Pigmentation

 Understanding why it's there is how we help it fade

You tend to notice it most in natural light. A patch that's settled on one cheek, freckling spread across your nose and forehead, or a shadow that foundation never quite covers. For a lot of people it shows up after one too many summers. For others, it arrives with pregnancy or a change in medication, and the serums or treatments that promised to fade it either did nothing or made the whole thing worse.

Pigmentation is one of the most common reasons people come to see us, and one of the most misunderstood. It responds beautifully when you treat the right type the right way. It gets more stubborn, and sometimes worse, when you don't. So this is where we slow down and get it right.

What pigmentation is

Your skin makes a pigment called melanin. When something provokes it, usually sun, hormones or inflammation, certain cells produce too much in one area, and it settles as the patches, spots and uneven tone you can see. Treating the surface alone rarely holds because the underlying trigger is still switched on. That's why our approach looks at the cause as much as the colour.

The type you have matters

Pigmentation isn't one condition, and the kind you're dealing with changes everything about how we treat it:

• Sun-induced pigmentation: the spots, freckles and patches that build up over years of UV exposure, often across the cheeks, hands and décolletage

• Melasma: larger, often symmetrical patches driven by hormones and heat, common through pregnancy or with certain medications and the most stubborn type to treat

• Post-inflammatory pigmentation: the marks left behind after a breakout, a scratch or a reaction, more common and longer-lasting in deeper skin tones

How we treat pigmentation at With Grace

Everything starts with a proper skin consultation, where we identify your type of pigmentation, look at what's triggering it, and build a plan around your skin and your life. From there, your pathway might draw on:

Cosmelan depigmentation program
A professional in-clinic and at-home program for stubborn pigmentation and melasma, where considered treatment matters most.

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Laser treatments for pigmentation
Targeted laser to break down sun-induced pigmentation, matched carefully to your skin.

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Aerolase
A gentler laser that suits a wider range of skin tones and addresses pigmentation alongside redness.

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Bespoke facials
Treatments that support the barrier and calm the overproduction of pigment at its source.

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LED light therapy
To settle inflammation and support healthy skin function between treatments.

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Prescriptive homecare
The part people underestimate. Targeted ingredients and daily SPF do as much of the work as anything we do in the room.

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The right mix is yours alone. We'll never put you through more than your skin needs to get there.

What to expect

Pigmentation takes patience, and we'd rather you hear that from us now than feel let down later. Most people see real improvement over a few months of consistent treatment and homecare, with sun protection holding the results in place. Skip the SPF and pigmentation will always find its way back, so that part isn't negotiable. We'll set honest expectations for your specific skin at your first visit.

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Frequently asked questions

What causes pigmentation?
Pigmentation happens when your skin overproduces melanin in response to a trigger. The three big ones are sun exposure, hormonal changes such as pregnancy or contraception, and inflammation from conditions like acne or skin reactions. Most pigmentation involves more than one of these, which is why identifying the cause is the first thing we do.

What's the difference between sun spots, melasma and post-acne marks?
Sun spots are patches formed by UV exposure over time. Melasma is larger, often symmetrical, and heavily influenced by hormones and heat, which makes it more variable and harder to treat. Post-inflammatory pigmentation is the brown or grey mark left after a breakout or injury heals, and it's especially common in deeper skin tones. Each one responds differently, so they're worth distinguishing properly.

Can pigmentation be removed completely?
Some can be cleared and kept away with the right treatment and diligent sun protection. Melasma is the exception. It's a long-term condition we manage and soften rather than cure outright, because the hormonal and heat triggers behind it don't simply switch off. We'll be honest about which camp your pigmentation falls into.

Is a laser safe for melasma?
It can be, in the right hands. An aggressive or poorly chosen laser can exacerbate melasma and leave it worse than before. This is exactly why we identify melasma before treating it and often lead with gentler options rather than reaching for a laser first. 

Is treatment safe for darker skin tones?
Yes, with care and the right choices. Deeper skin tones are more prone to post-inflammatory hyperpigmentation, so some treatments should be approached more conservatively to avoid provoking the very thing we're treating. We tailor everything to your skin tone and history, and we'll always tell you if a treatment isn't right for you.

How long until I see results?
Most people notice gradual improvement over a few months rather than a few days. Sun-induced pigmentation often responds faster than melasma. Your therapist will give you a realistic timeline for your specific skin once they've seen it.

What's the most important thing I can do at home?
Wear a high SPF every single day, rain or shine, and reapply it. Sunlight and visible light are the biggest drivers of most pigmentation, and without daily protection, even the best in-clinic results will fade. We'll also prescribe targeted homecare to support the work we do together.

How much does pigmentation treatment cost?
It depends on the type of pigmentation and the pathway that suits it. We'll walk you through the options and the investment during your consultation, with no pressure to commit on the spot.