Graceful #007 -Pigmentation: Why It’s a Marathon, Not a Sprint
Pigmentation 101
I don’t think many of us would object to a cute scattering of freckles across the nose or a delicate Marilyn Monroe-style beauty mark but when dark spots and uneven patches of pigmentation crop up across the face (and body), they collectively bother us — and there’s actually a scientific reason why.
I’ve been on my own journey with pigmentation — melasma and post-inflammatory hyperpigmentation. It was at its worst after having 2 consecutive children during a pandemic and I’ll discuss below why it makes sense my skin didn’t love that for me. And while I’ve made progress over the years, and particularly during winter (see 2023), every summer it returns with heat and sun (see now: 2025 post-summer). In the clinic, it’s also one of the most common concerns I see, and it’s stubborn. The good news? With the right approach, pigmentation can be softened, controlled, and slowly managed over time but it’s not necessarily linear. Let’s get into the nitty gritty (today’s a juicy one so stick with me):
Fun Fact: I love a good primitive explanation; and this is one of them; our brains are wired to prefer an even ‘canvas’ from a reproductive perspective. Caveman instincts once linked skin irregularities with illness or age, so uneven tone still registers subconsciously as a marker of declining health and therefore less optimal as a reproductive partner(!). Women have had their confidence dented thanks to pigmentation for centuries and it continues to be a skin concern we find extremely hard to manage.
Why Pigmentation Happens:
Most of us know UV exposure is the main culprit, but it’s not the only trigger. Pigment (melanin) is produced by cells called melanocytes in response to stress — from sun, hormones, heat, inflammation, or injury. There are three forms:
Post-Inflammatory Hyperpigmentation (PIH): Dark marks left behind by acne, eczema, psoriasis, rashes, or even harsh treatments. Very common, especially in darker skin tones. One very good reason to not squeeze your own spots at home.
Sun Spots (Solar Lentigines): Flat brown patches from cumulative sun exposure. They’re essentially your skin’s ‘memory’ of summers past, created as a defensive shield against UV damage.
Melasma: Larger, often symmetrical brown or greyish patches linked to hormones, heat, and stress. Common after pregnancy, starting contraception, or during perimenopause/menopause. It’s chronic and notoriously stubborn — management is the goal, not a permanent cure.
Knowing what type you’re dealing with matters, because treatment approaches differ.
The Treatments, Ingredients & Steps That Can Make a Difference:
Think of pigmentation care as a ladder: start with gentle over the counter options, move to clinic-guided actives, and then prescription treatments if needed.
SPF is your foundation though — daily, year-round, even in Autumn/Winter as your preventative care.
Mineral sunscreens (zinc oxide, titanium dioxide) reflect UV and tend to suit sensitive skin.
Chemical sunscreens absorb UV and layer easily under makeup and often are easier to find a match with.
Pick what you’ll actually wear.
Tinted formulas give coverage and interestingly offer extra protection against visible and blue light from screens, which can contribute to pigmentation over time.
Step 1: The Everyday Brighteners (Over-the-Counter)
If you’re just beginning, these are widely available, well-researched, and safe for many skin types, but as with anything cadence, and combinations matter so do get a consultation.
Vitamin C – The classic antioxidant. It helps neutralise free radicals (caused by UV and pollution) while slowing melanin production, leaving skin brighter. Look for a stable serum in the morning, under SPF.
Azelaic Acid – A brilliant multitasker: it reduces pigmentation, calms inflammation, and is pregnancy and breastfeeding safe. Think of it as the gentle all-rounder.
Niacinamide – Great for anyone prone to sensitivity, this helps to strengthen the skin barrier while dialling down uneven tone. Also great for congestion and oil control.
Exfoliating Acids (AHAs like glycolic or lactic) – By increasing cell turnover, they help fade marks faster. Just don’t overdo it – 1–2 times per week is plenty for most, and I prefer using in the evening.
Step 2: The Next Level (Clinic-led / Advanced Skincare)
If you’ve got a little more commitment (and perhaps a clinic or practitioner you trust), these are the ingredients with strong clinical backing that can move results on further.
Retinoids (retinol, retinal) – These vitamin A derivatives encourage fresh skin to the surface, break down excess pigment, and boost collagen. Best introduced slowly at night, with SPF in the day.
Tranexamic Acid (topical, ~2–5%) – A star for melasma and stubborn pigmentation. It can be layered into most routines and is well tolerated across skin tones.
Kojic Acid - In order for melanin to form, it needs an enzyme called tyrosine. Kojic acid is effective at reducing the look of hyperpigmentation because it blocks the production of tyrosine. This means less melanin in the skin and less dark spots and patches on the surface.
Step 3: Prescription-Only (Dermatologist Guided)
Reserved for the most persistent cases, these should only ever be used under professional supervision.
Hydroquinone – Long considered the gold standard for lightening pigmentation. Often prescribed in cycles, sometimes in combination with a retinoid. It can be transformative, but must be monitored closely as overuse can cause side effects, and has pretty unfavourable research in mice; pre-cancerous cells formed with very high doses so my personal view would be to let this be a last resort (if at all).
Tretinoin – A prescription retinoid with decades of data. Not only does it improve pigmentation, but it also targets acne and fine lines, making it a real all-rounder. It won’t suit everyone as it’s a very strong topical Vitamin A (for some this is flaking skin, purge of acne, redness/irritation) so it’s no silver bullet but for many persistence wins, myself included (I used Dermatica for the last 4 years).
Prescription-Strength Azelaic Acid – Often prescribed for rosacea, but also very effective at calming inflammation and fading pigmentation. It’s a great option for sensitive or acne-prone skin that can’t tolerate harsher ingredients.
The framework in practice:
Start simple: SPF + Vitamin C + Azelaic Acid
Level up: Add in a retinoid or tranexamic acid serum if you’re not seeing enough results.
Go prescription: For stubborn, long-term pigmentation, speak to a dermatologist about prescription options for an extra nudge.
Professional Treatments: When to Step It Up
For stubborn or deep pigmentation, in-clinic options can accelerate results and complement topical solutions nicely to ensure you’re targeting your specific pigmentation from multiple angles — but they must be chosen carefully and under guidance from someone/a clinic you really trust and have treated skin similar to yours. Don’t be afraid to ask for before/afters, request consultations before committing to anything.
Chemical Peels: AHAs, BHAs, and enzyme peels gently resurface, lifting pigment and brightening. Professional-strength options can boost cell turnover and help fade superficial pigment while improving overall skin texture.
Microneedling (with actives): Creates microchannels to push pigment-inhibiting ingredients deeper, bonus points for collagen production and evens out texture.
IPL (Intense Pulsed Light) & BBL (Broadband Light not the butt kind) – Great for sun spots and uneven tone. These treatments work by targeting melanin in the skin, helping to break up pigmentation over time. For melanin rich skin tones, these are often exacerbating so honest, expert advice is paramount.
Laser Treatments – Different types of lasers (including some fractional lasers) can reach deeper pigment, often used for more stubborn cases like melasma or post-inflammatory pigmentation but often they are heat inducing which can worsen rather than treat. These need really careful handling (especially on darker skin tones) but, in the right hands, can deliver excellent results.
Oral Tranexamic Acid: A dermatologist-prescribed option showing good results in melasma, but not suitable for everyone (as medical risks apply).
The key is seeing a practitioner experienced with your skin tone and pigment type — used incorrectly, these treatments can make pigmentation worse.
TLDR: The key Pillars of Long-Term Management
Think of pigmentation as a long game — you don’t “cure” it, you manage it. Here are the pillars:
Protect: Daily broad-spectrum SPF, no exceptions. Even brief lapses invite pigment to return. Think about heat (saunas, warmer climates, exercise, hot showers etc) and shade protection like hats and clothing in this category too, particularly for melasma.
Brighten: Use topical solutions like vitamin C, and melanin inhibitors consistently (azelaic acid, kojic, tranexamic acid, or prescription options).
Renew: Support skin turnover with retinoids and gentle exfoliation.
Soothe: Keep inflammation low — hydrate, repair your barrier, avoid harsh scrubs or aggressive treatments that can backfire. Think about internally supporting inflammation too, lifestyle, diet, movement, gut support and lowering stress impact results hugely.
Boost (Intentionally): Periodic professional treatments can enhance results, but always as part of a layered, cautious plan.
Final Thoughts:
Pigmentation is usually and sadly a long-term companion. It can fade substantially, but it often returns with sun, hormones, or stress. The goal isn’t then in my opinion, perfection, it’s management. With smart layering of SPF, consistent use of actives, and occasional professional support, you can absolutely achieve clearer, brighter, more even-toned skin but it requires patience. Pigment management is cumulative — and the sooner you start (and prevent), the more powerful the results over time.
From My Desk This Week:
One product I’m loving: I saw this on sale on Amazon about 6 weeks ago, so I nabbed the Naturium Azelaic Acid to support my skin with my revived summer melasma, overall clarity and some pesky spots I often see the week before my period. This serum contains a high concentration of an azelaic acid complex, along with niacinamide, vitamin C to help improve the appearance of skin tone (all ingredients I listed for pigmentation support above), & for generally brighter-looking skin. It has hugely helped bring a calmness to my skin, it’s too early to comment regarding changes to pigmentation or melasma but I think it’s a lovely complement to the rest of my routine (I also cut out eggs on a gut feel that this might be exacerbating my hormonal spots, but I think this has hugely helped too). I have seen overall changes in brightness, tone and even a little texture of the skin (fewer bumps under the skin). As it’s also lightly exfoliating, it’s a really nice option for more sensitive skin if you’re not able to tolerate chemical exfoliants.
What I’m reading/listening to: I’m still slowly making my way through Matrescence (which I mentioned a few weeks back) and I’ve honestly never related to something on motherhood and postpartum quite so much — it’s a must-read if you’re in this stage of life. Next on my bedside table is The 5 AM Club by Robin Sharma. It’ll be my second time reading it, but I want to revisit it before the darker mornings set in and all attempts at early rising feel futile. Last summer I experimented with waking earlier, shifting my alarm by 10 minutes each day; but my children, who usually need their names called four times before responding, somehow tuned into my quiet descent downstairs and joined me. Needless to say, I gave up and decided we all needed the extra sleep for now. Still, I’m determined to try again — carving out space for some mindful movement and exercise in the mornings. If you’re craving a little “me time” before the day begins, this book is a great motivator. I’ll keep you posted on how it goes.
In the media: I’m not sure this story made it into the mainstream media, but it’s been doing the rounds on my social feeds — and it’s truly heartbreaking. A woman in US was left with severe burns and permanent facial scarring after receiving a chemical peel from a well-known ‘celebrity’ facialist. From what I understand, the treatment was carried out beyond the scope of what she was qualified to offer. This isn’t a story to spark fear of facials in general, but it is an important reminder: most facial practitioners are trained and licensed to work only at a superficial level. Anything deeper than that should only ever be performed by either someone with accredited training (you’re totally within your rights to ask about this btw) or a medical professional. (In the UK, regulations around this are thankfully under consultation to be stricter so it’s going to be easier to navigate). The takeaway: always check that your practitioner is trained, insured, and working within their scope; here I like to deep dive online, check reviews, and check they’re sharing their qualifications online; look for VTCT or CIBTAC in UK. And if something does go wrong, seek help from a qualified medical professional — never from the person who caused the damage. And if they try to charge you to ‘fix’ their mistake like in this case? Run.
Small shift to try this week: I did a small Q&A in my stories this week on autumn skin changes, so it’s a good time to think about how to proactively support your skin as the seasons shift. As the weather cools, lower humidity and indoor heating can leave skin feeling dry, sensitive, or dull. Seasonal skincare as we head into winter focuses on restoring hydration, repairing any summer sun damage (many practitioners call this ‘peel season’), and supporting the skin barrier with richer moisturisers, gentle exfoliation, and targeted treatments in clinic. The cooler months also make certain procedures safer to do, giving your skin a chance to refresh and recover before the next summer.
As always, I hope this helps us all navigate some popularised topics around ageing with intention and ease. I’d love to hear your questions or any topics you’d like me to break down in future newsletters.
With grace,
Charlie x
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