gtag('config', 'AW-875563784');
Dr Justine Kluk - Consultant Dermatologist London
Other treatments

Melasma & Post-inflammatory hyperpigmentation

Melasma & Post-inflammatory hyperpigmentation icon

What is melasma and how is it treated?

Melasma is a common acquired pigmentary disorder affecting up to 30% of child‐bearing women in some populations. The clinical pattern is characterised by symmetrical light to dark brown patches with irregular borders. An almost constant worsening of the condition during the summer season is one of the hallmarks of this disorder.

Although treatment options are available, management of melasma remains challenging with inconsistent results & frequent relapses.

Melasma is still often called the “pregnancy mask” and has historically been considered the consequence of female hormone stimulation on a predisposed genetic background. Although these two factors do contribute to the disorder, research in the last few years has added new pieces to the puzzle.

The impact of ultraviolet (UV) radiation

Ultraviolet (UV) radiation as a trigger factor for melasma has been known for decades. However, even when using potent UVB & UVA protection during the summer, most patients have a worsening of their condition. The shorter wavelengths of visible light (blue-violet light) have recently been shown to induce hyperpigmentation through a specific sensor in melanocytes (pigment producing cells) called opsin 3. Sunscreens containing iron oxides and offering protection against the shorter wavelengths of visible light on top of broad spectrum UV protection can significantly reduce relapses of melasma during summer compared to UVA/UVB sunscreens alone.

The impact of female hormones

The impact of female hormones may not be as strong as originally believed. Population studies show that melasma is not uncommon in men. A study of female melasma patients in nine countries across the world showed that the onset occurs during pregnancy in only 26% of cases. Almost the same number occur pre-pregnancy (29%) and 10% of cases start after menopause. The study also showed that stopping the contraceptive pill (another frequently cited culprit) only has a weak impact on the evolution of the condition. Indeed, a hypothesis is emerging that melasma is a disease of photoageing (premature ageing of the skin from repeated sun exposure). This could explain why some treatments typically used for ageing may help melasma, for example retinoids.

Post-inflammatory hyperpigmentation (PIH)

Post-inflammatory hyperpigmentation (PIH) occurs after there is damage or irritation to the skin. The skin affected turns tan, brown or purplish, which brings about the term hyperpigmentation (deepening of colour).

PIH can affect anyone, but is very common in darker skin. Skin of colour has more pigment (melanin) so there is more of a chance of PIH with skin conditions, such as acne.

Post inflammatory hyperpigmentation can take months to years to fully clear. For effective long-term treatment of PIH, it is essential to treat the underlying skin problem that is leading to the discolouration. In addition, certain agents can speed up the healing process, such as topical niacinamide, retinoids, azelaic acid, glycolic acid, vitamin C and kojic acid. There are also very effective prescription creams and chemical peels that may improve the outcome beyond skincare products alone.

Sunlight causes PIH to darken, so it is essential to utilise protection from the sun (sunscreen & sun-protective clothing) on the areas involved.

Would you like to better understand your melasma and the different treatments and skincare products available to help?

Call now to book
5 stars

I have recently started seeing Dr Kluk and am highly impressed by her professionalism, wealth of knowledge and friendly, approachable nature. I would definitely recommend her to others.

5 stars

Wonderful service. Dr Justine helped me with my problem and identified immediately the treatment I needed. On top of everything, she gave great advice for other small things I mentioned. I truly recommend her, she is lovely and a great help.

5 stars

I had a very pleasant and informative skin consultation with Dr Kluk. She provided lots of practical advice and recommended affordable products for me to use. Highly recommend.

5 stars

I saw Justine recently for a consultation regarding pigmentation and scarring on my skin, plus various lines and wrinkles. Her manor was superb and she was very thorough when explaining to me all the information that could help with my skin conditions.

5 stars

Dr Justine is approachable, efficient and knowledgeable. She is by far the best dermatologist I have seen and has resolved issues others have been unable to. I would highly recommend her.

5 stars

Thank you for everything. For your kindness and repeatedly going above and beyond. The last few years have been really difficult, but you’ve been a major part of me not giving up hope. You’ve been very much appreciated.

5 stars

I was very impressed with Justine’s knowledge and advice and am seeing improvements in a very short space of time. I feel very confident being under her care and will continue to see her on a regular basis .

5 stars

Thank you so much for your kindness and expertise. You’ve made a huge difference to my confidence and have made every appointment such a pleasure.

5 stars

Justine is very happy to answer all of your questions and concerns. She has given me a great skin routine tailored to my individual needs and I am very happy that I was recommended to her.

5 stars

Justine was absolutely excellent. Wonderful bedside manner. Totally professional and in the know of so many different issues.
My treatment has already worked brilliantly and I would happily come back with any other problems. Thank you!!

5 stars

Justine is approachable, efficient and knowledgeable. She is by far the best Dermatologist I have seen and has resolved issues that others have been unable to.

5 stars

Dr Justine has completely changed my skin. From advice on products to use, to prescribing and adjusting medication, she has made such a difference. Would happily recommend her to anyone!

5 stars

5 stars are NOT enough for the wonderful Dr Kluk. She is truly professional, honest in her opinion and she takes great pride in the happiness of her clients. The best dermatologist!

5 stars

Justine was so reassuring and kind in her approach. She also clearly explained my treatment, so I feel really comfortable using the products. Fingers crossed it makes a difference – we’ll see in three months! Thanks Justine.

5 stars

I now see foundation as a choice, and not a “need” like I used to, and I feel so comfortable in my own skin. Dr Kluk is so kind, understanding and knowledgeable.

5 stars

The big difference with other clinics is that Dr Kluk went into great detail about how each cream should be used, in order to treat spots but avoid making my skin sore and inflamed. Couldn’t recommend more highly.

5 stars

Dr Kluk has been part of the biggest improvement that I’ve had in my skin journey so far. I’m so comfortable in my skin now and we’ve still got plans for improvement!

5 stars

I was very nervous about my first session and Dr Kluk was brilliant at picking that up and keeping me calm through the treatment. I would highly recommend seeing Dr Kluk.

5 stars

Dr Kluk is beyond amazing. I haven’t seen my skin like this for years and she’s helped me regain my self-confidence. I would highly, highly recommend this clinic!

5 stars

Justine is a complete expert about skin. She is so professional and friendly at the same time and I always know I’m in good hands with her. My skin dramatically improved after seeing her, giving me more confidence.

5 stars

Justine is very professional and offers a personalised service to treat all skin conditions. I couldn’t recommend her enough. She’s the skin guru!

5 stars

I can’t recommend Dr Kluk enough. Her friendly, professional & warm manner instantly put me at ease. A sensible, steady approach has given me improvements beyond my expectations & continues to do so. I feel so lucky to have found her.

5 stars

Dr Kluk really listens and gives you an entirely bespoke plan, unlike some of her contemporaries who roll out a one size fits all plan for everyone, which fails to address more nuanced needs. I couldn’t recommend her enough.

5 stars

Dr Kluk completely transformed my skin. I have never seen my skin so clear, and it has improved my confidence immensely. She is the only person now that I would ever trust to work on my skin.

Book now