Pigmentation, sun spots and dark marks
Four brown things that look alike and need four different answers.
"Pigmentation" is the word people type, and it covers at least four separate things: flat brown sun spots (solar lentigines), freckles, the marks left behind after spots or injury (post-inflammatory hyperpigmentation), and the soft-edged patches of melasma. They all come from the same pigment, melanin, but they sit at different depths and have different drivers, so the treatment that clears one can deepen another.
Sun spots and freckles respond well to IPL in lighter skin. Marks after spots fade with skincare and time, with gentle peels to speed them up. Melasma is a long-term condition held down with sunscreen and a prescription cream, and light makes it worse. This page helps you work out which you have; the treatments and prices are on our pigmentation treatment page, and melasma has its own page.
What causes it
Pigment cells make melanin to protect the skin, and three things make them over-produce. Sun, over years, gives sun spots on the face, chest, shoulders and hands, usually from the forties. Inflammation, from a spot, a burn, eczema or a procedure, leaves a brown mark where it healed; the darker your skin, the darker and longer-lasting the mark. Hormones with sun give melasma. Freckles are inherited and darken every summer.
Depth decides the outcome. Pigment in the top layer responds to creams, peels and light. Pigment that has dropped deeper looks grey rather than brown and barely responds to anything. Most dark marks and most melasma are a mix.
Some brown marks are not pigmentation at all. A slowly growing flat brown patch on a sun-damaged face in later life, a mark with more than one colour or an uneven edge, or a spot unlike your others, needs a medical check before anyone treats it as cosmetic.
What actually treats it
Sun spots and freckles. Daily sunscreen and a retinol slow them; IPL clears them. At Nova that is IPL on untanned skin types I to IV, usually in autumn and winter, as a course of three with a review. The spot darkens, crusts and flakes within about a week, and new ones come with sun, so plan a top-up. On darker skin types we do not use IPL, because the risk of burns and pigment change outweighs the benefit.
Marks after spots or injury. These fade on their own over months, slower in darker skin, and sun restarts them. The plan is to stop the cause (treat the acne, stop picking), daily tinted sunscreen, and a retinol, azelaic acid at cosmetic strength or vitamin C. A prescription lightening cream exists for stubborn marks and is discussed at a consultation, never named here. In clinic, a course of superficial peels after 2 to 4 weeks of priming speeds things up, test patched first in darker skin. IPL is usually not the tool here, because heat can deepen the marks.
Melasma. Tinted SPF 50 every day, skincare, a prescription cream at night in courses, and for some a prescription tablet; gentle peels after priming; no IPL, laser, microneedling or HIFU over it.
Dullness and uneven tone. A general muddy look rather than distinct marks responds to a Hydrofacial for a brighter surface and a peel course for renewal.
Dark circles. Under-eye darkness is usually a mix of pigment, visible vessels and shadow from a hollow, so it is assessed separately.
If your skin is type IV to VI, you are more prone to every kind of dark mark and more at risk of a treatment creating a new one. The plan for darker skin starts with skincare and sunscreen, uses gentler peels after a patch test, and avoids IPL.
When to see your GP
See your GP, and we will write to them the same day if we spot it, for a mark that has changed in size, shape or colour; a mark with an irregular edge or more than one colour; a mark that itches, bleeds or crusts; or a new mark after 40 that looks unlike your others. Moles and pigmented spots are never lasered at Nova: they are assessed and, where removal is wanted, referred to Mr Benedict Reed, our plastic surgery partner, so the tissue can be examined.
What we will not do
We will not put IPL or any light on a brown mark we cannot confidently name. Light can clear the surface colour of an early skin cancer while the abnormal cells carry on underneath, so an uncertain mark goes to your GP first, every time. We will not treat melasma with IPL, and we will not promise that any pigment stays away without daily sunscreen. Results vary and cannot be guaranteed.
Skincare at home
Sunscreen first: SPF 50, tinted with iron oxides if you have melasma, dark marks or darker skin, every day of the year. Then a vitamin C serum in the morning and, at night, a retinol or azelaic acid at cosmetic strength, introduced slowly. Do not use retinol or any retinoid if you are pregnant, planning a pregnancy or breastfeeding. No scrubs, mitts or harsh toners; friction makes pigment worse.
From the Obagi range we stock: Obagi Sun Shield Mineral SPF50 85g and the tinted Obagi Sun Shield Tint Warm SPF50 85g or Obagi Sun Shield Tint Cool SPF50 85g; Obagi Professional-C 15% Serum 30ml or Obagi Professional-C 20% Serum 30ml; Obagi Retinol 0.5 28g or Obagi Retinol 1.0 28g; Obagi Nu-Derm 3 Clear Fx 57g and Obagi Nu-Derm 5 Blend Fx 57g for a non-prescription lightening routine.
Common questions
What is the difference between sun spots and melasma?
Sun spots are small, sharp-edged and evenly brown, scattered where the sun hits, and respond to IPL. Melasma is larger, soft-edged and symmetrical on both cheeks or the forehead, driven by hormones and light, and IPL can make it worse.
Can pigmentation be cleared for good?
No treatment stops your skin making pigment. Sun spots can be cleared and kept away with sunscreen and a top-up. Marks after spots fade but return with each new spot. Melasma is held, not cleared.
Does IPL work on dark skin?
We do not use IPL on the darkest skin types, because the risk of burns and new dark or pale marks is high. For types III and IV we patch test. Peels, skincare and prescription options carry the plan in darker skin.
Is there a prescription cream for pigmentation?
Yes. For melasma and stubborn dark marks, a prescription lightening cream used at night in courses is often the most useful part of the plan. We cannot name or price it online; it is discussed at a face-to-face consultation.
How long do dark marks after spots take to fade?
Months, not weeks, and longer in darker skin. Sunscreen and a retinol or azelaic acid at cosmetic strength shorten it; a superficial peel course speeds it further. Each new spot restarts the clock, so the acne has to be controlled first.
Can you laser a mole or a brown spot off?
No. Moles and pigmented spots are never lasered or burned here. They are assessed, and if removal is wanted, referred to our plastic surgery partner so the tissue can be examined.
When is the right time of year for pigment treatment?
IPL needs untanned skin with no sun for four weeks before and after, so most people book it from autumn to spring. Peels and skincare run all year as long as you wear sunscreen daily.
Why did my mark get darker after treatment?
After IPL a sun spot darkens and crusts for about a week; that is expected. A mark after a peel or light that stays darker for weeks is post-inflammatory pigmentation, commoner in darker skin, and needs sunscreen and a lightening routine. Message us if you are unsure.
Related treatments
Book a free consultation. Or message us on WhatsApp: 077 21 400 600.
Nova Beauty Clinic is in East Finchley, three minutes on foot from East Finchley station on the Northern line, with a car park next door. Pigmentation is one of the commonest reasons people come to us from Hampstead, Highgate, Muswell Hill and Finchley, and from Hampstead Garden Suburb, Golders Green, Crouch End and Barnet.
This page is general information, not medical advice. What suits you depends on your own skin, health and history, which we go through at a free consultation before anything is booked.