The Late Late Aesthetics Show, hosted by Vanessa Lana Brown (owner of VL Aesthetics in Carlisle), delivers expert insights and engaging discussions on all things skincare, aesthetics, and wellbeing.
Video Summary
Pigmentation is one of the most common yet misunderstood concerns in aesthetic medicine. Dark patches may appear after acne, become more noticeable during summer, emerge during pregnancy or seemingly develop without warning. What makes the problem particularly frustrating is that two people with similar-looking pigmentation can respond very differently to the same skincare product or treatment.
In an episode of the Late Late Aesthetic Show, Dr Tego, founder of Skin Menu and an aesthetic doctor with a specialist interest in skin health and pigmentation, explored why this happens and what an effective pigmentation strategy should actually look like. The discussion covered everything from melasma and post-inflammatory hyperpigmentation to sunscreen, retinoids, lasers, skin of colour and the skincare mistakes that can make pigmentation worse.
Pigmentation Is a Symptom, Not a Diagnosis
One of the most important distinctions is that “pigmentation” does not describe a single condition.
Pigmentation itself is completely normal. Melanocytes within the skin produce melanin, the pigment responsible for our natural skin colour. Hyperpigmentation occurs when certain areas produce or accumulate more melanin than the surrounding skin, creating patches or spots that appear darker than a person’s baseline complexion.
The challenge is determining why that excess pigment has appeared.
A dark patch could be related to inflammation, ultraviolet exposure, hormonal influences or another dermatological process. Treating every area of pigmentation in exactly the same way therefore makes little sense.
Depth matters too.
Pigment located mainly within the epidermis, the upper layer of the skin, may respond more readily to treatment. Pigmentation extending more deeply into the dermis can be considerably more difficult to reach.
That explains why correct diagnosis should come before choosing products, peels or lasers.
The Three Common Types of Hyperpigmentation
In an aesthetic clinic, three forms frequently dominate consultations.
Post-inflammatory hyperpigmentation
Post-inflammatory hyperpigmentation, often shortened to PIH, develops after inflammation or injury to the skin.
Acne is a classic example. The active spot may disappear, yet a brown or dark mark remains behind long afterwards.
PIH is particularly important when treating darker skin tones because melanocytes can respond strongly to inflammation. Irritating the skin in an attempt to remove the pigmentation can consequently create even more pigment.
Successful treatment therefore involves controlling the original inflammation while gradually encouraging the unwanted pigment to clear.
Melasma
Melasma is considerably more complex.
It commonly produces symmetrical patches of pigmentation on areas such as the cheeks, forehead and upper lip. Hormonal influences are strongly associated with the condition, which helps explain why melasma frequently becomes apparent during pregnancy or alongside hormonal medication.
Environmental factors also matter.
Sun exposure and heat can aggravate melasma, creating a combination of internal and external triggers.
Unlike a straightforward superficial dark mark, melasma should usually be regarded as a chronic, relapsing condition. Treatment may place it into remission and dramatically reduce its visibility, but that does not necessarily mean it has been permanently cured.
Sunspots
Sun-related pigmentation develops following accumulated ultraviolet exposure.
Importantly, pigmentation appearing today may reflect sun exposure from many years earlier. Skin imaging can sometimes reveal extensive underlying sun damage before all of it becomes visible at the surface.
This is one reason sun protection is not simply about avoiding a temporary tan or sunburn. It is also about reducing the cumulative changes that may become apparent later in life.
Why Pigmentation Becomes More Noticeable During Summer
Melanocytes respond to ultraviolet radiation by producing melanin.
As UV exposure increases during summer, melanocytes receive greater stimulation. Existing pigmentation can consequently darken, while previously subtle areas of sun damage may become easier to see.
Melasma introduces another complication: heat.
For somebody prone to melasma, spending prolonged periods becoming very hot may contribute to worsening pigmentation even when sunscreen is being worn.
This makes summer pigmentation management about more than applying SPF before leaving the house.
Hats, shade, avoiding prolonged deliberate tanning and keeping the skin cooler all form part of the strategy.
Can Existing Sun Damage Be Reversed?
Not necessarily in the literal sense.
Once significant pigmentary changes have developed beneath the skin, it may not be possible to remove every trace of them permanently. What can be changed is how those changes behave and how visible they eventually become.
Consistent protection from excessive UV exposure, together with an appropriate skincare routine, may help reduce further stimulation of pigment-producing cells.
The earlier good sun habits begin, the better.
Why Sunscreen Matters So Much
Ask almost any dermatologist or aesthetic doctor for the single most important skincare product and sunscreen is likely to appear near the top of the list.
There is a reason.
UV exposure does considerably more than contribute to pigmentation. It is also associated with damage to the structures responsible for maintaining the skin’s youthful appearance and, most importantly, contributes to the risk of skin cancer.
Someone can invest in sophisticated retinoids, antioxidants, peels and laser treatments, but allowing the skin to receive repeated uncontrolled UV exposure works against many of those interventions.
For pigmentation specifically, sunscreen is not an optional extra added at the end of a routine. It is part of the treatment itself.
Are You Applying Enough Sunscreen?
Application is where many people’s routines begin to fall apart.
During the discussion, Dr Tego recommended approximately two finger lengths of sunscreen for the face and stressed the importance of reapplication during prolonged daylight exposure.
Realistically, reapplying sunscreen can be inconvenient, particularly when someone is wearing makeup.
Sprays, mists, hats and other forms of physical sun protection may help, but none should become an excuse for inadequate initial application.
The wider lesson is simple: effective sun protection depends on behaviour, not merely owning a bottle of SPF.
Three Common Summer Skincare Mistakes
The conversation highlighted three particularly common mistakes.
Failing to use sunscreen consistently
Applying too little, missing areas of the face or failing to reapply when necessary reduces protection.
Stopping every active ingredient for summer
There is a widespread belief that ingredients such as retinoids, exfoliating acids and vitamin C must automatically disappear from a skincare routine as soon as summer arrives.
That is not necessarily the case.
A clinician may recommend adjusting frequency, changing when a product is applied or reducing its intensity, but completely abandoning a well-designed routine for several months may allow pigmentation to become harder to control.
Relying on SPF while deliberately overexposing the skin to the sun
Sunscreen is not permission to spend unlimited periods tanning.
Shade, hats, appropriate clothing and sensible exposure remain relevant.
For melasma-prone skin, avoiding excessive heat may be helpful as well.
Can You Have Lasers or Peels During Summer?
The answer is more nuanced than simply “yes” or “no.”
Certain clinics continue to perform treatments such as laser resurfacing, chemical peels and microneedling throughout the year. After all, people living in hot, sunny countries do not necessarily stop aesthetic treatments for an entire season.
What changes is the level of caution required.
The intensity of the procedure, the individual’s skin type, recent sun exposure and their willingness to follow aftercare instructions all matter.
Someone undergoing an aggressive resurfacing procedure cannot treat sun protection casually afterwards. Avoiding significant exposure before and after treatment may be necessary, alongside rigorous sunscreen use and physical protection.
A gentler treatment may carry very different considerations.
For some patients, postponing intensive procedures until autumn simply makes more practical sense because they would rather enjoy summer without strict restrictions.
Why Skin of Colour Requires a Different Approach
Historically, dermatology and aesthetic medicine have not always represented the full spectrum of skin tones adequately in clinical research and training.
That has consequences.
A practitioner treating darker skin must understand how melanocytes respond to inflammation and how particular devices or treatment parameters may influence the risk of additional hyperpigmentation.
Being excessively cautious creates another problem, however.
If practitioners are so concerned about causing pigmentation that they use ineffective treatment settings, patients may undergo repeated procedures without receiving meaningful results.
The goal is therefore not to avoid treating darker skin.
It is to understand it well enough to treat it safely and effectively.
Is Pigmentation Harder to Treat in Darker Skin?
Not automatically.
According to Dr Tego, one of the biggest misconceptions is that pigmentation in darker skin is inherently too difficult to treat.
It requires an informed approach.
For post-inflammatory hyperpigmentation, that might mean reducing inflammation, supporting the skin barrier, encouraging controlled skin-cell turnover and reducing excessive melanin production.
The critical word is controlled.
Over-exfoliating or repeatedly irritating pigmentation-prone skin can produce exactly the opposite of the desired result.
What Actually Works for Hyperpigmentation?
There is rarely a single miracle product.
Effective pigmentation routines usually attack the problem at several stages.
1. Protect the skin
Sunscreen reduces one of the major external signals that encourages pigment production.
2. Use antioxidants
Vitamin C is one of the most familiar examples.
Antioxidants are commonly incorporated into routines designed to protect the skin from environmental oxidative stress.
3. Encourage appropriate cell turnover
Retinoids and exfoliating ingredients can help address pigment within the upper layers of the skin.
The important consideration is avoiding excessive irritation. More aggressive treatment is not automatically more effective.
4. Target melanin production
Pigmentation routines may contain ingredients intended to interfere with pathways involved in excessive melanin production.
The discussion referenced ingredients such as arbutin, kojic acid and hydroquinone.
Hydroquinone in particular is an ingredient that should not be casually incorporated into an unsupervised routine simply because somebody has seen it recommended online.
5. Add professional treatments when appropriate
Once the daily routine is established, procedures such as chemical peels and lasers may be used to accelerate or enhance results in selected patients.
The treatment must still match the diagnosis, depth of pigment and skin type.
Your Home Routine Is the Foundation
One of the strongest messages from the discussion was that clinic treatments cannot compensate for an ineffective daily routine.
A laser appointment happens occasionally.
Your skincare touches your skin every day.
Someone spending significant amounts of money on professional pigmentation treatments while repeatedly exposing their skin to triggers or using an unsuitable routine at home may undermine their own results.
That does not mean everybody needs an elaborate 10-step routine.
Quite the opposite.
More Skincare Is Not Necessarily Better
Social media has helped make people more interested in skincare, but it has also encouraged increasingly complicated routines.
Layering numerous serums, acids, essences and active ingredients can become counterproductive.
When someone develops inflammation or a compromised skin barrier, stripping the routine back may sometimes improve the problem more effectively than adding another trending serum.
The skin is an organ with its own barrier, repair mechanisms and natural processes.
Skincare should support those functions rather than constantly overwhelm them.
How Long Does Pigmentation Take to Improve?
One of the most unrealistic expectations surrounding pigmentation is the belief that it should disappear within a few weeks.
Dr Tego tells patients to think in terms of approximately six to nine months when approaching more significant pigmentation concerns.
That period may involve consistent home skincare together with a course of professional treatments.
Some conditions can respond much faster.
A superficial sunspot in an appropriate lighter skin type treated with a suitable light-based device may improve relatively quickly. Melasma or post-inflammatory pigmentation in darker skin may require a much longer programme.
The important point is that pigmentation management should be viewed as a process rather than a one-off appointment.
Can Hyperpigmentation Disappear Completely?
Sometimes.
Superficial post-inflammatory hyperpigmentation confined largely to the epidermis may potentially clear extremely well.
Melasma is different.
Because melasma is chronic and can be influenced by ongoing internal factors, the realistic goal is often control or remission rather than guaranteeing that it will never return.
This distinction matters because it changes the patient’s expectations.
Successful treatment does not always mean permanently eliminating every pigment-producing trigger. It may mean achieving clear skin and then following a maintenance strategy designed to reduce recurrence.
What Can Be Done About Melasma During Pregnancy?
Pregnancy creates additional treatment limitations, making conservative management particularly important.
During the conversation, azelaic acid and diligent sun protection were highlighted as options frequently considered in pregnancy.
Tinted mineral sunscreen was also discussed because melasma may be influenced not only by ultraviolet radiation but by visible light.
Anyone who is pregnant should still check their skincare products and treatment plans with an appropriately qualified healthcare professional rather than assuming that every pigmentation ingredient is suitable.
Tinted Sunscreen Is About More Than Makeup Coverage
Tinted SPF is often treated as simply sunscreen with enough colour to replace foundation.
Its role in pigmentation can be more significant.
Tinted mineral sunscreens may contain pigments such as iron oxides that provide protection from wavelengths of visible light relevant to hyperpigmentation.
That distinction matters because not every product marketed as “tinted SPF” is formulated in the same way.
A conventional sunscreen with cosmetic foundation pigments added to it is not necessarily equivalent to a mineral formulation specifically designed to provide additional visible-light protection.
For somebody with stubborn melasma, the details of the formulation may therefore be particularly relevant.
Chemical vs Mineral Sunscreen
The difference primarily relates to the UV filters being used.
Mineral sunscreens typically rely on mineral UV filters, while so-called chemical or organic sunscreens use different UV-filtering compounds.
Modern formulations have blurred some of the simplistic claims traditionally made about one type merely “reflecting” UV while the other “absorbs” it.
In practice, product tolerability and whether somebody will consistently wear enough sunscreen are extremely important.
Chemical formulations often have cosmetically elegant options that work well across darker skin tones without leaving a noticeable white cast.
Mineral formulations may be particularly useful for people who prefer them or whose sensitive skin struggles with other sunscreen formulations.
If You Could Buy Only One Pigmentation Product
Assuming sunscreen is already being used correctly, Dr Tego’s choice was a good-quality retinoid.
Retinoids can support skin-cell turnover and are often incorporated into programmes targeting uneven tone alongside their better-known role in addressing signs of ageing.
But the sunscreen assumption is crucial.
A pigmentation routine containing sophisticated active ingredients without adequate UV protection is fundamentally incomplete.
Do You Need Brightening Products If You Have No Pigmentation?
Probably not.
Someone without hyperpigmentation does not necessarily need to add multiple pigment-suppressing ingredients purely because they are popular online.
A straightforward preventative routine built around antioxidant protection, an appropriate retinoid and sunscreen can already address many of the factors associated with future skin ageing and uneven tone.
Additional pigmentation-specific products can be introduced if a genuine concern develops.
The Biggest Waste of Money
According to the discussion, one of the easiest ways to waste money is repeatedly buying products that do not target the underlying problem.
A viral serum may feel exciting.
A 10-step routine may look impressive.
Neither guarantees that the biological pathway responsible for the pigmentation is actually being addressed.
The same principle applies to procedures. Paying for lasers or peels without having an appropriate home routine may produce disappointing or short-lived results.
Good pigmentation treatment is not about collecting products.
It is about using the right interventions for the right diagnosis.
Pigmentation Treatment Is Moving Towards Combination Therapy
One of the most promising developments in aesthetic medicine is the shift towards combining treatment modalities rather than expecting a single device or product to solve everything.
Different treatments work through different mechanisms.
When carefully combined, practitioners may be able to use individual modalities more conservatively while still creating a meaningful overall result.
This may prove particularly useful when treating patients whose skin requires tighter control over inflammation and treatment intensity.
Skincare formulations are evolving too, with newer products exploring peptides and other ingredients intended to target different stages of the pigmentation process.
The Most Common Pigmentation Myths
Several misconceptions appeared repeatedly throughout the conversation.
There is no single miracle serum that reliably removes every form of pigmentation.
More skincare does not automatically produce better skin.
Darker skin is not untreatable.
Professional procedures cannot compensate indefinitely for poor daily habits.
And sunscreen is not merely something to use on holiday.
Perhaps most importantly, someone else’s successful treatment is not proof that the same treatment is appropriate for you.
Two dark patches can look similar while having very different causes.
A Simple Approach to Pigmentation
For anyone overwhelmed by online advice, the overall message is refreshingly straightforward.
Start with the diagnosis.
Protect the skin consistently.
Use evidence-led active ingredients appropriate for the condition and skin type.
Avoid creating unnecessary inflammation.
Give the routine enough time to work.
Then introduce professional treatments when they have a clear purpose rather than because they happen to be trending.
Pigmentation frequently takes months rather than weeks to improve, and conditions such as melasma may require long-term maintenance. That can feel frustrating, but a carefully designed strategy is far more likely to succeed than constantly jumping between products.
The Most Important Perspective
The episode ended with a point that goes beyond skincare.
People often see their own pigmentation far more intensely than anybody else does.
That does not mean pigmentation cannot affect confidence or quality of life. For some people, it has a significant psychological impact and deserves to be treated seriously.
But mirrors, close-up phone cameras, selfies and video calls encourage us to examine our skin at a level of detail that other people rarely do.
Healthy skin does not mean perfectly uniform, filtered or texture-free skin.
The goal of effective pigmentation treatment should therefore be improvement, control and healthier skin — not an impossible standard of perfection.
