Pigmentation Treatment
Melasma, sun damage and dark marks, assessed before they are treated
Dark patches, brown marks and uneven tone are not one condition. They are several, they respond to different things, and treating the wrong one makes some of them worse. That is why every pigmentation appointment here starts with working out what we are actually looking at.
We assess and treat pigmentation at our clinic on East End Road in East Finchley, a few minutes from the station and within reach of Muswell Hill, Highgate, Finchley and Barnet.
The four kinds we see most
Sun damage
Flat brown marks on the face, chest, shoulders and backs of the hands, built up over years of daylight rather than one bad holiday. This is the type that responds best and fastest.
Melasma
Larger, softer-edged patches, usually across the cheeks, forehead or upper lip, often symmetrical. Frequently triggered by pregnancy, the contraceptive pill or hormone changes. Melasma is a long-term condition, not a mark to be removed. It is managed.
Post-inflammatory pigmentation
The brown or grey shadow left behind after acne, a burn, a scratch or a previous treatment. More common and more stubborn in darker skin tones.
Freckles and lentigines
Small, well-defined marks. Usually cosmetic rather than clinical, and usually straightforward.
What we do not treat, and where we send you instead
A mark that is changing, growing, more than one colour, has an irregular edge, itches, bleeds or crusts is not a pigmentation problem and it is not treated with light. If you show us something like that, we will tell you and we will refer you rather than treat it. That is the entire reason assessment comes first.
How we treat it
IPL and laser, Lumenis Stellar M22
Our M22 delivers filtered light that is absorbed by the pigment itself, breaking it up so the skin clears it. It is the strongest option we have for sun damage and lentigines. Sun damage typically needs a short course rather than one session. Marks usually darken and look worse for a few days before they lift and flake away, which is expected and not a complication.
Chemical peels
Medical-grade peels lift pigment held in the upper layers and speed up cell turnover. Useful for post-inflammatory pigmentation and often used alongside the M22 rather than instead of it.
Medical-grade skincare
This does most of the quiet work. Pigmentation that is not supported by daily home care comes back, and we would rather tell you that at the start than after three sessions. We stock and prescribe from the Obagi range and build your routine around your skin, not around a box.
Prescription options
For some pigmentation, and for melasma in particular, there is a prescription route that works better than anything available over a counter. Ehsan is an independent prescriber, so it can be discussed and prescribed here after assessment. We are not permitted to name or advertise prescription medicines, so we will not do that on a web page. Bring it up at your consultation and we will talk about it properly.
What is realistic
Being straight with you about this saves everyone time.
- Sun damage: responds well. Most people see clear improvement over a course, and it holds if you use sun protection.
- Freckles and lentigines: respond well.
- Post-inflammatory pigmentation: responds, but slowly. Months, not weeks.
- Melasma: managed, not cured. It recurs. Sun, heat and hormones bring it back. Anyone promising to clear your melasma permanently is selling you something. What we can do is reduce it and keep it reduced, which is worth having.
Two things undo pigmentation work faster than anything else: sunlight and picking. Daily SPF is not an upsell here, it is the treatment.
What to expect
Consultation. Free. We look at your skin, work out which type or types you have, check your skin tone and how it is likely to respond, and rule out anything that needs a dermatologist rather than us. If light-based treatment is the plan, we patch test before we treat. Always.
Sessions. Depends on the type and how deep the pigment sits. We will give you an honest number at consultation rather than a number designed to get you booked.
Afterwards. Warmth and mild redness for a few hours. Treated marks darken, then flake off over one to two weeks. Sun protection every day, no exceptions, no sunbeds, no picking.
Cost. From £150 per session for a small area and £250 for the full face. Pigmentation is nearly always a course, so we will price the course rather than let you find out session by session.
Who this is not for
- Anyone with a tan, fake or real. We will reschedule you, not treat you.
- Anyone with a changing or suspicious lesion, until it has been seen by a dermatologist.
- Pregnancy and breastfeeding, for some of these options.
- Some darker skin tones need a different approach, and occasionally none of the light-based options. We will say so.
Frequently asked questions
Can pigmentation be removed permanently?
Sun damage and lentigines, often yes, provided you protect your skin afterwards. Melasma, no. It is a condition that is controlled rather than cured, and it will return if it is not managed.
Can I have it in summer?
You can, but you have to be honest about sun exposure. Recent sun or a tan means we postpone. Autumn and winter are the easier seasons for this.
Is it safe on darker skin?
It depends on the skin tone and the type of pigmentation. Some options are, some are not, and post-inflammatory pigmentation is a real risk if the wrong device or setting is used. That is what the assessment and the patch test are for.
Will IPL make my melasma worse?
It can, which is why we assess before we treat. Heat is a melasma trigger, so for some people the right answer is peels, skincare and a prescription route rather than light. We would rather turn down the treatment than make your face worse.
Will skincare alone fix it?
For mild pigmentation, sometimes. For most, skincare is what makes the in-clinic treatment last rather than a replacement for it.
How many sessions will I need?
Sun damage, usually three to six. Melasma is ongoing management. We give you a number at consultation once we know what we are dealing with.
Do I need a patch test?
Yes, for anything light-based. No exceptions.
Does it hurt?
IPL feels like a warm elastic band flicked against the skin. Uncomfortable rather than painful, and it is over quickly.
What if it turns out not to be pigmentation?
We tell you, and we refer you. That is a good outcome, not a wasted appointment.
Why does the mark look darker afterwards?
Because it is working. The pigment lifts towards the surface before it sheds. It settles over a week or two.