Pigmentation

Pigmentation refers to the colouring of your skin, which is determined by melanin. Melanin is a pigment produced by specialised skin cells called melanocytes. While melanin helps protect your skin from sun damage, an imbalance in its production can lead to skin discolouration.

When your skin produces too much or too little melanin, it can lead to visible discolouration, such as dark patches, white spots, or an uneven skin tone. These changes may affect how your skin looks and feels, potentially impacting your self-esteem and confidence over time.

There are two main types of pigmentation, which are:

Pigmentation changes occur when the skin’s normal melanin production is disrupted. These cells sit in the bottom layer of the skin’s epidermis and pass melanin to surrounding skin cells to create a consistent skin tone.

However, when the skin is exposed to certain triggers, whether internal or external, the activity of melanocytes can become imbalanced. This can lead to:

• Overproduction of melanin, causing dark patches or spots (hyperpigmentation)
• Underproduction or loss of melanin, resulting in lighter or white patches (hypopigmentation or depigmentation)

Some of the potential triggers include:

• Ageing as it slows down the skin’s ability to regulate pigment evenly
• Chemical reactions can directly impact how melanocytes function
• Excessive sun exposure
• Hormonal signals such as increased oestrogen during pregnancy
• Inflammation or injury can damage melanocytes or affect how they distribute pigment

Although pigmentation concerns can affect anyone, some individuals are naturally more prone to developing uneven skin tone or discolouration. Your skin type, lifestyle, genetics, and even environment can increase your susceptibility to both hyperpigmentation and hypopigmentation.

Factors that increase risk of pigmentation include:

• Family history – genetics can influence how the skin reacts to environmental and hormonal triggers. If your parents or close relatives have experienced melasma or other pigmentary disorders, your skin may be more responsive to melanin-stimulating factors, even with minimal exposure.
• Hormonal fluctuations – changes in hormone levels, such as during pregnancy, menopause, or with the use of oral contraceptives, can stimulate melanocyte activity. This increases the risk of melasma and other hormone-sensitive pigmentation conditions, especially when combined with sun exposure.
• Inflammatory skin conditions – if you have a history of acne, eczema, or dermatitis, your skin is more likely to develop dark marks after flare-ups. Inflammation, even mild or temporary, can disrupt melanin distribution, making discolouration a frequent after-effect.
• Medications – some prescription drugs can sensitise your skin or trigger pigment changes as a side effect. For example, certain antibiotics, anti-seizure medications, and hormonal treatments can alter how your skin reacts to light or inflammation, increasing the risk of both hyper- and hypopigmentation.
• Excessive sun exposure – whether from outdoor work, sports, or daily commuting, unprotected UV exposure accumulates over time. Even incidental exposure, such as walking to lunch or sitting by a window, can trigger pigment changes, especially in those with naturally photosensitive skin.
• Skin tone – individuals with medium to deep skin tones naturally have more active melanocytes. While this offers better UV protection, it also means the skin is more reactive to injury or irritation, making PIH more common and often more persistent. 

Benign moles typically have a consistent and predictable appearance. As such, knowing what normal moles look like helps you detect any changes that may warrant medical attention.

These characteristics include, but are not limited to:

• Size – most harmless moles are smaller than 6 mm in diameter, about the size of a pencil eraser. Larger moles, especially if growing, should be examined.
• Symmetry – a healthy mole is usually round or oval with both halves looking similar. Asymmetry, where one side does not mirror the other, may be a warning sign.
• Stable appearance – benign moles remain consistent in shape, colour, and size over time. Any noticeable evolution could indicate an abnormality.
• Uniform colour – normal moles are typically a single shade of brown, tan, or black. Moles that contain multiple colours, including red, white, blue, or grey, require closer inspection.
• Well-defined borders – benign moles tend to have smooth, clearly defined edges. In contrast, moles with blurry, jagged, or notched borders may indicate atypia.

We understand that every pigmentation case is unique. That is why we take a comprehensive and personalised approach to diagnosis, ensuring we understand both the underlying cause and depth of pigmentation before recommending treatment.

Our diagnostic procedure usually involves:

• Assessing skin type and history – we begin with a detailed discussion about your skin concerns, lifestyle, and medical background. This includes factors like your history of sun exposure, use of skincare products, previous skin conditions, and hormonal influences. Understanding your skin’s natural tendencies helps us identify what might be triggering or worsening your pigmentation.
• Physical assessment – our dermatologists perform a thorough examination of your skin to assess the location, size, and distribution of the pigmentation. Certain types, such as melasma, sunspots, or post-inflammatory marks, have distinct patterns and behaviours that help guide diagnosis.
• Dermoscopy – we use a dermatoscope to examine pigment changes below the skin surface. This reveals features that are invisible to the naked eye, such as pigment clusters or vascular changes, providing insight into whether the pigmentation lies in the epidermis or dermis.
• Biopsy (if needed) – in rare cases, we may perform a skin biopsy if the pigmentation is unusual, persistent, or shows signs of malignancy. This involves taking a small sample of tissue for laboratory analysis to rule out other underlying skin disorders or pigmentary conditions.

There is no universal cure for pigmentation. But with the right combination of in-clinic treatments and skincare, many types of pigmentation can be significantly improved and reduced.

At Cove Aesthetic Clinic, we tailor your treatment plan based on:

• Your skin type and tone
• Pigmentation type
• Depth of pigmentation
• Medical history and lifestyle factors

Once our medical team obtains all the information, they may formulate a treatment plan that consists of one or a combination of the following treatments:

Struggling with dark spots or uneven skin tone can be frustrating, but you do not have to live with it. At Cove Aesthetic Clinic, we are here to help you feel confident in your skin again. With expert care, personalised assessments, and medical-grade treatments tailored to your needs, achieving a clearer, more luminous complexion is entirely possible.