Pigmentation and melasma
Doctor-led assessment · Surry Hills, Sydney
The patches that fade over winter and come back every summer. Treating pigment well starts with working out which kind you have — because the wrong treatment can make some kinds worse.
Book a complexion consultation
Deposit redeemable on your treatment · (02) 8074 1559
- 01Skin imaging, including pigment below the surface
- 02A doctor-led clinic with a qualified dermal therapy team
- 03A staged plan in writing, with realistic timeframes
Not all pigmentation is the same
Most people arrive having already tried something — a serum, a peel, a laser somewhere else. Often it worked a little, or worked and then came back, or made things worse.
That is usually not bad luck. Pigmentation is several different conditions that happen to look similar in the mirror, and they respond to very different things. Sun damage and melasma can sit side by side on the same cheek and need almost opposite approaches.
So the first job is diagnosis, not treatment.
Three kinds, three different plans
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01
Sun damage
Flat brown spots with fairly defined edges, on the areas that see the most sun — cheekbones, nose, forehead, chest, backs of hands.
How it behaves: accumulates over years, and tends to respond predictably to treatment.
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02
Melasma
Larger, blotchier, often symmetrical across both cheeks, the forehead or the upper lip. Edges are less defined.
How it behaves: driven by hormones, heat and light rather than sun alone. It is managed rather than cured, and it does not respond well to aggressive laser. It is also the kind most often mistaken for ordinary sun damage.
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03
Post-inflammatory pigmentation
The marks left behind after a breakout, an injury, or a treatment that irritated the skin.
How it behaves: fades on its own eventually, and treatment is mostly about speeding that up while stopping the cause of the inflammation.
Plenty of people have more than one kind at the same time. That is the most common reason a previous treatment did not do what it was supposed to.
What happens before anything is treated
- Skin imaging, which shows pigment sitting below the surface as well as what you can see
- Where the pigment sits — surface, deeper, or both — because that changes what will work
- Your medical history and medications, since some drive pigmentation
- Your triggers: sun, heat, hormones, pregnancy, contraception
- Your skin type, and your risk of pigmenting in response to treatment itself
- What you have already tried, and what it did
You will be told what we are seeing and why, in plain language, before any treatment is suggested. If we think the honest answer is skincare and sun protection for three months before a device goes near your face, we will say that.
Treatments we use for pigment
Which of these suits you — and in what order — is decided at your consultation, based on which kind of pigmentation you have.
- Pico LaserTargeted pigment clearance, with settings chosen for your pigment type
- Alma HarmonyXLSun damage and pigment with a vascular component
- SkinCeuticals PeelSurface brightening and evenness
- ZO Skin Health PeelResurfacing where deeper work is appropriate
- HydraFacial SyndeoGentle brightening with no downtime
- Healite II LEDCalming inflammation, which drives pigment
- SkinPen MicroneedlingUsed selectively, and cautiously in melasma
More on the skin treatments we offer, or browse other skin concerns.
Not every treatment suits every kind of pigmentation. Some of these are deliberately avoided in melasma. Your plan will only include what is appropriate for your skin.
What a realistic timeline looks like
- Week 0Assessment and skincare
Imaging, diagnosis, and getting your home routine and sun protection right. For some skins this stage alone changes things.
- Weeks 2–6First in-clinic treatments
Started conservatively, especially where melasma is involved, and adjusted based on how your skin responds.
- Weeks 6–12Review and adjust
We re-image and compare. What is working continues; what is not is changed rather than repeated.
- OngoingMaintenance
Pigment that is driven by sun and hormones will try to return. Maintenance is what keeps the result, and it is mostly done at home.
The part nobody wants to hear
Daily sun protection is not the boring advice at the end of the appointment. For pigmentation it is the treatment. Without it, in-clinic work has to fight against a Sydney summer, and the results are much harder to hold.
Heat matters too, which surprises people — hot cars, hot showers, and cooking over a stove can all drive melasma independently of UV.
We will go through what you are using now, what is worth keeping, and what is doing nothing. You leave with a written plan for what to use, when, and why.
Wondering why there are no before and after photographs? We explain why, and what we do instead.
Common questions
Can pigmentation be removed permanently?
Sun damage often responds well and can stay clear for a long time with good sun protection. Melasma is different. It is a long-term condition that is managed rather than cured, and it can return with sun, heat or hormonal changes. We would rather set that expectation early than have you disappointed later.
Why did laser make my pigmentation worse?
It usually comes down to the pigment being melasma, or to a skin type with a higher risk of pigmenting in response to treatment. Both are things a thorough assessment is designed to pick up beforehand.
How many treatments will I need?
It depends entirely on which kind you have and how deep it sits. You will be given a staged plan with an expected number at your consultation, rather than an open-ended package.
Is there downtime?
It varies by treatment, from none at all to a few days of looking flushed or of darkened spots lifting. Downtime is discussed before you commit to anything, so you can plan around it.
Can I be treated while pregnant or breastfeeding?
Some options are not appropriate during pregnancy or breastfeeding, and melasma is common in both. Tell us at your consultation and the plan will be built around it.
Do I have to start with a consultation?
Yes. Treating pigment without knowing which kind it is, is how skin gets worse rather than better.
Start with a skin consultation
Imaging, a clear explanation of what your pigmentation actually is, and a staged plan in writing.
Book a complexion consultation
240 Riley St, Surry Hills · (02) 8074 1559
Further reading
Pico or IPL for pigmentation · How long results last · All guides · A second opinion
