Pigmentation & Melasma Treatment in Maidenhead
Doctor-led treatment for pigmentation disorders including post-inflammatory hyperpigmentation (PIH), melasma, sun damage and age spots. We combine medical-grade chemical peels, advanced laser therapy, LED phototherapy and targeted skincare to reduce discolouration and restore a clearer, more even skin tone.
At Berkshire Aesthetics, pigmentation treatment is supervised by Dr Selena Langdon. Every treatment plan begins with a thorough clinical assessment of your pigmentation type, skin tone and medical history to ensure the safest and most effective approach. See our Acne & Scarring overview for a full guide to the conditions we treat within this service.
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Who is pigmentation treatment for?
Pigmentation treatment is suitable for patients experiencing visible discolouration of the skin caused by excess melanin production. This includes post-inflammatory hyperpigmentation (PIH) that develops after acne breakouts, injuries or inflammatory skin conditions, as well as melasma — a chronic, hormonally driven pigmentation condition that typically appears as symmetrical brown or greyish patches on the cheeks, forehead, upper lip and chin. We also treat sun damage, solar lentigines (age spots) and general uneven skin tone resulting from cumulative UV exposure or ageing.
Pigmentation concerns affect patients across all skin tones, though the type, severity and treatment approach differ significantly depending on your Fitzpatrick skin type. Patients with darker skin tones (Fitzpatrick types IV–VI) require particularly careful treatment selection, as certain modalities carry a higher risk of worsening pigmentation. A thorough clinical assessment ensures that the treatment plan is both safe and effective for your individual skin characteristics.
Understanding pigmentation: types and causes
Pigmentation disorders result from disruptions in the skin's melanin production. Melanin is the natural pigment produced by melanocyte cells in the epidermis that gives skin its colour and provides some protection against UV radiation. When melanocytes are stimulated by inflammation, hormones or UV exposure, they can overproduce melanin, leading to localised or widespread darkening of the skin. Understanding the specific type of pigmentation is essential for selecting the correct treatment, as different causes require fundamentally different approaches.
Post-Inflammatory Hyperpigmentation (PIH)
PIH occurs when skin inflammation triggers melanocytes to produce excess melanin at the site of injury or irritation. Common causes include acne lesions, eczema flares, cuts, burns, insect bites, and even aggressive cosmetic treatments. The resulting dark spots appear as flat brown, tan or dark patches directly at the site of the original inflammation. PIH is more common and often more persistent in patients with darker skin tones (Fitzpatrick types III–VI) because their melanocytes are naturally more reactive. Superficial PIH confined to the epidermis responds well to treatment, while dermal PIH (where pigment has dropped into the deeper dermis) can be significantly more challenging and slower to resolve.
Melasma
Melasma is a chronic pigmentation condition driven primarily by hormonal factors, although UV exposure and genetic predisposition also play significant roles. It presents as symmetrical brown or greyish-brown patches, typically on the cheeks, forehead, bridge of the nose, upper lip and chin. Melasma is far more common in women, particularly during or after pregnancy (chloasma or “mask of pregnancy”), during oral contraceptive use, or during hormone replacement therapy. Unlike PIH, melasma is not triggered by a single inflammatory event but is a chronic condition that tends to wax and wane. It requires ongoing management rather than a one-off treatment course, and aggressive treatments such as certain lasers can paradoxically worsen melasma by triggering a rebound melanin response.
Solar Lentigines (Sun Spots & Age Spots)
Solar lentigines are well-defined, flat brown spots caused by cumulative sun exposure over many years. They are most commonly found on sun-exposed areas including the face, backs of the hands, chest and shoulders. Unlike freckles, which fade without sun exposure, solar lentigines are permanent unless treated. They represent a localised increase in melanocyte number and melanin production in response to chronic UV damage. While benign, solar lentigines are a visible marker of photodamage and often motivate patients to seek treatment for a more even, rejuvenated complexion.
The Fitzpatrick skin type classification (types I–VI) plays a critical role in pigmentation treatment planning. Patients with higher Fitzpatrick types have more active melanocytes that respond more vigorously to stimulation, which means they are more susceptible to PIH and require gentler treatment protocols. Your doctor will assess your skin type during consultation and select treatment parameters that minimise the risk of post-treatment pigmentation changes.
Treatment options for pigmentation and melasma
Pigmentation treatment requires a targeted, multi-modal approach. The correct treatment depends on the type, depth and cause of your pigmentation, your Fitzpatrick skin type, and whether the condition is acute (such as recent PIH) or chronic (such as melasma). We use a combination of in-clinic treatments and prescribed medical skincare to achieve the best possible outcome.
Chemical Peels
Medical-grade chemical peels are a first-line treatment for most types of pigmentation. Glycolic acid peels promote rapid cell turnover and help shed pigmented surface cells. Lactic acid peels offer a gentler alternative suitable for sensitive or darker skin tones, while also providing hydrating benefits. TCA (trichloroacetic acid) peels penetrate more deeply and are used for more stubborn or resistant pigmentation. For melasma, modified Jessner's peels and carefully titrated glycolic peels are preferred because they deliver results without over-stimulating melanocytes. A course of 4–6 peels spaced 2–4 weeks apart is typically recommended, with ongoing maintenance peels to sustain results.
Learn more about chemical peelsAlma Hybrid CO2 Laser
Fractional CO2 laser resurfacing is effective for deeper, more stubborn pigmentation that has not responded to peels or topical treatments. The laser creates controlled micro-channels in the skin, removing pigmented tissue and stimulating collagen renewal from the dermis upward. This is particularly useful for solar lentigines, photodamage and deep dermal PIH. However, it is important to note that CO2 laser is generally not suitable for melasma. The thermal energy can stimulate melanocytes and trigger a rebound darkening that worsens the condition. Your doctor will advise whether laser is appropriate for your specific pigmentation type.
Learn more about Alma Hybrid CO2 laserDermalux LED Therapy
LED phototherapy provides gentle, anti-inflammatory support that complements other pigmentation treatments. Red and near-infrared wavelengths reduce inflammation in the skin, calm reactive melanocytes and accelerate post-treatment healing. LED therapy is particularly valuable as an adjunct to chemical peels, helping to reduce the risk of post-inflammatory pigmentation from the peel itself. It is safe for all skin types, requires no downtime and can be used during all phases of pigmentation management.
Learn more about Dermalux LEDHydraFacial with Brightening Boosters
HydraFacial treatment with targeted brightening boost serums provides a gentle but effective approach to improving skin tone and reducing superficial pigmentation. The treatment combines deep cleansing, gentle exfoliation and vortex extraction with the infusion of brightening actives including vitamin C and alpha arbutin. HydraFacial is well-suited to maintenance between more intensive treatments and can be performed regularly to sustain an even, luminous complexion. It is also an excellent option for patients who prefer non-invasive treatments or whose skin is too sensitive for chemical peels.
Learn more about HydraFacialMedical Skincare
A prescribed medical-grade skincare regimen is an essential foundation of any pigmentation treatment plan. Key active ingredients include vitamin C (a potent antioxidant that inhibits tyrosinase and brightens skin tone), retinoids (accelerate cell turnover and promote even pigment distribution), azelaic acid (anti-inflammatory with melanin-inhibiting properties, particularly effective for melasma), tranexamic acid (reduces melanin transfer and is increasingly recognised as a gold-standard topical for melasma management), and arbutin (a naturally derived tyrosinase inhibitor that lightens existing pigmentation). Daily broad-spectrum SPF 50 is non-negotiable — without rigorous sun protection, all other pigmentation treatments will be undermined by ongoing UV-driven melanin stimulation.
Treatment pathways
Your treatment pathway will be tailored to the type and severity of your pigmentation, your Fitzpatrick skin type and your treatment goals. Below are the key modalities we use, often in combination, to address pigmentation and melasma effectively.
Expected results
The speed and degree of improvement depend on the type, depth and cause of your pigmentation. Superficial epidermal pigmentation responds more quickly than deeper dermal pigmentation, and conditions like melasma require ongoing management rather than a single course of treatment.
Superficial PIH and recent post-acne dark marks often show visible improvement after the first 2–3 chemical peel sessions. Skin tone appears more even and the contrast between affected and surrounding skin begins to diminish.
Deeper pigmentation, solar lentigines and more established PIH require longer treatment courses. Progressive lightening is visible over 4–6 sessions, with full results becoming apparent as treated skin completes its renewal cycle.
Melasma is a chronic condition that requires long-term maintenance. Treatment can significantly reduce its appearance, but ongoing sun protection, prescribed skincare and periodic maintenance treatments are essential to prevent recurrence.
Your doctor will monitor your progress at follow-up appointments and adjust your treatment plan as your skin responds. Realistic expectations will be discussed during your consultation.
Risks and safety
Pigmentation treatment carries specific risks that require careful clinical management. The most significant risk is paradoxical worsening of pigmentation if the wrong treatment is selected for the patient's skin type or pigmentation type. This is why a thorough assessment by an experienced doctor is essential before any treatment begins.
Incorrect treatment selection can worsen pigmentation, particularly in patients with darker skin tones or melasma. Your doctor will assess your Fitzpatrick skin type and pigmentation type before recommending any treatment.
CO2 laser is generally not suitable for melasma. The thermal energy can trigger a rebound melanin response that darkens the condition. Laser treatment for pigmentation is reserved for appropriate candidates following clinical assessment.
Chemical peels may cause temporary redness, tingling and mild peeling for 1–5 days depending on depth. Stronger peels carry a higher risk of post-inflammatory pigmentation in darker skin tones and are used with caution.
Patch testing may be performed before certain treatments to assess your skin’s response and minimise the risk of adverse reactions.
Sun exposure during and after treatment can reactivate pigmentation and undermine results. Strict adherence to daily SPF 50 and sun avoidance is essential throughout your treatment course.
Certain medications, hormonal contraceptives and medical conditions can affect your suitability for pigmentation treatment. This is assessed during your consultation.
Aftercare
Proper aftercare is critical to the success of pigmentation treatment. Without consistent sun protection and adherence to your prescribed skincare regimen, treatment results can be compromised and pigmentation may return. Your doctor will provide detailed, personalised aftercare instructions at each stage of your treatment plan.
Pricing guidance
Treatment costs vary depending on the type and number of sessions recommended for your pigmentation concern, and whether combination treatments are required. We provide transparent, upfront pricing at your consultation so you can make an informed decision before proceeding.
A consultation fee applies and is credited toward treatment if you proceed within 28 days. Full details are available on our prices page and in our booking conditions.
Related concerns
Pigmentation is closely related to other skin concerns within our acne and scarring service. Explore these related topics for more information.
Why we start with a consultation
Every treatment begins with a medical assessment. We need to understand your medical history, current health, skin condition and concerns before prescribing any procedure. This protects your safety and ensures the treatment is clinically appropriate for you.
During your consultation, Dr Langdon will explain what the treatment can realistically achieve, any risks specific to you, and whether an alternative might be more appropriate.
All bookings are subject to our Booking Conditions.
Frequently Asked Questions: Pigmentation & Melasma
This content is for informational purposes only and does not constitute medical advice. Individual suitability for any treatment is assessed during a consultation. Always seek the guidance of a qualified medical professional with any questions regarding a medical condition or treatment.
- CQC registered clinic — regulated and inspected
- Doctor-led clinical oversight by Dr Selena Langdon (GMC 6159259)
- Complaints process and patient rights
Page last reviewed: February 2026
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