Hyperpigmentation
Uneven skin tone, dark patches or spots?
Hyperpigmentation is a common skin concern where certain areas become darker than others. It may appear as brown, grey, black, red, or pink marks. Common types include:
- Melasma – Often on the face, triggered by sun, pregnancy or hormones
- Post-inflammatory hyperpigmentation (PIH) – Follows acne, eczema, or injury
- Age Spots – Caused by sun exposure, especially on the face, hands, and arms
Melasma
What is Melasma?
Melasma is a skin condition that causes patches and spots, usually on the face, which are darker than your natural skin tone.
It is usually fairly symmetrical, patchy, ill defined and light or dark brown depending on recent sun exposure. Melasma is a common skin condition of adults mostly women, in which light to dark brown patchy pigmentation develops usually on the face.
Although it can affect both genders secondary to excess ultraviolet irradiation it is more common in women. It occurs in pregnancy and also can be caused or exacerbated by the oestrogen in the oral contraceptive pill. Melasma is usually very noticeable during the summer months when the face can actually appear dirty and fades a lot during the winter months. It has no cancerous potential.
What causes Melasma?
The cause is not fully understood although it occurs quite frequently in pregnancy and in the majority the condition fades after the delivery.
Some acquire it while taking oral contraceptives although it doesn’t always fade after discontinuation of these.
All patients with melasma find that it is increased with increased exposure to UV light and this must indeed be the cause in males where oestrogen is not contributory.
Post-inflammatory Hyperpigmentation
What is PIH?
Post-inflammatory hyperpigmentation (PIH) is a common acquired disorder occurring after skin inflammation or injury. It is chronic and is more common and severe in darker-skinned individuals (Fitzpatrick skin types III–VI). PIH usually looks like a flat area of discoloration on the skin. It can appear white, pink, red, purple, brown, or black, depending on your skin tone and the depth of the discoloration. PIH can develop in all skin types. However, it tends to be more severe and longer-lasting for people with medium to dark complexions.What causes PIH?
When your skin cells react to damage or irritation by making extra melanin, post-inflammatory hyperpigmentation is the result. This skin condition shows up as tan, brown, dark brown, or even blue-gray patches and spots on your skin. The most common causes are acne, eczema, and impetigo, but any type of trauma or irritation to the skin has the potential to cause PIH.
Age Spots
What are Age Spots?
Age spots are small, flat dark areas on the skin. They vary in size and usually appear on areas exposed to the sun, such as the face, hands, shoulders and arms. Age spots are also called sunspots, liver spots and solar lentigines.
What causes Age Spots?
Age spots are caused by overactive pigment cells. Ultraviolet (UV) light speeds up the production of melanin, a natural pigment that gives skin its color. On skin that has had years of sun exposure, age spots appear when melanin becomes clumped or is produced in high concentrations.
Treatment Options
At Adare Dermatology, our doctors offer a range of treatments to reduce pigmentation and improve skin tone such as:
- Medical-grade skincare (AHAs, BHAs, brightening creams)
- Prescription creams for stubborn pigmentation
- Chemical peels (used cautiously, especially for melasma)
- RF microneedling
- Sun protection guidance to prevent recurrence
Note: Treatments vary depending on skin type, cause, and severity. Melasma and Post-inflammatory Hyperpigmentation can be chronic and need long-term care.
Book online with our dermatology doctors for a personalised treatment plan
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Adare Dermatology is a patient-focused dermatology clinic