Why Pigmentation Comes Back: Sun Damage, Melasma and the Treatments That Actually Work

Pigmentation is one of the most common reasons people book a skin consultation, and one of the most misunderstood. You put in the work, the brown patches soften, your skin looks clearer, and then the weather turns warm and it all seems to creep back. It can feel like starting from scratch. It isn't, and understanding why it happens is the first step to keeping it under control.

In a recent reel, I explained exactly why pigmentation behaves this way and what actually shifts it. My take is refreshingly honest: different types of pigmentation need different approaches, there is no single magic fix, and skincare and sun protection do the heavy lifting long before any device comes into play. At Wellface my focus is on long-term skin health rather than a quick result that fades by summer.

This article expands on what I covered. We'll look at the three main causes of pigmentation, why warmer months and inflammation make it flare, the skincare foundations that genuinely matter, and how our two workhorse devices, BBL and MOXI, treat pigment at different depths.

The three main causes of pigmentation

Pigmentation is simply an overproduction of melanin, the pigment that gives skin its colour. When melanin clusters unevenly, you see it as patches, spots or a general muddiness in the complexion. As I point out, it tends to come from three main places.

The number one cause, by a wide margin, is the sun. Ultraviolet light is a direct trigger for melanin production, which is your skin's way of trying to protect itself from damage. Over years of exposure, that shows up as sunspots, age spots and diffuse patchy tone, particularly on the face, chest and backs of the hands. This is what we call photodamage, and it is cumulative. The tan you had in your twenties is still writing cheques your skin is cashing now.

The second cause is inflammation. Any injury or irritation to the skin can leave a pigmented mark behind, and this is known as post-inflammatory hyperpigmentation, or PIH. Acne is the classic culprit. A spot heals, but a brown or grey shadow lingers for weeks or months afterwards. PIH can also follow aggressive treatments, picking at the skin, eczema flares or even harsh scrubbing. Darker skin tones are more prone to it, which is one reason treatment choice matters so much.

The third cause is hormonal, and here the main condition is melasma. Melasma shows up as larger, symmetrical patches, often across the cheeks, forehead and upper lip, and it is strongly linked to female sex hormones. Pregnancy, the combined contraceptive pill and hormone therapy can all set it off. It is more stubborn than sun-related spots because the trigger is coming from inside the body, and heat and light make it worse. That combination of hormones plus UV is what makes melasma so frustrating to treat.

Why it flares up again when you thought it had gone

Here is the part that catches people out. You can lighten pigmentation successfully, admire your clearer skin, and then watch it darken again a few months later. That doesn't mean the treatment failed. It means the melanin-producing cells, called melanocytes, are still primed and ready to react.

Warmer weather is a big trigger. Longer, brighter days mean more UV reaching your skin, even on cloudy days and even through car and office windows. UVA in particular passes through glass and drives pigmentation year round. So the sunny stretch that lifts everyone's mood is also the stretch that quietly reactivates old pigment.

Heat itself plays a role too, which is a point often missed. Melasma in particular responds not just to light but to warmth, whether that comes from the sun, a hot kitchen, saunas or intense exercise. That is why melasma can flare in the summer even when someone is diligent with sunscreen.

Inflammation is the other reason pigment returns. If your skin barrier is compromised, if you're breaking out, or if you've had a reaction to a product, the resulting inflammation can switch melanocytes back on. This is why treating the underlying skin concern, not just the visible mark, matters so much. Calm, healthy skin is far less likely to over-produce pigment in the first place.

Skincare first: the ingredients that do the work

I'm clear that your first port of call is skincare, and this is where a lot of long-term progress is either won or lost. The right topical routine can lighten existing pigment, slow new pigment forming and keep results stable between clinic treatments.

A few ingredient categories genuinely earn their place. Topical vitamin A, in the form of retinoids, speeds up cell turnover so pigmented skin cells are shed and replaced more quickly, and it helps regulate melanin over time. Vitamin C is a brightening antioxidant that both fades existing pigment and shields the skin from some of the daily UV and pollution damage that drives it. Then there are targeted pigment suppressors, ingredients that dial down the enzyme responsible for melanin production, which help interrupt the cycle at its source.

Used together and consistently, these build a foundation that clinic treatments can then work on top of. But they need time and patience. Pigmentation that took a decade of sun to form will not disappear in a fortnight, and the most common reason a routine appears to stop working is simply that it hasn't been given long enough, or the SPF step has slipped.

SPF is the non-negotiable

My phrasing here is worth repeating: if you're not using an SPF, you are fighting a completely losing battle. This is not marketing, it is how the biology works. Every unprotected UV exposure re-stimulates the melanocytes you're trying to calm, so without daily broad-spectrum sun protection, even the best actives and the most advanced laser will keep being undone.

A high-factor, broad-spectrum SPF worn every single day, reapplied when you're outdoors, is the single most effective anti-pigmentation product you own. For melasma especially, a tinted mineral SPF adds a layer of defence, because the iron oxides in tinted formulas also help block the visible light that can worsen the condition. Think of sunscreen as the thing that protects your investment in everything else.

BBL and MOXI: treating pigment at different depths

Once skincare and sun protection are in place, in-clinic treatments can accelerate results and reach pigment that creams alone struggle with. My favourite approach uses two advanced devices, and the clever part is that they work at different depths, so they complement each other rather than compete.

BBL for superficial pigment

BBL, which stands for BroadBand Light, is an advanced form of intense pulsed light. It delivers precisely tuned pulses of light that are absorbed by melanin in the skin. That energy converts to heat, which breaks down the pigment and prompts the body to clear it away naturally. It also targets the redness from broken capillaries, so it treats browns and reds at the same time.

After a BBL session, superficial pigmented spots often look temporarily darker, almost like tiny coffee grounds, before they flake away over the following days to leave clearer, more even skin. Downtime is minimal, with most people back to normal activities the same day, and results build best over a short course of sessions. Because it heats melanin directly, BBL is brilliant for sun-related pigment and sunspots but is used with more caution in active melasma, which is precisely where the second device comes in.

MOXI for deeper, dermal pigment

MOXI is a non-ablative fractional laser that works on a 1927nm wavelength. Rather than targeting melanin directly, it targets water in the skin, creating thousands of microscopic treatment zones that trigger renewal and gently lift out pigment sitting deeper in the skin. Because it doesn't rely on heating pigment aggressively, it is considered one of the safer laser options for all skin tones and for tricky conditions like melasma, where over-heating can backfire and make things worse.

This is why I describe MOXI as the tool that goes down to reach the deeper, more dermal pigmentation. It resurfaces and brightens, improves texture and works with your skin's natural healing process. Downtime is modest, typically a few days of mild redness and a slightly sandpapery feel as the skin renews, with the fresh, clearer complexion emerging over the following week or two. A short series spaced a few weeks apart gives the best outcome, followed by occasional maintenance.

Used thoughtfully, BBL clears the surface layer while MOXI addresses what sits beneath, and both sit on top of a solid skincare and SPF routine. That layered strategy is what delivers even-toned skin that actually lasts, rather than a result that fades with the first warm spell.

Common questions about pigmentation

Can pigmentation be cured permanently?

Not exactly, and any clinic promising a permanent cure isn't being straight with you. Melanocytes remain in the skin and can always be re-triggered by UV, heat or inflammation. What you can do is clear existing pigment substantially and then keep it controlled with daily SPF, the right skincare and periodic maintenance treatments. Managed well, most people keep their skin looking clear and even for the long term.

Is melasma treated the same way as sunspots?

No, and this is where getting the right advice matters. Sunspots respond very well to light-based treatments like BBL. Melasma is more temperamental because it is driven by hormones and worsened by heat, so it needs a gentler, more considered approach, often leaning on skincare, strict sun protection and carefully chosen laser settings such as MOXI. Treating melasma too aggressively can make it darker, which is why a proper diagnosis comes first.

How soon will I see results?

Skincare typically shows meaningful change over eight to twelve weeks of consistent use. With BBL, surface spots often lift within a week or two of a session. With MOXI, brighter skin tends to appear over the week following treatment, with collagen and tone continuing to improve over the following weeks. Pigmentation rewards patience and consistency far more than intensity.

Why does my pigmentation look worse in summer?

More daylight means more UV reaching your skin, and both UV and heat directly stimulate melanin. Melasma in particular reacts to warmth as well as light. This is why pigmentation that looked settled over winter can darken as spring turns to summer, and why year-round sun protection, not just holiday sunscreen, is so important.

Are these treatments safe for darker skin tones?

Treatment choice is everything for deeper skin tones, which are more prone to post-inflammatory pigmentation. MOXI's 1927nm wavelength targets water rather than pigment, which makes it a gentler, safer option across a range of skin tones. Light-based treatments need careful settings and an experienced hand. At a consultation I'll assess your skin type and tailor the plan accordingly.

Book a skin consultation at Wellface

Pigmentation is rarely one-size-fits-all, and the reason it keeps returning is usually that the wrong tool has been used, or the sun protection hasn't kept pace. The most reliable results come from a proper assessment, an honest plan and treatments matched to the type and depth of your pigment.

If uneven tone, sunspots or melasma are bothering you, I can look at your skin properly and build a plan around it, combining medical-grade skincare, sun protection and, where it's right for you, BBL or MOXI. You can book a skin consultation with me at our Cobham, Esher or Wimbledon clinics and take the first step towards clearer, more even skin that holds up through the seasons.