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Common Concerns
Pigmentation & Sun Damage
Treatments in London
From sun spots and uneven tone to more complex pigmentation like melasma, the right approach depends entirely on the type — because some respond beautifully to light and laser, while others can be made worse by them.
- What causes it
- Excess melanin — most often from UV/sun exposure, with hormones, inflammation and ageing also contributing
- Types of pigmentation
- Sun spots & age spots (lentigines), diffuse sun damage, post-inflammatory pigmentation, and melasma (hormonal, chronic)
- Key areas
- Cheeks, forehead, upper lip, temples, nose and the backs of the hands
Pigmentation is excess melanin in the skin, most often triggered by sun exposure, ageing or hormones. It is not a single condition: sun spots and age spots (lentigines), general sun damage and uneven tone behave very differently from melasma, a chronic, hormone- and heat-sensitive pigmentation that needs a far more cautious approach. Because the wrong treatment can make some pigmentation worse, identifying the type correctly is the most important step — which is why a proper clinical assessment with Dr Nina comes first.
As seen in
Understanding the concern
Why patches of uneven, darker skin develop over time
Pigmentation describes any darkening of the skin caused by excess melanin, the pigment produced by cells called melanocytes. When those cells are stimulated — by ultraviolet light, inflammation, ageing or hormonal changes — they produce more melanin, which can collect in patches, spots or a generally uneven tone. Most facial pigmentation is driven by years of accumulated sun exposure, which is why it so often appears alongside the other visible signs of photoageing.
Crucially, pigmentation is not one condition but several, and they do not respond to treatment in the same way. Sun spots and age spots (also called solar lentigines) are discrete brown marks from UV damage; diffuse sun damage shows as a dull, mottled, uneven complexion; and post-inflammatory pigmentation follows spots, injury or irritation. These types generally respond well to light-, laser- and resurfacing-based treatment, and to good skincare.
Melasma is the important exception. It is a chronic, often symmetrical pigmentation on the cheeks, forehead or upper lip, strongly linked to hormones (pregnancy, the contraceptive pill) and made worse by heat and light as much as by UV. Melasma is managed rather than cured, it tends to recur, and aggressive light- or heat-based devices can actually worsen it. This is precisely why assessment matters: the same brown patch can call for completely different — sometimes opposite — treatment depending on its cause.
Not all pigmentation should be treated the same way. Melasma in particular can be worsened by light- and heat-based devices, so it is managed cautiously and medically rather than treated aggressively — and Dr Nina will tell you honestly at consultation if energy-based treatment is not appropriate for your skin.
Quick reference
- What causes it
- Excess melanin — most often from UV/sun exposure, with hormones, inflammation and ageing also contributing
- Types of pigmentation
- Sun spots & age spots (lentigines), diffuse sun damage, post-inflammatory pigmentation, and melasma (hormonal, chronic)
- Key areas
- Cheeks, forehead, upper lip, temples, nose and the backs of the hands
- What worsens it
- Sun and UV exposure, heat, hormonal changes, picking or inflammation, and aggressive treatment of melasma
- What to consider
- Sun spots and uneven tone respond well to light/laser and peels; melasma is managed cautiously and medically, not aggressively
The main causes
Sun exposure (UV)
By far the most common cause. Ultraviolet light stimulates melanocytes to produce more melanin, creating sun spots, age spots and a generally uneven, mottled tone over years of accumulated exposure.
Hormones
Hormonal changes from pregnancy, the contraceptive pill or HRT can trigger melasma — a chronic, symmetrical pigmentation that is heat- and light-sensitive and behaves very differently from sun spots.
Inflammation & ageing
Post-inflammatory pigmentation follows acne, injury or irritation, while skin naturally accumulates pigment irregularities with age. Both add to overall unevenness of tone.
Where it tends to show up
- Discrete brown spots — sun spots or age spots — on the cheeks, temples or hands
- A dull, mottled or generally uneven complexion from accumulated sun damage
- Symmetrical brown or grey-brown patches on the cheeks, forehead or upper lip (suggestive of melasma)
- Darker marks left behind after spots, blemishes or irritation
- Pigmentation that worsens in summer or with sun and heat exposure
- Patchy tone that makes the skin look older or more tired than it feels
Treatment guidance
Matching treatment to your concern
The single most important factor in treating pigmentation is identifying its type, because the right treatment for one can be the wrong treatment for another. Sun spots, age spots and general sun damage respond well to light- and laser-based treatment; surface dullness and uneven tone respond to resurfacing peels; and melasma needs a deliberately cautious, conservative approach. Underpinning every plan, daily SPF and medical-grade skincare prescribed by Dr Nina are the foundation — without them, no in-clinic treatment will hold. These are the presentations we see most often, and what tends to suit each.
Sun spots & age spots
Sun spots, age spots & lentigines
Discrete brown marks from years of sun exposure — solar lentigines — tend to respond very well to targeted light and laser. BBL® HEROic™ uses intelligent broadband light that is absorbed by unwanted pigment so the body can clear it, while Lutronic LaseMD Ultra gently resurfaces and renews. Both are well suited to clearly defined sun damage on the face and, for BBL® HEROic™, the hands.
General sun damage
General sun damage & uneven tone
For a dull, mottled, generally photo-aged complexion rather than isolated spots, the aim is to even out tone across the whole area. Lutronic LaseMD Ultra resurfaces and stimulates renewal while infusing brightening actives, and BBL® HEROic™ addresses sun damage and the redness that often accompanies it. These are frequently planned as a short course for the most even result.
Dullness & brightening
Surface dullness, uneven tone & brightening
Where the concern is more about surface dullness, lacklustre tone and overall radiance, gentler resurfacing peels are often the right starting point. AlumierMD Peels are tailored on the day — including a tranexamic-acid option aimed at uneven tone — and PRX-T33 Peel brightens and refines with no visible peeling. Both improve skin quality and the look of mild, superficial pigmentation.
Melasma
Melasma — a cautious, medically-led approach
Melasma is the exception that changes everything. Because it is hormone- and heat-sensitive and can be made worse by aggressive light or heat, energy-based devices are not always appropriate and are used only with great caution, if at all. The foundation of melasma care is daily SPF and medical-grade topicals prescribed by Dr Nina; where an in-clinic treatment is considered, gentler, tranexamic-acid-focused options such as AlumierMD Peels may have a role. Melasma is managed, not cured — assessment is essential before any treatment.
Prevention & maintenance
Prevention, skincare & maintenance
No pigmentation treatment holds without sun protection, because UV continually re-triggers melanin. Daily broad-spectrum SPF and a medical-grade skincare routine prescribed by Dr Nina are the foundation of every plan — they protect results and, for melasma, are the mainstay of management. In-clinic treatments such as BBL® HEROic™, Lutronic LaseMD Ultra and tailored peels work best when supported by consistent home care and ongoing maintenance.
Pigmentation is one of the concerns where honest assessment matters most — Dr Nina will tell you clearly which type you have and whether energy-based treatment is appropriate, and for melasma will favour a cautious, conservative, medically-led plan over aggressive intervention.
At Facial Sculpting
What happens at your consultation
A consultation is not a commitment to treatment — it is a proper clinical assessment. Here is what to expect.
01
A full clinical assessment
Dr Nina examines the type of pigmentation you have — distinguishing sun spots and general sun damage from melasma — along with your skin type, sun exposure, hormonal factors and history. This matters enormously, because the type of pigmentation determines whether light- and laser-based treatment is appropriate or whether a more cautious route is safer.
02
An honest, specific plan
If light, laser or a peel is likely to help, she will recommend it specifically and explain why, always over a foundation of daily SPF and medical-grade skincare. If your pigmentation is melasma, she will favour a cautious, conservative, medically-led plan — and will be clear that energy-based treatment is not always appropriate and can sometimes make it worse.
03
No obligation
Consultations are never upsells. The outcome may be an in-clinic treatment, a skincare-led plan, or honest advice that your pigmentation is best managed conservatively for now. The goal is the right answer for your skin and the type of pigmentation — not a booking.
Full treatment directory
Explore the treatments
Each card links to a full treatment page with procedure details, suitability, and what to expect. Your exact route is confirmed at consultation.
Broadband light
BBL® HEROic™
Sciton’s most advanced BroadBand Light® technology — intelligent broadband light that targets pigmentation, redness and sun damage to even tone and restore clarity, with minimal downtime.
Best for: Sun spots, age spots, sun damage, redness, uneven tone
Find out more
Laser
Lutronic LaseMD Ultra
A gentle, non-ablative thulium (1927nm) laser that resurfaces and stimulates renewal while infusing brightening actives — refining tone, pigmentation, sun damage and texture with minimal downtime.
Best for: Uneven tone, pigmentation, sun damage, texture
Find out more
Peel
AlumierMD Peels
Medical-grade chemical peels tailored to your skin on the day — including a tranexamic-acid option — to brighten, smooth and even out tone, with little or no downtime.
Best for: Dullness, uneven tone, mild pigmentation, congestion
Find out more
Peel
PRX-T33 Peel
A no-needle bio-revitalising peel (TCA, hydrogen peroxide and kojic acid) that brightens, hydrates and firms without visible peeling — refreshing tone and the look of mild pigmentation.
Best for: Dullness, uneven tone, brightening, crepey skin
Find out more
Peel
Jalupro Glow Peel
A revitalising peel combining Jalupro amino acids with a brightening peel — improving radiance, hydration and skin quality, with a gentle resurfacing effect that can help even out tone and dullness.
Best for: Dullness, uneven tone, brightening, skin quality
Find out moreSide by side
How the options compare
An honest comparison — the right option depends on the type of pigmentation, your skin and goals. This is a guide, not a prescription, and melasma in particular needs individual assessment.
| Treatment | Approach | Invasiveness | Downtime | Best for |
|---|---|---|---|---|
| BBL® HEROic™ | Non-invasive broadband light | Non-invasive | Minimal | Sun spots, sun damage, redness |
| Lutronic LaseMD Ultra | Non-ablative thulium laser | Non-invasive | Minimal (~1–3 days) | Tone, pigmentation, texture |
| AlumierMD Peels | Tailored chemical peel | Non-invasive | Little to none | Dullness, uneven tone, brightening |
| PRX-T33 Peel | No-needle bio-revitalising peel | Non-invasive | None | Brightening, mild pigmentation |
Pigmentation plans are often combined — for example BBL® HEROic™ for sun spots alongside Lutronic LaseMD Ultra for tone and texture, always over a foundation of daily SPF and medical-grade skincare. For melasma, light- and heat-based options are approached with caution; Dr Nina advises honestly what is genuinely appropriate.
Common questions
FAQs about pigmentation & sun damage
What is the best treatment for pigmentation and sun damage?
There is no single best treatment — the right approach depends on the type of pigmentation. For discrete sun spots and age spots, and for general sun damage, BBL® HEROic™ broadband light and the Lutronic LaseMD Ultra thulium laser are often the most effective options. For surface dullness and uneven tone, AlumierMD Peels or the PRX-T33 Peel can brighten and refine the skin. Melasma is a different matter and is managed cautiously and medically rather than treated aggressively. Whatever the plan, daily SPF and medical-grade skincare are the foundation. Dr Nina identifies the type of pigmentation at consultation before recommending anything.
Can pigmentation be treated without surgery?
Yes — pigmentation is treated entirely with non-surgical, non-invasive approaches. Light- and laser-based treatments such as BBL® HEROic™ and Lutronic LaseMD Ultra target sun spots, age spots and general sun damage, while resurfacing peels such as AlumierMD Peels and PRX-T33 brighten and even out tone. Alongside these, daily SPF and a medical-grade skincare routine prescribed by Dr Nina are essential, because UV continually re-triggers pigment. For melasma, a cautious, skincare-led approach is usually the mainstay. The right combination depends on the type of pigmentation and is confirmed at assessment.
Why does melasma need a different approach?
Melasma is a chronic, often hormone-driven pigmentation that is sensitive to heat and light as well as UV. Unlike sun spots, it can be made worse by aggressive light- or heat-based devices, which is why energy-based treatment is not always appropriate and is used only with great caution, if at all. Melasma is managed rather than cured, and it tends to recur. The foundation of care is diligent daily SPF and medical-grade topicals prescribed by Dr Nina; where an in-clinic treatment is considered, gentler tranexamic-acid-focused options may have a role. This is exactly why proper assessment matters before any treatment.
Is BBL® HEROic™ or Lutronic LaseMD Ultra better for sun spots?
Both are well suited to sun spots and sun damage, and neither is universally better. BBL® HEROic™ uses intelligent broadband light absorbed by unwanted pigment so the body can clear it, and is particularly good for discrete sun spots, redness and sun damage on the face and hands. Lutronic LaseMD Ultra is a non-ablative thulium laser that gently resurfaces, stimulates renewal and infuses brightening actives, making it a strong choice for overall tone and texture as well as pigment. They are sometimes used together as part of a wider plan. Dr Nina advises which suits your skin type and pigmentation at consultation.
Do chemical peels help pigmentation?
Peels can help with surface dullness, uneven tone and the look of mild, superficial pigmentation. AlumierMD Peels are medical-grade and tailored on the day, including a tranexamic-acid option specifically aimed at uneven tone, while the PRX-T33 Peel brightens and refines with no visible peeling. They work by encouraging renewal and improving overall skin quality, and are best over a short course with daily SPF in between. For deeper or more stubborn pigmentation, light or laser may be more effective, and for melasma any peel is approached cautiously. Dr Nina advises which is appropriate after assessing your skin.
What causes pigmentation on the face?
Facial pigmentation is caused by excess melanin, the skin’s natural pigment, produced when melanocytes are over-stimulated. By far the most common trigger is ultraviolet light from sun exposure, which causes sun spots, age spots and a generally uneven, mottled tone over time. Hormonal changes — from pregnancy, the contraceptive pill or HRT — can trigger melasma, while inflammation from acne or injury can leave post-inflammatory pigmentation. Ageing adds further irregularity. Because these types behave differently and respond to different treatments, identifying the cause is the most important first step.
Can sun damage be reversed?
The visible signs of sun damage — sun spots, uneven tone and dullness — can often be significantly improved, though sun damage is best thought of as managed rather than fully reversed. Treatments such as BBL® HEROic™ and Lutronic LaseMD Ultra target existing pigment and stimulate renewal, and peels refresh surface tone. However, results are not permanent, because ongoing UV exposure creates new damage over time. This is why daily broad-spectrum SPF and medical-grade skincare are essential, both to protect results and to slow further change. A short course of treatment with consistent sun protection gives the most lasting outcome.
How long do pigmentation treatment results last?
Results vary by treatment, by the type of pigmentation and by how well the skin is protected afterwards. After light, laser or peel treatment, improvement is often visible within a few weeks and continues over a course, but no result is permanent — ongoing sun exposure and ageing create new pigment over time. This is why periodic maintenance and, above all, daily SPF and medical-grade skincare are essential to hold results. Melasma in particular is prone to recurrence and needs continuous management rather than a one-off fix. Dr Nina will set out realistic, honest expectations for your specific pigmentation.
Is laser safe for pigmentation on darker skin tones?
Light- and laser-based treatments require careful assessment in deeper or sun-reactive skin tones, because they carry a higher risk of pigment change — either lightening or darkening — if not chosen and set correctly. BBL® HEROic™ is best suited to lighter and medium skin tones, while the Lutronic LaseMD Ultra thulium laser can be a more thoughtful option across a range of skin tones with appropriate settings. In all cases, suitability is assessed individually, and Dr Nina may recommend a gentler approach if a device is not ideal for your skin. Honest skin-type assessment is central to a safe result.
Can pigmentation come back after treatment?
Yes — pigmentation can return, which is why ongoing protection matters as much as the treatment itself. Because UV exposure continually re-triggers melanin, sun spots and uneven tone can recur without diligent daily SPF and good skincare. Melasma is especially prone to recurrence because it is also driven by hormones and heat, and is managed over the long term rather than cured. Maintaining results means treating sun protection and medical-grade skincare as a permanent part of your routine, not an optional extra. Dr Nina will build this into any plan from the outset.
Does skincare alone improve pigmentation?
Medical-grade skincare and daily SPF are the foundation of every pigmentation plan, and for mild pigmentation or melasma they can be the mainstay of treatment. Prescribed topicals can help to brighten, regulate pigment production and protect the skin, while broad-spectrum SPF prevents UV from re-triggering melanin. For more established sun spots and sun damage, skincare works best alongside in-clinic treatments such as BBL® HEROic™, Lutronic LaseMD Ultra or tailored peels, which target existing pigment more directly. Dr Nina prescribes a skincare routine suited to your skin and the type of pigmentation as part of any plan.
How do I know if I have melasma or sun spots?
They can look similar but tend to behave differently. Sun spots and age spots are usually discrete, well-defined brown marks on sun-exposed areas such as the cheeks, temples and hands. Melasma typically appears as larger, more diffuse, often symmetrical brown or grey-brown patches across the cheeks, forehead or upper lip, and frequently worsens with sun, heat or hormonal changes. Because the distinction determines whether light- and laser-based treatment is safe or potentially harmful, it should be made by proper clinical assessment rather than guessed. Dr Nina identifies the type of pigmentation carefully before recommending any treatment.
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Why choose us
Why patients choose us for pigmentation
Pigmentation is one of the most commonly mis-treated concerns in aesthetics — melasma especially, where aggressive light or heat can make things worse rather than better. Dr Nina’s approach is different: identify the type correctly, treat only what is appropriate, and be honest when caution serves you better than a device.
The right diagnosis first
Sun spots and melasma can look similar but need opposite handling. Dr Nina identifies the type of pigmentation properly before recommending anything, so the treatment matches the cause.
Honest about melasma
We will not treat melasma aggressively for the sake of a quick result. Where energy-based treatment is not appropriate, we say so and favour a cautious, medically-led plan built on SPF and topicals.
Results protected for the long term
Because pigmentation is driven by sun and recurs without protection, every plan is built on daily SPF and medical-grade skincare — so improvements are gradual, natural and genuinely maintained.
Ready to explore your options?
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Your practitioner
Dr Nina Bal
BDS (Hons)
GDC 208766
Save Face Platinum
JCCP
“In my practice, I focus on addressing life’s moments and the emotions they carry, rather than merely correcting lines and imperfections. I aim to provide therapies that respect and reflect the individual’s personal story.”
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Save Face Platinum accredited
Registered with the General Dental Council
British College of Aesthetic Medicine member
Save Face COVID-19 Operational Protocol Certified
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