Hyperpigmentation is one of the most common and complex concerns we see at Dr Miriam A. It can appear as scattered sun spots, stubborn melasma, or the lingering shadow of a past breakout. While it’s tempting to focus only on what you can see, we’ve learned that these marks are rarely just a surface-level problem. 

For us, pigmentation is a signpost. It’s a reflection of what’s happening deeper within your skin and, often, your body. Key factors that influence pigment production include:

• Sun exposure
• Inflammation
• Hormonal fluctuations
• Nutrition and gut health
• Blood sugar balance

This is why our approach is always twofold. First, we treat the visible pigment. Then, we address the internal drivers causing it. This combination delivers superior, long-lasting results, not just fading existing marks but making their return far less likely.

We believe that a bespoke plan is the only way to achieve clear, even-toned skin. It all starts with an accurate diagnosis.

Step 1: Precision Topical Care to Treat Visible Pigmentation

Treating pigmentation isn’t a one-size-fits-all process. An incorrect treatment can worsen the condition, leading to what is known as rebound hyperpigmentation.

At Dr Miriam A, we begin by identifying the specific type of hyperpigmentation you have:

• Solar Lentigines (Sun Spots/Age Spots): Flat, well-defined brown marks from cumulative UV exposure.
• Post-Inflammatory Hyperpigmentation (PIH): Dark marks left after acne, injury, or inflammation, especially common in medium to deeper skin tones.
• Melasma: Symmetrical, patchy pigment strongly linked to hormones and aggravated by heat and sun.
• Freckles: Small, light-brown spots that darken with sun exposure.

Once diagnosed, your personalised topical plan will typically include a combination of the following:

1. Daily Sunscreen: A non-negotiable. Broad-spectrum SPF is essential every single day to prevent new pigment from forming and existing spots from darkening.

2. Tyrosinase Inhibitors: These are powerhouse ingredients that block the enzyme responsible for melanin production. We may recommend ingredients like hydroquinone, Vitamin C, cysteamine, or tranexamic acid.

3. Vitamin A (Retinoids): Clinically proven to accelerate skin cell turnover, helping to fade existing pigment and regulate its production over time.

For those needing to accelerate results, we may recommend targeted in-clinic treatments like CryoPen for isolated sun spots, microneedling with mesotherapy for diffuse pigment, or resurfacing peels for overall brightness.

Step 2: Supporting Your Skin from the Inside Out

Even the most effective topical regimen can be undermined by internal imbalances. This is where our in-house nutritionist, Jodie Abrahams, provides crucial support, addressing the root causes of stubborn pigmentation.

Some key areas of focus include:

• Targeted Nutrients & Antioxidants:

– Vitamins C, E, & Glutathione: A powerful trio that protects skin cells from oxidative stress, a known trigger for excess pigment.

– Folate & Vitamin B12: Deficiencies in these vitamins have been linked to disruptions in normal pigment cell function.

– Zinc: An essential mineral for skin healing, reducing inflammation, and maintaining a strong skin barrier.

• An Anti-Inflammatory Diet: We often recommend a Mediterranean-style way of eating, rich in colourful vegetables, fruits, nuts, seeds, extra virgin olive oil, and oily fish. This provides the antioxidants, healthy fats, and fibre needed for balanced melanin production.
• The Gut-Skin Axis: An imbalanced gut microbiome can drive systemic inflammation and disrupt hormones—both major players in pigmentation. We may suggest increasing fibre, adding fermented foods, or using a high-quality probiotic.
• Blood Sugar Balance: Blood sugar spikes can create oxidative stress and glycation, which are linked to pigmentation, especially hormonal melasma. We focus on building balanced meals with protein, healthy fats, and complex carbs.
• Strategic Supplementation: When needed, we may recommend targeted supplements such as full-spectrum antioxidants, omega-3s, N-Acetyl Cysteine (NAC), glutathione, or chromium for blood sugar support. 

By tackling hyperpigmentation from both angles, we create a powerful synergy. Topicals work from the outside to fade existing marks and protect the skin’s surface. Simultaneously, targeted nutrition and lifestyle changes work from the inside to calm inflammation, balance hormones, and reduce the oxidative stress that triggers pigment in the first place.

Your journey to clearer skin is unique. That’s why every plan we create is tailored to your skin, your health, and your lifestyle. The results you see in the mirror are built on a foundation of true internal health.

Are you ready to address your hyperpigmentation at its source? Book a comprehensive consultation with our experts to receive your personalised treatment plan.

Frequently Asked Questions (FAQ)