How to Treat Pigmentation: 4 Approaches We Use at Wellface

Pigmentation is one of the most common concerns I see across our clinics, and it is also one of the most misunderstood. Patches of brown, freckling that seems to spread with each summer, the shadow left behind after a spot has healed, the general loss of an even tone as skin ages. It all falls under the same broad heading, yet the causes and the best fixes can be quite different from one person to the next.

In a recent reel, I talked through the ways we tackle pigmentation at Wellface, from a daily serum you use at home to in-clinic devices that resurface and remodel the skin. The point I keep coming back to is that no single treatment suits everyone. Some pigment sits high in the surface layers and lifts quickly. Some sits deeper and needs a more considered plan. And almost all of it comes back if the underlying triggers, mainly sun exposure and hormones, are not kept in check.

This article walks through the four approaches I highlighted, how each one actually works, what a course involves and who tends to benefit most. Think of it as a starting map rather than a prescription, because the right combination is always decided in person.

First, why pigmentation happens

Your skin colour comes from melanin, a pigment made by cells called melanocytes. When those cells are provoked, they produce more melanin and deposit it unevenly. The most common provocation by far is ultraviolet light. Years of sun, holidays, the daily drive to work with your face at the window, all of it adds up and shows as sun spots, freckling and a mottled tone, usually across the cheeks, forehead, chest and backs of the hands.

Hormones play a part too. Melasma, the larger symmetrical patches that often appear across the cheeks and upper lip, is linked to oestrogen and is common in pregnancy or with the contraceptive pill. It is notoriously stubborn and can flare with heat and light, so it needs a gentler, more patient approach than sun spots do.

Then there is post-inflammatory pigmentation, the marks left after acne, an injury or even an overly aggressive treatment. This type is about the skin's reaction to inflammation rather than sun alone, and it tends to fade over time with the right support.

Knowing which type you are dealing with matters, because a device that works beautifully on sun spots can actually make melasma worse if it is used carelessly. That is why an assessment comes first, every time.

1. A vitamin C serum to brighten and protect

My first recommendation is the one anyone can start with, and it is my personal favourite: the Vitamin C Clarifying Serum from Obagi. Vitamin C is an antioxidant, which means it mops up the free radicals generated by UV light and pollution before they can trigger more pigment and break down collagen. Used every morning, it gives your skin a layer of defence that sunscreen alone does not provide.

It does two useful things for tone specifically. It helps to interrupt the production of excess melanin, so new pigment forms more slowly, and it gently brightens the skin you already have, softening dullness and evening things out over a few weeks of consistent use. A good vitamin C will not erase a deep sun spot on its own, but it is the foundation that makes everything else work harder.

We class this as medical-grade skincare for a reason. The concentration, the form of vitamin C and the way it is stabilised all affect whether it actually penetrates and does its job, and that is where pharmacy products often fall short. In clinic we stock a wider range of medical-grade options alongside the Obagi serum, including pigment-targeting actives and, crucially, a high-protection sunscreen. I will tell you plainly that any pigmentation plan without daily SPF is a plan that will disappoint you. Sun protection is not the boring afterthought. It is half the treatment.

2. Secret Pro: resurfacing with CO2 laser and RF microneedling

For pigment that skincare cannot reach on its own, we move to the Secret Pro by Cutera, which lives in our Esher clinic. It is a clever bit of kit because it combines two technologies in one platform, and we can dial in the right one for your skin.

The CO2 laser is the resurfacing side. It delivers fractional columns of energy that vaporise tiny channels of damaged surface skin, taking pigmented and sun-worn cells with them and prompting fresh, more even skin to grow in their place. Because it is fractional, it treats a fraction of the surface at a time and leaves healthy skin in between to speed healing, which makes it far more comfortable and lower-risk than the old fully ablative lasers.

The second technology is radiofrequency microneedling. Fine needles deliver heat into the deeper layers to stimulate collagen and tighten, which addresses the texture, fine lines and laxity that so often sit alongside sun damage. So you are not only lifting pigment, you are rebuilding the quality of the skin underneath.

What a Secret Pro session is like

We apply numbing cream first, and treatment itself takes around thirty to forty-five minutes depending on the area. Afterwards the skin feels hot, like sunburn, and looks pink or red for a few days. With the CO2 resurfacing you may see fine bronzing and light flaking as the treated cells lift away over the following week. Most people plan a few quiet days around it, and we give clear aftercare with a strict instruction to stay out of the sun and wear SPF religiously while the skin recovers. Results build over the weeks that follow as new collagen forms, and a short course spaced several weeks apart usually gives the best result for stubborn pigment and sun damage.

3. Morpheus8: remodelling from within

At our Cobham clinic we use Morpheus8, another radiofrequency microneedling device, and one of its recognised uses is improving pigmentation and overall skin quality. The needles create controlled micro-injuries while delivering heat at an adjustable depth, which triggers the skin's own repair response: new collagen, new elastin, and a gradual remodelling of the deeper layers.

For tone, the benefit is twofold. The controlled resurfacing and cell turnover help to break up and clear uneven pigment, while the collagen rebuild firms and refines the skin so it reflects light more evenly and simply looks healthier. It is a favourite for people who want to treat pigment but are also starting to notice softening along the jaw, enlarged pores or crepey texture, because it handles all of that in one treatment.

Morpheus8 has very little downtime compared with ablative laser. Expect redness and a slightly gridded look for a day or two, sometimes minor swelling, and then you are back to normal fairly quickly. Because the energy can be placed deep and the surface is largely protected, it is often a sensible choice for darker or more reactive skin types where surface lasers carry more risk of rebound pigmentation. As with everything, we assess first and set the settings to your skin.

And the SkinPen option

I also mentioned SkinPen, the medical microneedling device we have in Cobham. This is microneedling without the radiofrequency, using fine needles to create tiny channels that kickstart collagen and improve the penetration of the serums we apply. It is gentler and more affordable than the energy devices, with only a day or so of redness, and it works well for milder pigmentation, post-acne marks and general dullness, particularly as part of a course. For some patients it is the ideal starting point; for others it complements the bigger treatments between sessions.

4. BBL Hero: photorejuvenation for sun damage

The fourth approach, and the one I was most excited to tease in the reel, is BBL Hero, our broadband light system. Since that reel it has landed in clinic, and it is widely regarded as one of the gold-standard tools for pigmentation and sun damage.

BBL works differently from the laser and microneedling devices. It sends pulses of broadband light into the skin, and that light is absorbed by the melanin in pigmented spots. The energy heats and breaks up the pigment, which then rises to the surface over the following days, darkens briefly like coffee grounds, and flakes away to reveal clearer skin beneath. The same light also targets the redness and broken capillaries that often accompany sun-damaged skin, so it evens out both brown and red tones at once. The Hero version delivers this quickly and comfortably, treating larger areas like the face, neck, chest and hands in a short appointment.

There is very little downtime. The skin feels warm and looks a little flushed straight afterwards, spots go darker before they fade, and most people are comfortable going about their day. A course of sessions gives the most complete result, and light maintenance once or twice a year keeps sun damage from creeping back. BBL is best suited to lighter skin tones and to genuine sun-related pigment; for melasma and deeper skin tones we choose more carefully, which again is why the consultation matters.

Building the right plan for your skin

The reason we offer four routes rather than one is that most people do best with a combination. A typical plan might pair daily vitamin C and sunscreen at home with a course of BBL for surface sun spots, then Morpheus8 to firm and refine the deeper skin. Someone with melasma might avoid aggressive light altogether and lean on skincare, gentle resurfacing and rigorous sun protection instead. There is no league table where one treatment simply beats the others. There is only what suits your skin, your pigment type and your life.

What every plan shares is patience and protection. Pigment that took a decade of sun to form does not vanish in a single session, and any result you achieve will fade if UV keeps provoking the melanocytes. Consistent SPF and antioxidant care are what make the in-clinic work last.

Common questions about treating pigmentation

Will my pigmentation come back after treatment?

It can, if the triggers are not managed. Treatment clears the pigment that is already there, but your melanocytes will happily make more if you go back to unprotected sun exposure, and hormonal pigment like melasma is prone to flaring. Daily sunscreen, antioxidant skincare and occasional maintenance sessions are what keep results looking good long term.

How soon will I see a difference?

It depends on the treatment. A vitamin C serum brightens gradually over several weeks. With BBL, spots often darken within a day or two and then flake away over the following week, so you see change quite quickly. Laser resurfacing and radiofrequency microneedling reveal their fuller results over the weeks that follow as new collagen forms, and a course usually gives the best outcome.

Is treating pigmentation painful?

Most of our treatments are very tolerable. We use numbing cream before the microneedling and laser treatments, and patients usually describe the sensation as heat or light prickling rather than pain. BBL feels like a warm elastic band flick. Serums, of course, are simply part of your daily routine.

Can darker skin tones be treated safely?

Yes, but the choice of treatment matters more. Deeper skin tones and reactive skin carry a higher risk of rebound pigmentation from surface lasers and intense light, so we often favour radiofrequency microneedling or a carefully tailored skincare-led approach. This is exactly what the initial assessment is for, and our doctors will be honest about what is and is not appropriate for you.

Do I still need sunscreen if I am having treatments?

Absolutely, and arguably more than ever. Freshly treated skin is more vulnerable to UV, and unprotected sun is the fastest way to undo your results and trigger new pigment. A high-factor sunscreen every morning, reapplied through the day, is non-negotiable in any pigmentation plan.

Ready to even out your skin tone?

If uneven tone, sun spots or old pigment have been bothering you, the most useful next step is simply to have your skin looked at properly. Book a consultation with me or one of our doctors at Wellface in Cobham, Esher or Wimbledon, and we will work out which of these approaches, or which combination, will get you to clearer, more even skin. Bring your questions and your current skincare, and we will build a plan around your skin rather than a one-size-fits-all package.