Pigmentation & Hyperpigmentation in Islington, London
Pigmentation & Hyperpigmentation Treatment in Islington – Understanding Causes & Treatment Options
Dark patches, uneven skin tone, stubborn discolouration can be caused by several distinct conditions, each with different causes, different biology, and critically different responses to treatment.
Getting the diagnosis right before anything else begins makes the difference between results that work or worse, a condition that comes back darker than it started.
Diagnosis before is the foundation of everything that follows.
Why Does Pigmentation Happen?
Skin colour in all its variation is produced by melanin, a pigment made by specialised cells called melanocytes, which sit in the deepest layer of the epidermis. Every skin tone has roughly the same number of melanocytes. What differs is how active they are and how much melanin they produce.
The enzyme at the centre of melanin production is called tyrosinase. It converts the amino acid tyrosine into the compounds that eventually become melanin either as eumelanin (brown-black pigment) or pheomelanin (red-yellow pigment).
Hyperpigmentation occurs when something stimulates melanocytes to produce excess melanin in particular areas. That trigger could be UV radiation, hormones, inflammation from a breakout or injury, or a combination of these. Each trigger produces a different pattern and a different type of pigmentation which means each type has a different treatment approach.
At Refind Aesthetics a consultation helps us understanding precisely what type of pigmentation is present before any treatment is discussed.
What Type of Pigmentation Do You Have?
Identifying the correct type is the non-negotiable first step. The main categories we treat at Refind Aesthetics are:
Solar lentigines (sun spots / age spots)
These are flat, well-defined dark spots with a clear border, typically on areas of chronic sun exposure such as the face, hands, forearms, décolletage. They appear from the thirties onward as cumulative UV exposure accumulates. Unlike freckles, they don't fade in winter because the melanocytes responsible have permanently reset to a higher baseline of production. Highly treatable with the right approach.
Melasma
These are Larger, irregular brown or grey-brown patches, typically symmetrical, across the cheeks, forehead, upper lip, or chin. They are closely tied to hormonal factors and pregnancy, the contraceptive pill, and HRT are the most common triggers. UV exposure (including visible light) worsens it. Melasma is a chronic, relapsing condition that can be effectively controlled, but it requires a different approach from other pigmentation types and long-term management rather than a one-off treatment.
Post-inflammatory hyperpigmentation (PIH)
These are the flat dark mark left after skin inflammation due to acne, eczema, an injury, or picking at a spot. The colour ranges from pink to brown to grey depending on skin tone and the depth of melanin deposition. PIH is particularly common in Fitzpatrick skin types III–VI. Epidermal PIH (brown tone) tends to respond well to treatment; dermal PIH (grey tone) is more persistent. The critical point is that many aggressive treatments cause their own inflammation which means in reactive skin types, this can worsen PIH rather than improve it.
Freckles (ephelides)
These are small, flat, scattered spots of concentrated melanin. They are genetically determined and primarily associated with fair skin. Unlike solar lentigines, freckles lighten in winter and darken with summer UV exposure. Many people are happy with their freckles but for clients who want to reduce them, the same approaches used for sun spots can apply but without strict daily SP, they will return.
Periorbital hyperpigmentation (dark circles)
Darkening around the eye can have several distinct causes: vascular (blood pooling showing through thin skin), structural (hollowing and shadow), or pigmentary (actual melanin deposition). Treatment depends on identifying the underlying cause. This concern is addressed in more detail on the dark circles page.
Why Skin Tone Affects Treatment
The Fitzpatrick scale classifies skin into six types based on how it responds to UV exposure and ranges from Type I (very fair, always burns) to Type VI (deeply pigmented, never burns).
Darker skin types (Fitzpatrick IV–VI) have more reactive melanocytes, which means they produce melanin more readily in response to any stimulus. This includes the stimulus of certain treatments. The same chemical peel or energy-based treatment that safely fades sunspots in lighter skin can cause significant post-inflammatory hyperpigmentation in darker skin, leaving a client with worse discolouration than they started with.
Dr Dana has specific clinical experience treating pigmentation across all Fitzpatrick skin types, including IV, V, and VI. Every protocol at Refind Aesthetics is selected and adjusted based on your individual skin type.
Why Diagnosis Before Treatment Matters
The most common cause of worsened pigmentation in aesthetic medicine is incorrect treatment applied without proper diagnosis. Three specific risks are worth understanding:
Melasma flared by heat-based treatments
IPL and certain laser wavelengths can produce an initial improvement in melasma followed by a severe rebound. The heat stimulus triggers widespread melanocyte activation that dramatically worsens the condition. Melasma requires melanin inhibition — not heat.
PIH from too-aggressive peels in darker skin
A peel appropriate for Fitzpatrick I–III can cause severe, prolonged post-inflammatory hyperpigmentation in Fitzpatrick IV–VI by triggering the very melanocyte overactivity it was meant to treat.
Misidentification of the lesion type
Not every dark spot is benign pigmentation. Seborrhoeic keratoses, dermatofibromas, and atypical melanocytic lesions can superficially resemble benign hyperpigmentation.
Any lesion that is raised, irregularly bordered, multicoloured, or changing should be medically assessed before cosmetic treatment.
Dr Dana's medical background means every pigmented lesion is evaluated, and any that raise clinical uncertainty will be referred for dermatological review before treatment proceeds.
Treatments Available at Refind Aesthetics
This Is a specialised depigmentation treatment that reduces excess melanin production at multiple stages of the pigmentation process. It is one of the most effective treatments for stubborn pigmentation and is combined with a pesonalised home skincare programme to maximise and maintain results.
Ideal for:
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Moderate to severe melasma
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Stubborn pigmentation
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Sun damage
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All skin types
Frequently Asked Questions
Results disclaimer
Results may vary between individuals. All treatments are subject to a consultation to confirm suitability. Refind Aesthetics does not guarantee specific outcomes.
Related Conditions
Age spots — causes and treatment in Islington
Redness & rosacea
Dark circles & tired eyes
North London Location
Refind Aesthetics is based in North London, conveniently located for clients in Angel, Highbury & Islington, Canonbury, Barnsbury, De Beauvoir, and Clerkenwell. Our clinic is designed to feel calm and welcoming, offering a refined space where patients feel at ease.