What causes hyperpigmentation?
Hyperpigmentation occurs when the skin produces excess melanin, the pigment responsible for skin colour. The trigger differs depending on the underlying condition:
Acne, eczema or injury
Inflammation from acne, eczema, injury, insect bites or other forms of skin trauma can leave dark marks behind.
Hormones
Hormonal fluctuations can contribute to the development of melasma.
UV exposure
Cumulative UV exposure can lead to solar lentigines and other areas of pigmentation.
Medication
Some antibiotics, antimalarials and chemotherapy agents can cause changes in skin pigmentation.
Types of hyperpigmentation Dr Phillips treats
Melasma Typically presenting as symmetrical facial pigmentation influenced by factors including hormones and UV exposure. See the dedicated Melasma Treatment page for more detailed treatment options.
Melasma is a common type of facial pigmentation that often appears as brown or grey-brown patches, usually on the cheeks, forehead and upper lip. It can be influenced by hormones, sun exposure and visible light, and it often comes back even after it has improved.
Because melasma behaves differently from dark marks left by acne, eczema or sun damage, it needs a different treatment approach. For a full guide to melasma, including what causes it, how to recognise it and the treatment options available, see the dedicated Melasma Treatment London page.
Concerned about facial pigmentation?
Book a consultation for an accurate diagnosis and personalised melasma treatment plan.
Post-inflammatory hyperpigmentation Dark marks that develop after acne, eczema, injury or other inflammatory skin conditions.
Post-inflammatory hyperpigmentation (PIH) refers to the dark marks that can remain after inflammation or injury to the skin. Common triggers include acne, eczema, insect bites, burns and other forms of skin trauma. Unlike a scar, the surface of the skin remains smooth, but the affected area becomes darker than the surrounding skin. PIH is particularly common in darker skin tones, where the pigmentation can be more noticeable and may take longer to fade.
An important part of treating PIH is controlling whatever is causing the inflammation in the first place. If active acne or eczema continues to create new dark marks, treating the pigmentation alone is unlikely to give the best results. Dr Phillips therefore treats the underlying skin condition alongside the pigmentation.
Treatment may include ingredients such as azelaic acid, retinoids, niacinamide, kojic acid and, where appropriate, prescription hydroquinone. Daily broad-spectrum sunscreen is also important, as UV exposure can make existing pigmentation darker and slow its improvement. If topical treatments are not sufficient, carefully selected laser and light treatments may be considered, with the treatment chosen according to your skin tone, the type of pigmentation and your individual risk of further pigmentary change.
For more information, see Dr Phillips’ Guide to Post-Inflammatory Hyperpigmentation.
Dark marks lingering after acne, eczema or inflammation?
Book a consultation to identify the cause and discuss a personalised treatment plan.
Solar lentigines and sun spots Including discrete sun spots and more diffuse uneven pigmentation caused by cumulative UV exposure.
Sun-induced pigmentation develops gradually after years of UV exposure. It can appear as individual brown spots, known as solar lentigines, age spots or liver spots, as well as more diffuse uneven pigmentation across sun-exposed areas. Unlike melasma, it is not driven by hormonal factors and often responds more predictably to treatment.
IPL and laser treatments can be effective for solar lentigines. The Stellar M22 IPL, Nd:YAG laser and PicoWay can all be used in selected cases, with the choice of treatment based on factors such as skin tone, the depth of the pigmentation and how widespread it is. Prescription topical treatments and chemical peels may also be suitable for some patients.
Daily broad-spectrum SPF 50 is an important part of long-term management, as ongoing UV exposure can lead to new pigmentation developing over time.
Concerned about sun spots or uneven pigmentation?
Book a consultation to discuss suitable treatment options.
Drug-induced pigmentation Where changes in skin pigmentation are related to medications.
Medication-induced pigmentation can develop as a side effect of certain medicines, including some antibiotics, antimalarials and chemotherapy drugs. It may appear as localised dark patches or more widespread changes in skin colour, depending on the medication and the individual response.
Dr Phillips assesses whether medication is the likely cause and recommends treatment according to the type and depth of pigmentation. This may include topical treatments, sun protection and, where appropriate, carefully selected laser and light treatments. Any prescribed medication should only be stopped or changed in discussion with the clinician who prescribed it.
Noticed pigmentation changes while taking medication?
Book a consultation for an assessment and to discuss appropriate treatment options.
Hyperpigmentation treatment in skin of colour
Hyperpigmentation is particularly common in darker skin tones and is often more persistent. Melanin-rich skin can produce more pigment in response to inflammation or UV exposure, which is why dark marks left by acne, eczema and other inflammatory skin conditions may be more noticeable and take longer to fade.
Darker skin can also be more prone to treatment-induced pigmentation if a laser, peel or topical treatment is too aggressive. For this reason, treatment needs to be carefully selected and adjusted according to both the type of pigmentation and the individual skin tone.
Dr Phillips has particular experience treating pigmentation in skin of colour, and this is considered at every stage of assessment and treatment planning.Book a consultation with Dr Derrick Phillips to discuss a personalised treatment plan for hyperpigmentation in skin of colour.
How Dr Phillips treats hyperpigmentation
Treatment is tailored to the type, depth and underlying cause of the pigmentation and may combine several approaches:
Broad-spectrum sun protection
With daily SPF 50 forming an important part of any pigmentation treatment plan and helping to prevent existing pigmentation from becoming darker.
Prescription topical treatments
Including hydroquinone, tretinoin, tranexamic acid and azelaic acid, used individually or in combination according to the type of pigmentation and skin tone.
Compounded prescription formulations
Allowing combinations of active ingredients to be tailored to individual treatment needs where appropriate.
Laser and light treatments
Including IPL, Nd:YAG laser, PicoWay and Lutronic DermaV, selected according to the type and depth of pigmentation, skin tone and individual treatment goals.
What to expect at consultation
Your consultation begins with an assessment of the type of pigmentation, how deep it is and what may be causing it. Dr Phillips will explain the diagnosis, discuss what improvement can realistically be expected and develop a treatment plan tailored to your skin.Pigmentation often improves gradually, and some conditions can recur. Treatment may therefore involve more than one approach and can be reviewed over time depending on how your skin responds.
Assess your pigmentation
Review the type and depth of pigmentation and identify factors that may be contributing to it.
Understand your diagnosis
Dr Phillips explains the diagnosis and discusses what level of improvement can realistically be expected.
Personalised treatment plan
Develop a treatment approach tailored to your skin, which may combine more than one treatment.
Review your progress
Monitor how your pigmentation responds and adjust treatment over time where needed.
Why choose Dr Derrick Phillips for hyperpigmentation in London
Effective treatment starts with the correct diagnosis. Melasma, post-inflammatory hyperpigmentation and sun-induced pigmentation can look similar, but they do not all respond to the same treatments.
Dr Phillips has particular experience treating pigmentation across a wide range of skin tones. Treatment is selected according to the type of pigmentation, your skin tone, previous treatment history and individual risk of further pigmentary change. This may include topical treatment, oral medication or laser and light procedures where appropriate.
As a Consultant Dermatologist with 12 years of NHS clinical experience, including at Imperial College Healthcare NHS Trust, his approach is based on careful assessment and evidence-based treatment rather than a one-size-fits-all approach.
Dr Phillips's approach to hyperpigmentation is built on:
Getting the diagnosis right first, because melasma, post-inflammatory hyperpigmentation and sun damage require different treatment approaches.
Treating the underlying cause, particularly where active acne, eczema or inflammation is continuing to produce new pigmentation.
Consistent sun protection, which is an important part of managing almost every form of hyperpigmentation.
Adapting treatment for skin tone, particularly in skin of colour where some treatments carry a greater risk of causing further pigmentation.
Managing melasma over the long term, as it is a recurring condition rather than something that can usually be permanently cleared with a single course of treatment.
Using laser and light treatments selectively, with the device and settings chosen according to the pigmentation, skin tone and individual risk profile.
FAQs
Can hyperpigmentation be removed completely?
Many forms improve significantly with treatment. Sun-induced pigmentation and post-inflammatory hyperpigmentation from a single episode often clear well with appropriate treatment and sun protection. Melasma is a chronic condition, prone to recurrence, where the aim is long-term control rather than a permanent cure. An accurate diagnosis and individualised plan are essential to achieving the best possible result.
What is the most effective treatment for hyperpigmentation?
There is no single best treatment for all hyperpigmentation. Treatment depends on whether the pigmentation is caused by acne or inflammation, melasma, sun damage, medication or another underlying condition. Options may include topical treatments such as azelaic acid, retinoids or hydroquinone, alongside diligent sun protection and, where appropriate, laser or light-based treatments.
Can lasers make pigmentation worse?
Yes. Laser treatment can sometimes trigger inflammation in the skin, which can stimulate further melanin production and cause post-inflammatory hyperpigmentation. This risk is higher when an unsuitable laser or overly aggressive settings are used, particularly in darker skin tones.
For this reason, the type of hyperpigmentation, skin tone and choice of device all need to be considered before treatment. Dr Phillips uses conservative, skin-tone-appropriate settings and will not recommend laser where the risk of worsening the pigmentation is greater than the likely benefit.
Which treatments are safe for darker skin?
This depends on the type of pigmentation and your individual skin tone. Sun protection and appropriate topical treatments form the foundation of most treatment plans.
Where laser treatment is appropriate, technologies such as Nd:YAG and PicoWay can be safer options for darker skin because they can treat selected pigmentation with less risk of unwanted pigmentary change than some shorter-wavelength or more heat-based treatments. IPL generally requires greater caution in darker skin tones.
Dr Phillips selects the treatment and settings according to your skin tone, the type and depth of pigmentation and your individual risk of post-inflammatory hyperpigmentation.
How long does hyperpigmentation take to fade?
How quickly hyperpigmentation fades depends on its cause, depth and your skin tone. Some superficial pigmentation may improve gradually over several months, while deeper or more persistent pigmentation can take longer. Ongoing inflammation and sun exposure can also slow improvement. In selected cases, laser and light treatments may help speed up the process.
Can treating hyperpigmentation make it worse?
Yes. Overusing active ingredients, causing irritation or using inappropriate peels, lasers or other treatments can trigger inflammation and make pigmentation worse. This is particularly important in darker skin tones, where the skin may be more prone to developing post-inflammatory hyperpigmentation after irritation or injury.
Dr Phillips tailors treatment to the type of pigmentation and your skin tone, with the aim of improving dark marks while minimising irritation and protecting the skin barrier.
Is hyperpigmentation permanent?
Not necessarily. Many forms of hyperpigmentation can fade or improve significantly with time and appropriate treatment, although some are more persistent than others. Melasma is a chronic condition and can recur, while post-inflammatory hyperpigmentation may gradually fade once the underlying inflammation has been controlled.
Explore knowledge base
Learn more about hyperpigmentation, melasma and skin pigmentation through Dr Derrick Phillips' expert videos and articles. Explore trusted information on common causes, treatment options and protecting your skin from further pigmentation.