Pigmentation treatment in London. Melasma, dark marks and uneven tone, planned for your skin, not a one-size protocol.

It depends on which pigmentation it is, so the assessment comes first. For melasma the strongest evidence sits with daily broad-spectrum SPF 50+ and prescribed topicals, with low-strength superficial peels and skin-quality support layered in cautiously. For post-inflammatory dark marks the priority is stopping the cause, then sun protection and gentle peels matched to your skin tone. For sun damage, a course of superficial peels with strict SPF afterwards. In Fitzpatrick IV to VI we avoid aggressive lasers and high-strength peels because they can darken the area they were meant to clear. Individual results vary.

At Melatone in Battersea, South London, it starts with a £30 consultation, deducted from your first treatment. The plan is built from what your pigmentation actually needs: sun protection and prescribed topicals, superficial peels from £110 a session or £99 each in a course of three, brightening microneedling for dark spots and uneven tone at £150 a session or £399 for a course of three where it is indicated, and polynucleotides from £200. The full price table is on this page. We will tell you at the consultation which of those you need and which you do not.

Usually not. Melasma, post-inflammatory dark marks and sun spots are treated as cosmetic in most NHS areas, so a GP can confirm the diagnosis and rule out anything that needs a dermatologist, but treatment is generally private. Any patch that is new, changing shape, bleeding or irregular is different: see your GP first, before any cosmetic treatment.

Melasma is currently considered a chronic, relapsing pigmentary condition rather than a curable one. Most patients can achieve substantial visible improvement with a consistent personalised programme of daily sun protection, prescribed topical agents, and selected in-clinic treatments, but recurrence after sun exposure, pregnancy, or hormonal changes is well-documented in the published literature. We will be honest about realistic expectations during your consultation. Our approach is to reduce the visible pigmentation, protect the result with rigorous sun-protection coaching, and provide a structured maintenance plan you can follow long-term.

Most lasers used for general pigmentation carry a higher risk of post-inflammatory hyperpigmentation (PIH) and rebound melasma in Fitzpatrick V to VI skin. Published guidance generally cautions against IPL and aggressive laser pigment-removal in darker skin types for melasma specifically. We do not lead with laser for melasma in Fitzpatrick V to VI. We lead with topicals, sun protection, low-strength superficial peels, polynucleotides, and where indicated microneedling with melanin-aware parameters.

We build a personalised plan from the following options: daily broad-spectrum SPF 50+ with visible-light coverage, prescribed topical depigmenting agents (tyrosinase inhibitors, retinoids, hydroquinone where appropriate), low-strength superficial chemical peels layered cautiously, polynucleotide injections for skin barrier and overall skin-quality support, and microneedling with melanin-aware parameters where indicated. Treatment is delivered by Arman Zaki, GMC-registered Physician Associate, with a special interest in Skin of Colour. The exact protocol is tailored to your Fitzpatrick type, melasma subtype, hormonal triggers, and lifestyle factors.

Most patients begin to see gradual lightening of pigmentation between weeks four and eight of a consistent topical and sun-protection programme, with more visible change at twelve weeks if in-clinic treatments are added in. Melasma is slow by nature, the pigment sits in the dermal and epidermal layers and is influenced by sun, hormones, and inflammation. Photographic comparison at consistent lighting at the four-week and twelve-week mark is the most reliable way to track progress. Individual results vary.

Pregnancy and breastfeeding are common melasma triggers, but the majority of in-clinic procedures and many prescribed topicals are not appropriate during these periods. We do not deliver chemical peels, polynucleotides, or microneedling during pregnancy or breastfeeding, and hydroquinone and retinoids are contraindicated in pregnancy. We can offer a conservative skincare and sun-protection programme using pregnancy-safe ingredients, photographic monitoring, and a structured plan to resume in-clinic treatments once you have finished breastfeeding.

Arman Zaki, the founder and lead clinician of Melatone Skin Clinic, GMC-registered Physician Associate (Ref A8131967), with NHS general practice experience. Arman offers personalised skin consultations across a wide range of conditions including melasma and other pigmentation disorders, and delivers microneedling, chemical peels, PRP, skin boosters, polynucleotides, and other regenerative skin solutions.

On darker skin tones (Fitzpatrick IV to VI) melasma treatment starts gently and avoid anything that can trigger rebound pigmentation. Daily broad-spectrum SPF 50 with visible-light cover is the foundation, followed by prescribed topical pigment regulators and, where suitable, low-strength superficial peels formulated for darker skin. Aggressive lasers and IPL are generally avoided for melasma in darker skin because they can make it worse. Arman Zaki confirms your melasma subtype and Fitzpatrick type before starting, because the wrong treatment can darken melasma further. See DermNet: melasma and the DFTB Skin Deep image library (clinical images across diverse skin tones) for background. Book a consultation and patch test first.

Hydroquinone, particularly the triple combination of hydroquinone with a retinoid and a mild steroid, is the most studied topical treatment for melasma and is widely regarded as first-line. In the UK it is prescription-only and used in supervised courses rather than indefinitely. It is not automatically right for everyone. The best choice depends on your melasma subtype, your Fitzpatrick type, whether you are pregnant or breastfeeding, and how your skin tolerates it. At Melatone we assess this at consultation and prescribe hydroquinone only where it is appropriate, alongside daily sun protection which protects any result.

Several non-hydroquinone options can help, including azelaic acid, topical tranexamic acid, cysteamine, niacinamide, kojic acid, and vitamin C, and in selected moderate to severe cases oral tranexamic acid under clinical supervision. Some approach hydroquinone in studies, though head-to-head evidence is more limited. These are especially useful for long-term maintenance and for skin that cannot use hydroquinone. Professional in-clinic depigmentation systems also exist, though data comparing them directly with prescription hydroquinone are limited. Whichever active is used, daily broad-spectrum SPF 50 with visible-light cover is the foundation, and a clinician confirms the plan for darker skin.

A chronic pigmentary condition that shows as symmetrical brown or grey-brown patches, most often on the cheeks, forehead and upper lip. It is driven by hormones and by sun and visible light, which is why pregnancy, the combined pill, HRT and summer are common triggers, and why it is more common and more visible in Fitzpatrick IV to VI. It is managed rather than cured.

A combination of hormonal influence, ultraviolet and visible light, and genetic tendency; family history, pregnancy, the combined oral contraceptive and hormone replacement therapy are all recognised triggers. Heat and inflammation can worsen it, which is why aggressive treatments can backfire on deeper skin tones.