Hyperpigmentation is a very common and harmless skin condition that gives rise to darker patches of colour on the skin.


Hyperpigmentation is a very common and harmless skin condition that gives rise to darker patches of colour on the skin.


An increase in melanin in the skin causes hyperpigmentation. Melanin is the naturally occurring pigment that gives our skin, hair and eyes their colour. There are several triggers that can increase the amount of melanin produced in the skin. The most common for this is exposure to the sun followed by hormones, age and inflammation.


There are different types of hyperpigmentation that give rise to different appearances on the skin. The three main types are:

  • Age or sun spots are small dark patches of pigment on the face. The cause of this is sun exposure. They’re most commonly found on sun-exposed areas like the face, neck, chest, hands and arms.
  • Melasma is the most common type of hyperpigmentation and it appears as larger patches of pigment that develop mainly on the forehead, cheeks, lips and nose. The cause of this thought to be a combination of sun damage, hormonal changes and heat. It can also occur in pregnant women. In this case it happens due to trigger by pregnancy hormones. Melasma that occurs in pregnancy is called Chloasma.
  • Post-inflammatory hyperpigmentation is occurs when there is injury or trauma to the skin which when it heals leaves flat dark spots behind. It is very common in acne sufferers but can also occur due to skin damage from dermabrasion, laser treatment and chemical peels.


As with most things in life, prevention is better than cure. Hyperpigmentation is no exception and even if you require treatment, it’s important to follow a few precautions to prevent it from coming back again. Sun damage is a major cause and so sun protection is essential. Protecting your skin with sunscreen and avoiding direct sun exposure will prevent sun or age spots as well as reduce the risk of melasma. Even in cases where the cause is trauma such as in post-inflammatory hyperpigmentation, sun exposure can still darken the hyperpigmented patches.

Where hyperpigmentation occurs due to hormonal imbalance caused for example by the oral contraceptive pill, it may be possible to change medication and prevent this from developing. Good control of acne can help prevent post-inflammatory hyperpigmentation. Avoiding harsh skin agents and not squeezing or popping spots will also help reduce the risk of this. It’s also important to consider that post-inflammatory hyperpigmentation can be caused by the inappropriate use of chemical peels or lasers on the skin. This is especially important to consider in skin of colour where brown and black skin is particularly sensitive to post-inflammatory hyperpigmentation. As such it is essential to only have these treatments performed by qualified medical practitioners.


There are a number of ways to treat hyperpigmentation and which one depends on the severity and your treatment goals. Professional in-clinic treatments for hyperpigmentation usually involve chemical peels or laser therapy. These procedures are effective but patient selection is important and they require a course of treatments. It is especially important for patients with skin of colour to seek an experienced medical professional as these treatments can sometimes trigger post-inflammatory hyperpigmentation.

Prescription Treatments

Prescription skincare remains the gold-standard of treating hyperpigmentation. These treatments when prescribed correctly and for certain patients can be as effective as in-clinic treatments but with less downtime. Hydroquinone remains seen as the most effective topical agent for fading hyperpigmentation. This product reduces excess pigment and stabilises the pigment reducing cells. Often you can results as early as 4 weeks into treatment. It is however only available under strict medical supervision and you should only use it for a limited period. Tretinoin is a prescription retinoid that is also effective in treating mild hyperpigmentation, acne, and skin ageing. It is also often combined with Hydroquinone to offer a powerful treatment for hyperpigmentation.

Over The Counter Skincare

Glutathione is another treatment that is available in clinical but you can also get it without prescription. It is hyped up as a potent hyperpigmentation treatment. Whilst in some cases it may work over a period of time, there is no robust clinical evidence that shows this consistently. There is also some doubt as to the longevity of the results.

For very early or mild signs of hyperpigmentation, there are a number of over the counter treatments that can help. Look for products containing Arbutin, Azelaic Acid, Kojic AcidRetinol, Adapalene and Vitamin C. These products can help even out skin tone over time and may improve the quality of your skin overall.

For more info:

Check out our website for more information about our virtual hyperpigmentation clinic.

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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