Not all pigmentation is the same.
Let’s talk about pigmentation - because lets face it, most of us have it. Whether its a few freckles, sun spots or darker patches, pigmentation is a common part of everyone’s skin story. It occurs when our pigment producing cells produce a little bit too much pigment, creating uneven patches or discolouration. It’s important to understand that not all pigmentation is the same.
Sunspots: little brown spots that are often found on the face, hands and shoulders, and they tend to go darker with more sun exposure.
Melasma: typically shows up as brown or grayish patches on the face, usually symmetrical on the cheeks, forehead and upper lip. It is often triggered by hormonal changes, like pregnancy or birth control but sun exposure and heat can worsen the condition.
Post-inflammatory Hyperpigmentation (PIH): this type of pigmentation appears after injury or inflammation which can be caused by acne, rashes or cuts. The skin darkens in response to the healing process, leaving a spot after the injury heals.
Freckles (Ephelides): these are typically genetic and are small tan to light brown spots that become more visible with sun exposure.
Pigmentation is the concern we are asked about most often, and it is the one where getting the diagnosis right matters most.
Sun damage, post-inflammatory marking, and melasma can all present as brown patches on a face. They have different causes, they sit at different depths, they respond to completely different treatments, and one of them can be made significantly and lastingly worse by a treatment that clears the other two beautifully.
That is not a detail. It is the whole thing.
So this page is going to spend more time than you might expect on telling the difference, because the single most common reason someone arrives here with worse pigmentation than they started with is that they were treated confidently for the wrong type.
Before we talk about treating pigmentation, we need to talk about checking it.
Australia has among the highest rates of melanoma and skin cancer in the world, and a page about brown marks on skin would be irresponsible if it did not say so plainly.
Please see a GP or have a skin check if any pigmented spot or mole is changing in size, shape, or colour; asymmetric, or has an irregular or poorly defined border; made up of more than one colour, or has an unusual colour; larger than about six millimetres, or growing; itching, bleeding, crusting, or not healing; new, and you are over about forty; or simply different to all your other spots.
That last one is worth taking seriously. A lesion that stands out from the rest of your pattern is worth showing to a doctor even if it breaks none of the other rules.
We are a medical-dermal clinic. We do not diagnose or treat skin cancer, and we do not remove moles. If we see anything at consultation that we are not completely comfortable with, we will tell you and we will send you for a skin check before we treat anything.
For skin checks we refer to Avatar Imaging in Toorak, a few minutes from us.
They combine a Vectra WB360 three-dimensional whole-body scan with dermoscopic imaging of individual spots, assessed by an accredited skin cancer doctor. The scan produces a detailed record of every visible mark on your skin, which means future checks are comparing against an actual baseline rather than someone's recollection. For anyone with a lot of moles, a family history, or fair sun-damaged skin, that record is worth a great deal.
You do not need a GP referral to book with them.
Avatar Imaging, Dr Michelle Pearse, B3, Level 1, Tok H Centre, 459 Toorak Road, Toorak. 1800 282 827. www.avatarimaging.com.au
If you would rather see your own GP or an existing skin cancer clinic, that is completely fine. What matters is that the check happens, not where.
If you have not had a full skin check, book one. It matters more than anything else on this page.
Pigment is produced by cells called melanocytes, which sit at the base of the epidermis. They manufacture melanin inside small packages and hand those packages to the surrounding skin cells, which carry the pigment upward as they rise toward the surface.
This system exists to protect you. Melanin absorbs UV and shields the DNA in the cells underneath. Pigmentation, in other words, is not a malfunction. It is a defence mechanism that has been switched on too hard, for too long, or in the wrong place.
Several things switch it on. Ultraviolet light, the main driver, and the one most people already know about. Visible light, less well known and genuinely important, particularly in melasma and in deeper skin tones. Ordinary daylight in the visible spectrum stimulates pigment production, which is why a conventional clear sunscreen can be insufficient on its own for some conditions. Heat, also underappreciated. Infrared and heat exposure can stimulate pigment independently of UV, which has practical consequences for saunas, hot yoga, cooking over a stove, and long hot showers. Inflammation, since any inflammatory event in the skin can trigger pigment production as part of the healing response, such as acne, eczema, an injury, an insect bite, a reaction, or an overly aggressive treatment. Hormones, since oestrogen and progesterone influence melanocyte activity, which is why pregnancy, hormonal contraception, and hormone therapy are so often part of the melasma story. And genetics, since some people are simply more prone to it, and it frequently runs in families.
Two things follow from this that shape everything we do. Pigment can sit at different depths, and depth determines what is realistically achievable. And in almost every case, the thing that turned it on is still there, which is why sun protection is not the aftercare. It is the treatment.
Pigment sitting in the epidermis, near the surface, is comparatively accessible. It responds to topical treatment, to resurfacing, and to light-based treatment, and it can improve substantially.
Pigment sitting in the dermis, deeper down, is a different proposition. It is far more resistant, it responds slowly and partially, and no amount of enthusiasm changes that. Some dermal pigment can be improved. Very little of it disappears.
Most people have a mixture of both.
This is precisely why we assess with a Wood's lamp. Under its UV light, epidermal pigment becomes more sharply defined and more obvious, while dermal pigment does not. It is one of the fastest ways to get a realistic sense of what is sitting where, and therefore what we can honestly promise you.
We would rather tell you at consultation that you are likely to get a sixty percent improvement than sell you a course on the promise of a hundred and have you disappointed at the end of it.
Discrete, well-defined tan to brown patches on areas that have taken years of sun. Face, hands, forearms, chest, shoulders, upper back.
These are cumulative UV damage made visible. They tend to appear from the thirties onward, they do not fade in winter, and they are largely stable rather than fluctuating.
Of all the pigmentation we treat, these respond the best and the fastest. They are the ideal target for light-based treatment.
Small, scattered, genetically determined, and UV-responsive. They darken with sun exposure and lighten in winter, and they usually appear in childhood.
Freckles are not damage and they do not need treating. Some people want them reduced, which is reasonable, but we will not pretend they are a health concern.
Flat brown, grey, or deeper marks left behind after something inflamed the skin. Acne is the most common cause. So are eczema, injuries, ingrown hairs, reactions, and treatments that were too strong.
The key feature is that these marks sit exactly where the original inflammation was. They fade, but slowly, and the timeline is measured in months rather than weeks. They are considerably more common, more intense, and more persistent in olive and deeper skin tones.
The most important thing about post-inflammatory pigmentation is that treating the mark without controlling the cause is pointless. If you still have active acne, we treat the acne first.
Redness and brown mottling across the sides of the neck and the upper chest, characteristically sparing the shaded area under the chin. That sparing is the giveaway, and it tells you exactly what caused it.
This is combined vascular and pigmentary sun damage, and it responds well to light-based treatment, although the neck and chest are more delicate than the face and require more conservative settings.
Genuinely multifactorial and frequently misunderstood. What looks like pigment under the eyes may be true pigment, or visible blood vessels through thin skin, or a structural shadow cast by the underlying anatomy, or a combination of all three.
Only one of those is a pigmentation problem. Treating a shadow with a brightening cream will not work, and no one should be selling you a course of anything until it has been established which you actually have.
Melasma is the last type, and it has its own section below, because it behaves differently to everything above.
Melasma appears as symmetrical brown or grey-brown patches, most often across the cheekbones, forehead, upper lip, and jawline. It is far more common in women, it typically begins between the twenties and forties, and it is more prevalent in olive, Mediterranean, Asian, Latin, and deeper skin tones.
It is the most challenging pigmentation condition we treat, and there are specific reasons why.
It is not only a melanocyte problem. Research over the past decade has made it clear that melasma involves considerably more than overactive pigment cells. There is a vascular component, with increased blood vessel activity in affected skin. The basement membrane, the layer separating epidermis from dermis, is often damaged, which allows pigment to drop deeper where it becomes far harder to address. Surrounding cells appear to behave abnormally and continue signalling the melanocytes to produce.
This is why melasma recurs. You are not treating a stain. You are treating a skin that is actively, continuously making one.
It is driven by three things, not one. UV, visible light, and heat. Most people know about the first. Very few know about the other two, and it explains a great deal of frustration. Sitting near a window, working under bright light, cooking, exercising in heat, and hot showers can all contribute.
It is hormonally influenced. Pregnancy, hormonal contraception, and hormone therapy are common triggers. It sometimes resolves after pregnancy and often does not. Thyroid dysfunction is associated in some people.
It fluctuates. Melasma has good months and bad months, and it worsens through summer almost universally. This makes self-assessment unreliable and makes photographic tracking under consistent conditions genuinely useful.
Melasma cannot be cured. It can be improved substantially, and it can be held there with maintenance and disciplined sun protection.
What we aim for is meaningful lightening, a longer gap between flares, and a plan you can sustain. What we will not do is tell you it will be gone.
Anyone who promises to clear your melasma permanently is either misinformed or selling something. This is a chronic, relapsing condition and honest expectation-setting at the start is the difference between a patient who is pleased with a good result and one who feels let down by the same result.
Pigment cells carry receptors for oestrogen and progesterone. That single fact explains a great deal about why pigmentation behaves the way it does across a life, and why it so often arrives at particular moments rather than gradually.
If your pigmentation appeared or changed around a hormonal event, that is not coincidence and it is not something you did.
Combined hormonal contraception is one of the most common triggers for melasma we see. It can appear within months of starting, or years later, which is part of why people rarely make the connection themselves.
Some people find their pigment improves after stopping. Many find it does not, because by then the pattern is established and UV and heat are keeping it going independently.
We want to be clear about the boundary here. We will raise the association with you if it seems relevant. We will not advise you to stop or change your contraception, because that is a decision for you and your GP, weighing considerations that have nothing to do with your face.
Melasma appears or worsens in pregnancy commonly enough that it was historically called the mask of pregnancy.
Oestrogen, progesterone, and melanocyte-stimulating hormone all rise, and melanocytes respond. It typically shows up in the second or third trimester, usually across the cheeks, forehead, and upper lip, and it often arrives alongside other pigmentary changes: a darkened line down the abdomen, darker areolae, and deepening of existing marks and freckles.
Two frustrating truths about this timing. It may fade after delivery, but frequently not completely, and the residual pigment can be more dermal and therefore harder to treat than what came before. And it recurs in subsequent pregnancies, often more strongly.
Meanwhile, most of what we would normally reach for is unavailable. Retinoids are contraindicated. Several actives are unsuitable. Stronger peels and IPL are off the table.
So what we build in pregnancy is a holding plan rather than a corrective one. Rigorous sun protection, ideally tinted mineral. Attention to heat, which matters more than people realise when you are already running warm. Pregnancy-appropriate actives, with azelaic acid usually the most useful thing available to us. LED and enzyme treatments in clinic.
The aim is to limit how much pigment forms in the first place, because preventing it is considerably easier than removing it later.
Pigment often improves in the months after delivery as hormones settle. Often, not always, and rarely completely.
This is also the point at which most people want it dealt with urgently, and it is close to the worst time to be aggressive. Hormones are still shifting, sleep is broken, cortisol is high, and skin does not tolerate or heal the way it will in six months.
Some options remain limited while breastfeeding. Where the corrective phase involves anything stronger, we would generally rather wait until you have finished, or at least until things have stabilised, and use the interval to protect what you have and prevent more.
We know that is not what anyone wants to hear at four months postpartum. It is what produces the better result.
This is the phase nobody warns people about, and it is genuinely difficult.
Oestrogen in perimenopause does not decline smoothly. It fluctuates erratically, sometimes to levels higher than in your thirties, before falling. That instability can cause melasma to appear for the first time in someone who has never had it, or to flare unpredictably in someone who thought it had settled years ago.
At the same time, the skin you are treating it in has changed. Barrier function declines, dryness and reactivity increase, healing slows, and collagen loss accelerates. So the pigment is more active in skin that tolerates less than it used to, which narrows the options considerably.
And there is a factor that almost never gets mentioned. Heat stimulates pigment production independently of UV. Hot flushes are heat. Repeated vasomotor flushing through the day is a genuine pigmentary consideration, not just an uncomfortable symptom, and it is worth raising with your GP as part of a broader conversation rather than treating as separate from your skin.
Practically, perimenopause is a phase for gentler actives, slower progression, considerably more attention to barrier support, and patience. Aggressive correction in reactive skin at this stage tends to produce more pigment, not less.
Once oestrogen is low and stable, melasma frequently improves or at least stops surprising you.
What tends to take over is a different problem entirely: solar lentigines and mottled sun damage accumulated across decades, now surfacing. These are more discrete, more stable, and considerably more treatable than melasma, and this is often the point at which light-based treatment becomes genuinely useful for someone who could never have had it before.
One thing worth knowing. Menopausal hormone therapy can reactivate melasma in people who have had it previously, and can occasionally trigger it in those who have not. If your pigmentation changed after starting hormone therapy, mention it. There are usually options, and it is a conversation for your prescribing doctor rather than a reason to abandon treatment that is helping you in other ways.
There is a recognised association between thyroid dysfunction and melasma. If your pigmentation is stubborn and you also have fatigue, temperature intolerance, weight change, or menstrual irregularity, that is worth raising with your GP for review.
We do not order or interpret those tests. We do notice patterns and suggest you ask.
This deserves saying directly, because it is often glossed over.
The more melanin your skin contains, the more readily it responds to injury by producing pigment. That is the same protective mechanism described earlier, and it means that in olive and deeper skin tones, the treatment itself carries a real risk of causing the exact problem you came in to fix.
A peel that is well tolerated on fair skin can leave post-inflammatory pigmentation on deeper skin. Light-based treatment carries higher risk. Aggressive resurfacing carries higher risk again.
This does not mean deeper skin tones cannot be treated. It means the approach has to be different: gentler actives, longer preparation before any procedure, conservative settings, slower progression, and considerably more caution about heat and inflammation. Mandelic and lactic acids are frequently preferred over stronger options for this reason.
If you have been offered the same protocol that was described to a fair-skinned friend, ask why.
People here underestimate their exposure, consistently.
Melbourne's UV index reaches damaging levels for a substantial part of the year, and UV is not related to temperature or to whether the sun feels warm. A cool, overcast December day will still burn you. Cloud cover reduces UV far less than people assume.
The bigger issue is incidental exposure. The drive to work, the walk to the tram, lunch outside, the school pick-up. Almost nobody applies sunscreen for those, and cumulatively they account for a large proportion of the damage we treat.
Winter brings a different problem, which is complacency. Pigmentation improves slightly over winter, people conclude it is resolving, they relax their routine, and it returns with the first stretch of summer.
The practical consequence is that the corrective phase of pigmentation treatment is best run through the cooler months, with summer used for protection and maintenance.
We are a medical-dermal clinic. Caitlin is a Registered Nurse with ten years in cosmetic medicine, Belinda is our Senior Dermal Clinician with around ten years of industry experience, and the whole team works to a shared philosophy: assess first, treat conservatively, sequence with intent, and never do more to the skin than it can handle.
In pigmentation that philosophy is not a preference. Inflammation causes pigment. Any treatment that inflames the skin more than it needs to is working against itself, and the harder path is very often the slower one.
Our approach has four parts. Establish what type of pigment you have and how deep it sits. Remove or control whatever is still driving it. Reduce the pigment already there. Then protect the result, permanently.
Home care carries more weight in pigmentation than in almost anything else we treat, because the driver is daily and so is the defence.
We want to be clear about something before we go any further. What follows is not a list for you to shop from.
Pigmentation skincare is not a pick and mix, and this is a condition where the wrong choice does more than fail. Aggressive actives applied to melasma or to deeper skin tones can provoke inflammation and leave you with more pigment than you started with. We see this regularly, and it is almost always the result of a well-intentioned routine assembled from good products chosen for the wrong condition.
The most reliable way to treat pigmentation properly is to come in and be assessed. It is also, for most people, the least expensive route in the end.
In clinic we look at your skin in person and in real time, which is something no online tool or phone camera can do.
We use a Wood's lamp, a specialised UV light that separates epidermal pigment from dermal pigment and reveals distribution that is invisible under normal light, including damage that has not yet surfaced. In pigmentation this is the single most useful diagnostic step available to us, because it determines what is realistically achievable before we promise you anything.
We use a dermatoscope to examine individual lesions under magnification, assess pigment network and pattern, and identify anything that needs a doctor rather than us.
Then we apply experience to what we are seeing. Our Dermal Clinicians hold a Bachelor of Dermal Science and bring over a decade of hands-on work with skin. That combination, a proper diagnostic view of your skin plus someone who has treated thousands of variations of it, is what a search bar cannot replicate.
We are putting this before everything else because it is the single most important thing on this page.
Every treatment we perform for pigmentation is undone by unprotected exposure. Not slowed. Undone. There is no product, peel, or device that outpaces daily UV, and a patient who treats diligently and protects casually will spend a great deal of money standing still.
For pigmentation, and for melasma in particular, we generally recommend a tinted mineral sunscreen. The iron oxides that provide the tint also block visible light, which conventional clear sunscreens largely do not. This is one of the few genuinely evidence-supported refinements in melasma care and it costs nothing extra to implement.
Applied every morning, reapplied when you are outdoors, and worn in winter. Yes, in winter.
We retail from professional ranges, primarily Dermaceutic and iS Clinical. Both are formulated for clinical use and backed by real research rather than marketing.
We prescribe from these ranges rather than handing you a list. Pigment routines are built in stages, and in melasma or deeper skin tones we build slowly, because provoking the skin is the one thing we cannot afford to do.
What you end up with depends on what we find. It will generally involve something that interrupts pigment production, something that supports cell turnover, antioxidant protection, and sun protection. Tranexamic acid, niacinamide, azelaic acid, vitamin C, and retinoids all have a place depending on the picture. Which ones, at what strength, and in what order is the decision we make with your skin in front of us.
A word on prescription options. Some of the most effective topical treatments for melasma require a doctor's prescription, and we do not prescribe. Where that is the right path for you, we will say so and help you get there.
Vitamin C does three separate jobs in a pigmentation routine, and most people only know about one of them.
It is a tyrosinase inhibitor, meaning it interrupts the enzyme that produces melanin in the first place. It is a potent antioxidant, neutralising the free radical damage from UV and pollution that drives pigment formation before it starts. And it supports collagen synthesis, which matters because the sun damage causing your pigment has usually damaged the underlying structure too.
That is why it sits in almost every pigmentation routine we build. It is also why we carry several formulations rather than one, because the right vitamin C for inflamed acne-prone skin is not the right vitamin C for sun-damaged skin in its fifties.
iS Clinical Super Serum Advance+. Fifteen percent L-ascorbic acid combined with a bioidentical copper tripeptide growth factor, alongside arbutin and kojic acid. What makes this one useful for pigment specifically is that it attacks the problem from more than one direction: the ascorbic acid inhibits tyrosinase, the arbutin and kojic acid inhibit it again by different mechanisms, and the copper tripeptide supports repair and remodelling underneath. Our most-reached-for serum where pigmentation sits alongside general skin quality and scarring.
iS Clinical Pro-Heal Serum Advance+. L-ascorbic acid at a gentler concentration, combined with olive leaf extract and pure vitamins E and A. This is the calming option, built for compromised, reactive, blemish-prone skin and for use after procedures. Where someone has post-inflammatory pigmentation from active acne, or a barrier that has been pushed too hard, this is frequently the more appropriate choice, because a stronger formulation that causes irritation will generate more pigment than it clears.
Dermaceutic Tri Vita C30. Thirty percent total vitamin C in three distinct forms, which is the point of it. Fifteen percent L-ascorbic acid working at the surface, fourteen and a half percent ascorbyl silanol penetrating deeper, and half a percent ascorbyl ester for sustained release. Stabilised with vitamin E ester and ferulic acid ester, which both extend its life in the bottle and enhance its photoprotective effect.
The multi-depth delivery is what makes it interesting for pigmentation, because pigment does not sit at a single level. Note that it suits most skin but not the very sensitive, and it is one we introduce carefully.
Dermaceutic C25 Cream. A cream-format antioxidant concentrate, which suits skin that finds a high-strength serum too much, or anyone who prefers their antioxidant step to double as moisturiser.
Alongside these, both ranges carry dedicated pigment-targeted products working through different mechanisms again, and post-procedure formulations designed to support the skin through recovery. Which combination you end up with depends on your pigment type, your barrier, your tolerance, and what else is in your routine.
Beyond the serums, the iS Clinical range extends considerably further, and for pigmentation specifically the dedicated brightening products often matter more than the vitamin C itself. iS Clinical Brightening Serum and Brightening Complex are built around pigment inhibition rather than antioxidant protection, targeting the melanin pathway directly. They are designed to sit alongside your vitamin C rather than replace it, because the two are doing different jobs at different points in the same process.
On the data. A well-cited trial found that five percent topical vitamin C used consistently over six months produced measurable improvement in photodamaged skin, assessed both at the surface and in the deeper structural layers. That is a meaningful finding, and it is also a six-month finding. Nobody in that study saw much at week three. We include figures like this because you deserve to know what is actually established rather than what is claimed. They are not a prediction of your individual result.
Two practical notes. Vitamin C is not a substitute for sunscreen, and it never has been. What good evidence supports is that vitamin C used alongside vitamin E and ferulic acid measurably boosts the photoprotection your sunscreen provides. And more is not automatically better. Skin saturates. Once it has absorbed what it can hold, a higher percentage adds irritation rather than benefit, and irritation in a pigmentation patient produces exactly the outcome we are trying to avoid.
Over-exfoliating, layering multiple strong actives, scrubs, picking, and anything that reliably leaves your skin red.
Also, and we mean this seriously: stop buying skin-lightening products online from unregulated sources. Imported creams marketed for brightening have repeatedly been found to contain undisclosed and unsafe ingredients, including potent steroids and mercury. Prolonged misuse of high-strength pigment inhibitors can also cause a paradoxical darkening that is extremely difficult to reverse.
If you have been using something you are not certain about, bring it in. No judgement. We would much rather look at it than have you continue.
Every treatment below is selected during consultation, not from a menu. In pigmentation, what we choose not to do matters as much as what we do.
Our peel work runs across three levels, and behind those levels sits a considerable inventory. We stock professional ranges from PCA Skin, Dermaceutic, Toskani, Société, Cosmedix and Mesoestetic, alongside compounded mono peels formulated to concentration.
That range exists for one reason. Pigment is not one problem, and a clinic holding two or three peels will inevitably fit your skin to what is on the shelf. We would rather select the formulation to the pigment.
Level One, from $259. Our gentlest tier and the right starting point for most people. Enzyme and lactic-based work including the PCA Enzymatic and No Peel Peel, the Dermaceutic Milk Peel, the Société Açaí Berry lactic peel, the Cosmedix Blueberry Smoothie, and Toskani's Radiance and Mandesome Duosome peels, alongside mandelic and lactic acid mono peels.
Mandelic deserves a specific mention here. Its larger molecular size means it penetrates more slowly and evenly, which makes it one of the more reliable options for pigment in olive and deeper skin tones where the risk of provoking inflammation is the central concern.
Level Two, from $279. Active corrective work. This tier includes the PCA Pigment Correcting peel, Dermaceutic's Crystal Peel and Cosmo Peel, the Toskani Clarifying Booster, Cosmedix Timeless, glycolic and photo-ageing formulations, and retinol-based peels. This is where most established epidermal pigment is addressed, and where a properly prepared skin starts to show real change.
Level Three, from $299. Advanced corrective. Modified and enhanced Jessner formulations including the Mesoestetic Meso Jessner and PCA's hydroquinone-free Enhanced Jessner's, the Toskani Rejuvenating peel, Dermaceutic Cosmo Peel Forte and Exo Peel, TCA at twenty percent and above, and Cosmelan.
Cosmelan warrants its own explanation, because it is not a conventional peel. It is a depigmenting protocol rather than a single treatment, combining an in-clinic mask with a structured home regime over several months, and it is one of the more intensive options available for stubborn pigment. It requires genuine commitment, careful patient selection, and a full discussion of what it involves before anyone starts. We do not sell it casually.
Level Three always requires skin preparation beforehand. Nothing at this depth touches your skin before it is ready, and in pigmentation that preparation is not a formality. Treating unprepared skin at depth is one of the more reliable ways to produce more pigment than you started with.
On melasma specifically. Peels can help melasma and peels can worsen it, and the difference lies in depth, preparation and selection. We work conservatively here by choice, generally in the lower tiers, progressing only when the skin has demonstrated it can tolerate more. Level Three is rarely the right answer for melasma. If it is offered to you as a first-line solution, get a second opinion.
Skin needling creates controlled micro-channels that trigger the skin's own repair and collagen response. Those same channels also allow us to deliver targeted actives far more effectively than topical application alone, and in pigmentation that second mechanism is where most of the value sits.
We run this across two tiers. Tier One pairs the needling treatment with an LED or peel selected for your skin on the day, using a hyaluronic acid glide for comfort throughout, plus post-care products to take home so the skin is supported through recovery. Tier Two builds on that with a medical booster infusion, formulated to your presenting concern rather than drawn from a single generic serum.
For pigmentation, the actives we most often reach for are tranexamic acid, which acts on the signalling pathways driving pigment production rather than simply bleaching what is already there, and which has become one of the more useful tools available for melasma specifically. Ascorbic acid, for antioxidant protection and tyrosinase inhibition delivered directly rather than through the barrier. Niacinamide, which interrupts the transfer of pigment from melanocytes to surrounding skin cells, a different point in the pathway again. And glutathione, for its role in shifting melanin synthesis toward the lighter pigment pathway.
Depending on what else your skin needs, an infusion may also include polynucleotides for regenerative repair and skin quality, biostimulatory actives for structural support, hyaluronic acid for hydration, peptides and growth factors to support collagen synthesis, and amino acids and targeted skin vitamins. Each of these is selected and combined intentionally, never at random.
Two honest notes. We do not needle over active inflammation, because inflammation produces pigment and we would be working against ourselves. And in melasma we are careful with frequency, because over-treatment provokes rather than resolves. More is not faster here.
We use the Lumenis M22 Stella with XPL, one of the first of these systems in Australia, and for the right kind of pigmentation it is the most effective thing we own.
How it works. Light at selected wavelengths is absorbed preferentially by melanin. The pigment absorbs the energy, heats, and fragments. Over the following one to two weeks the treated pigment darkens, rises to the surface, takes on a characteristic coffee-ground appearance, and flakes away. The surrounding skin is left intact throughout.
That mechanism is why IPL outperforms topical treatment so decisively on the right target. A tyrosinase inhibitor slows new pigment production. It does not remove a lentigo that has been sitting there for fifteen years.
Where IPL excels. Solar lentigines and sun spots. Diffuse photodamage across the face, décolletage, hands and forearms. Freckling, where someone wants it reduced. And the mottled combination of redness and brown on the neck and chest that we call poikiloderma, where the same device addresses both components in one treatment.
Our IPL work is matched to three concern categories: pigmentation, acne, and redness with rosacea and vascular concerns. This page deals with the first, though a great many people have more than one and the device handles them together.
What to expect. Most people describe the sensation as a brief snap of heat with each pulse. Treated spots darken noticeably before they clear, and that darkening is the treatment working rather than a problem. Expect around seven to fourteen days for that pigment to lift and flake, longer on the body than the face. Sun avoidance afterwards is not negotiable.
Typically three to four sessions spaced three to four weeks apart, then maintenance. For discrete sun spots on suitable skin, the change can be dramatic and it can be fast.
Where we will not use it. Melasma, in most cases. This is the most important paragraph on the page. IPL and similar light-based treatments can make melasma significantly and lastingly worse. The heat involved stimulates the very pathways that drive the condition, and while the pigment frequently lifts at first, it often returns darker and more entrenched within weeks to months. Once that has happened it is considerably harder to treat than it was before.
Melasma is treated with IPL in Melbourne every week, usually with genuine good intentions, and we see the results of it.
There are narrow circumstances where light-based treatment has a place in a melasma plan, in carefully selected patients, at conservative settings, alongside everything else. That is a specific clinical judgement made after full assessment, not a default.
A patch test and full consultation are required for all IPL. It is not suitable for every skin type, and recent sun exposure rules it out entirely.
We are adding fractional CO2 resurfacing to the clinic.
The DEKA Tetra Pro is a CO2 platform capable of working across a genuine range of depths, and it brings with it the CoolPeel protocol. CoolPeel delivers CO2 energy in extremely short pulses, so the tissue is resurfaced without heat accumulating in the surrounding skin. That distinction matters, because the historical trade-off with CO2 has always been results against downtime.
For pigmentation, this fills a specific gap. Where the concern is stubborn epidermal pigment sitting alongside textural change, photodamage, enlarged pores, and the general surface deterioration of decades of Australian sun, resurfacing addresses all of it at once in a way that neither a peel nor IPL quite manages.
It will also extend considerably what we can offer for acne scarring, which is why it has been on our list for some time.
The same honesty applies. CO2 is a thermal treatment, and everything we have said on this page about heat and melasma still holds. Tetra is not a melasma solution and we will not present it as one. Where it will be genuinely valuable is sun damage, texture and scarring.
Arriving at Plump shortly. If it is relevant to your concern we will tell you at consultation, and we would rather have you wait a few weeks for the right treatment than sell you the wrong one now.
Red and near-infrared light to reduce inflammation and support healing, with no downtime and no risk of provoking pigment.
In pigmentation, LED is a supporting treatment rather than a primary one. It is valuable after peels and needling to settle the skin quickly, because the faster inflammation resolves, the lower the risk of post-inflammatory pigmentation. In deeper skin tones that is a meaningful advantage rather than a nicety.
Suitable during pregnancy and breastfeeding.
Alida is our naturopath. In pigmentation, the relevance is narrower than in acne or rosacea, and we would rather be accurate about that than oversell it.
Where it is genuinely useful is hormonal. Melasma is hormonally influenced, and where there is an underlying pattern worth investigating, including thyroid function or a broader hormonal picture, that is a reasonable conversation to have. Alida works alongside your GP rather than instead of them, and anything requiring medical investigation goes to a doctor.
There is also a reasonable case for antioxidant and nutritional support, given the role of oxidative stress in pigment formation, though this is supportive rather than transformative.
What we will not tell you is that pigmentation can be resolved from the inside. It cannot. Sun protection and appropriate topical and in-clinic treatment do the work.
Our wellness room houses an infrared sauna, cold plunge, and private shower in a fully private, solo-use space.
We need to be direct about this in the context of pigmentation. Heat stimulates pigment production independently of UV, and infrared sauna is a heat treatment. For someone actively treating melasma, regular sauna use is working directly against the plan.
For other forms of pigmentation the concern is smaller, but it is not nothing.
We will talk it through honestly rather than adding it to your plan by default. The same applies to hot yoga, very hot showers, and standing over a stove, none of which people connect to their face until someone points it out.
Weeks 1 to 8. Assessment and diagnosis, including Wood's lamp to establish depth. Sun protection corrected first, always. Home care built in stages. Any ongoing driver addressed, whether that is active acne, an inflammatory condition, or a hormonal factor worth reviewing with your GP. Gentle in-clinic treatment begins.
Weeks 8 to 24. The corrective phase. Peels progressing through the tiers as tolerance builds, skin needling with targeted actives where indicated, and IPL where the pigment type is suitable. Run through the cooler months wherever possible.
Ongoing. Maintenance and protection. For solar damage this can be relatively light. For melasma it is continuous, and stopping is what produces recurrence.
A note on how we measure. Pigmentation improves slowly and the change is gradual enough that you will not see it day to day. We photograph under standardised conditions at intervals, because comparing your face in a bathroom mirror in January to your memory of it in June is not a measurement.
We will not quote you a number before we have seen your skin, because a plan for a handful of sun spots and a plan for established melasma are not remotely the same investment.
What we will do is give you a clear, itemised plan at consultation, including what the corrective phase is likely to cost, roughly how long it will run, and what maintenance looks like afterwards.
For melasma in particular, think of this as ongoing rather than one-off. The corrective phase has an end point. The protection does not.
Please note that cosmetic and dermal treatments do not attract a Medicare rebate. Some private health extras policies cover naturopathy consultations, so it is worth checking your own policy.
See a GP or dermatologist if any lesion is changing or suspicious, if you have not had a skin check, if you may need prescription pigment treatment, or if there is an underlying medical or hormonal factor to investigate.
Dermal clinicians handle assessment of pigment type and depth, home care, resurfacing, targeted delivery of actives, light-based treatment where appropriate, and the long-term maintenance that keeps a result.
For most people the answer is both, in sequence. Get the skin check first. Then treat.
We will refer you if any lesion looks suspicious or you have not had a recent skin check, if pigmentation appeared suddenly or is unusual in pattern, if there is a possible medication-related cause, if we suspect a hormonal or thyroid factor, or if your melasma warrants prescription treatment we cannot provide.
We do not remove moles and we do not assess lesions for cancer. That is a doctor's work and we are clear about the line.
For skin checks we refer to Avatar Imaging in Toorak, or to your own GP if you would prefer. Details are further up this page.
UV is not the same as heat or brightness. Melbourne reaches damaging UV levels for much of the year, cloud reduces it far less than people assume, and it comes through windows.
The exposure that causes most of the pigmentation we treat is incidental. The commute, the walk to lunch, the school pick-up. Daily application is the entire point.
This is the most costly misunderstanding on the page. Light-based treatment is excellent for sun spots and can be genuinely damaging in melasma, where heat drives the condition and the pigment frequently returns darker than before.
If you have melasma and someone offers you IPL as the answer, ask what they will do if it worsens.
Sometimes it improves after pregnancy. Frequently it does not. Melasma is a chronic, relapsing condition, and waiting it out generally means it becomes more established and more dermal, which makes it harder to treat.
In pigmentation this is precisely backwards. Inflammation produces pigment. A treatment aggressive enough to leave your skin red and irritated is generating the exact response you are trying to switch off.
Slow, well-tolerated, and consistent beats fast and harsh, every time.
Lemon juice on skin, followed by sun exposure, can cause a genuine phototoxic burn and leave pigmentation considerably worse than what you started with. It is one of the more reliable ways to make this condition worse at home.
Natural is a marketing category, not a measure of safety.
Imported and unregulated skin-lightening products have repeatedly been found to contain undisclosed potent steroids and mercury. Long-term misuse of high-strength pigment inhibitors can also cause a paradoxical darkening that is very difficult to reverse.
This is one area where the cheap option carries genuine risk.
No. Most pigmentation improves with the right approach. What varies is how much, and how quickly, and that comes down to type and depth. That is what assessment is for.
Sun spots are usually discrete, well-defined, and scattered on sun-exposed areas. Melasma tends to appear as larger, symmetrical patches with less defined edges, most often across the cheekbones, forehead, and upper lip, and it fluctuates with sun, heat, and hormones.
The distinction matters enormously because the treatments differ, and one is worsened by what helps the other. This is an assessment question rather than a self-diagnosis one.
It depends on the type. Sun spots that are properly treated and properly protected can stay gone for years. Melasma is chronic and will recur without maintenance and disciplined sun protection.
The driver is the deciding factor. Where the driver is past sun exposure, the result holds well. Where the driver is hormonal and ongoing, it needs managing.
Expect three months before making any judgement, and six months for the full picture of a corrective phase. Pigment turnover is slow, deeper pigment is slower again, and the change is gradual enough that photographs are more reliable than memory.
Melasma commonly appears or worsens in pregnancy, and it is a frustrating time to have it, because most of what we would ordinarily use is unsuitable.
LED, enzyme treatments, azelaic acid, and rigorous sun protection are generally suitable. Retinoids, several actives, and most in-clinic procedures are not. We will build a holding plan focused on protection and prevention, and start corrective work afterwards.
Yes, with a different approach. Deeper skin tones carry a higher risk of the treatment itself causing post-inflammatory pigmentation, so protocols are gentler, preparation is longer, progression is slower, and some options are avoided altogether.
Careful treatment produces excellent results. Standardised treatment is what causes problems.
It may fade in the months after delivery, and for a proportion of people it does not fully resolve. Residual pigment often sits deeper than what appeared initially, which makes it more stubborn.
It also tends to recur in subsequent pregnancies, often more strongly.
The most useful thing you can do during pregnancy is limit how much forms, through rigorous sun protection, attention to heat, and the actives that are safe to use. Corrective work comes afterwards.
Oestrogen does not decline smoothly in perimenopause. It fluctuates erratically before it falls, and that instability can bring on melasma for the first time or reactivate it after years of quiet.
Two other things are happening at once. Your barrier is less resilient than it was, which limits what your skin will tolerate. And hot flushes are heat, which stimulates pigment independently of UV.
It is a phase for gentler treatment and more patience, not for pushing harder.
Not directly in any meaningful way. There is a reasonable argument for antioxidant support given the role of oxidative stress, but nobody clears pigmentation through diet. Anyone suggesting otherwise is overselling.
Yes, and we will ask. If you have not had a full skin check, please have one. We do not treat over anything we are unsure about, and we do not remove moles.
We refer to Avatar Imaging in Toorak, who provide three-dimensional whole-body imaging alongside dermoscopy and do not require a GP referral. Your own GP or an existing skin cancer clinic is equally fine. The check is what matters.
Every pigmentation plan at Plump begins with a full consultation. We assess your skin under Wood's lamp and dermatoscope, establish what type of pigment you have and how deep it sits, identify what is still driving it, and build a plan with realistic expectations and clear timelines.
There is no cost and no obligation.
Book online, or call or text us on 0478 844 048.
Plump Aesthetic Clinic, 525 Chapel Street, South Yarra. www.plumpaestheticclinic.com.au
We see patients from South Yarra, Prahran, Windsor, Toorak, Armadale, Richmond, Malvern, St Kilda, and across inner Melbourne.
Reviewed by the clinical team at Plump Aesthetic Clinic. Caitlin King, Registered Nurse, Founder and Clinical Director, ten years in cosmetic and skin medicine. Belinda, Senior Dermal Clinician, approximately ten years of industry experience.
We treat skin, not trends. Where we make a claim about what a treatment does, we want it to be traceable to something better than marketing.
The recommendations on this page are informed by current systematic reviews and evidence-based clinical literature, alongside the clinical experience of our team. Melasma in particular is an area where the evidence base is genuinely limited and no single treatment has been shown to be reliably superior, which is why we are cautious about promising outcomes.
Key sources informing this page: Rajaratnam R, Halpern J, Salim A, Emmett C. Interventions for melasma. Cochrane Database of Systematic Reviews. 2010;(7):CD003583. Jutley GS, Rajaratnam R, Halpern J, Salim A, Emmett C. Systematic review of randomized controlled trials on interventions for melasma: an abridged Cochrane review. Journal of the American Academy of Dermatology. 2014;70(2):369-373. McKesey J, Tovar-Garza A, Pandya AG. Melasma treatment: an evidence-based review. American Journal of Clinical Dermatology. 2020;21(2):173-225. Rivas S, Pandya AG. Treatment of melasma with topical agents, peels and lasers: an evidence-based review. American Journal of Clinical Dermatology. 2013;14(5):359-376.
Important information: All treatments described on this page require an individual consultation with a qualified practitioner to determine suitability. Results vary between individuals and depend on skin type, pigment type and depth, sun exposure, hormonal factors, home care compliance, and the treatment plan followed. Melasma is a chronic and relapsing condition and no result is guaranteed. All treatments carry risks and potential side effects, including the risk of post-inflammatory pigmentation, which will be explained to you in full before you proceed. This information is general in nature and is not a substitute for individual medical advice. We do not diagnose or treat skin cancer. If you have a pigmented lesion that is new, changing, or concerning, please see your GP for a skin check.
