prescription creams containing hydroquinone, retinoids, azelaic acid, kojic acid, or tranexamic acid help reduce pigment production. These are usually combined with strict sun protection.

Procedures

Chemical peels, microdermabrasion and fractional or pigment-targeting lasers may improve pigmentation when supervised by specialists. Energy-based treatments require careful skin-type assessment.

Lifestyle and skin care

Daily broad-spectrum sunscreen is essential. Avoid picking spots, use non-irritant skincare, and manage acne or eczema to prevent further PIH. Camouflage makeup may support confidence during treatment.

When urgent review is needed

Pigmentation that is irregular, changing, bleeding, or ulcerating could indicate melanoma and requires urgent dermatologist review.

Why choose Skinhorizon for hyperpigmentation?

• Consultant dermatologist-led diagnosis to exclude melanoma and other skin cancers.
• Access to advanced topical, laser, and peel treatments tailored to skin type.
• Safe, outcome-focused plans under CQC standards, with full aftercare support.

Your first visit — what to expect

1. History: Onset, triggers, sun exposure, medications, hormones, past skin conditions.
2. Examination: Distribution, depth assessment with dermoscopy, and exclusion of concerning features.
3. Discussion: Differentiation between benign pigmentation and suspicious lesions; tailored advice.
4. Treatment plan: Sun protection, topical/light-based options, and lifestyle guidance.
5. Follow-up: Monitor response, reduce recurrence, and maintain skin clarity long term.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 21 August 2025