Pigmentation removal

2 Apr

Excessive skin pigmentation is often a sign of long-term sun exposure and in itself isn’t harmful (although it can be a sign of sun-damaged skin which is at risk of developing cancer). Many people with skin pigmentation find it unsightly. For these people, multiple pigmentation removal treatments are available. Spot Check Clinic offers BBL intense pulsed light treatment which can be highly effective in treating pigmentation due to sun exposure.

Understanding hyperpigmentation

Skin pigmentation occurs due to the skin producing melanin (skin pigment). Hyperpigmentation (increased skin pigmentation) appears as “sun spots” or areas that are darker than the surrounding skin, especially on the face, chest and hands. It is a medically harmless issue, so treatment is not required for health reasons, but treatments are able to fade or remove pigmentation if desired for cosmetic effect.

Causes of skin pigmentation issues

Increased pigmentation of the skin has multiple causes:

  • Sun exposure: usually over many years. Pigmentation can be caused by low levels of sunlight: it doesn’t always occur in areas that have been sunburnt
  • Genetics/hormonal influences e.g. melasma, childhood freckles
  • Scarring following injuries or surgical procedures
  • Medical conditions including Addison disease and haemochromatosis
  • Drugs including certain antibiotics and chemotherapy agents

Is treatment or removal possible?

Many treatments are available for hyperpigmentation. The most suitable treatment is usually best decided in consultation with an experienced doctor.

In general, pigmentation removal treatments work best on solar lentigines, also known as “sun spots” or “age spots”. Certain birth marks known as café-au-lait spots also respond well to treatment. The best results are achieved with people who have fair skin, where there is a greater colour difference between the underlying skin and the pigmentation to be treated.

Treatment is more challenging and may have a lower success rate in cases of:

  • Melasma
  • Hyperpigmented scars
  • Darker-skinned people
  • People who spend a lot of time outside

Skin pigmentation treatment options

The first step in skin pigmentation treatment should be a consultation with an experienced doctor, nurse or dermal therapist in a medical clinic to assess the cause of increased pigmentation and decide which of the available treatments is most likely to be effective while minimising unwanted effects.

Laser treatments

Laser and other light-based treatments are the fastest and, in many cases, the most effective treatment for skin pigmentation. At Spot Check Clinic we use BBL intense pulsed light for treatment of some skin pigmentation issues. This is similar to a laser, but a wider range of light wavelengths is used. (Because of the similarity to laser treatment, we sometimes use the term “laser” to refer to all light-based treatments (laser, IPL/intense pulsed light and BBL/broadband light).

IPL treatments

Intense pulsed light (IPL) is a light-based treatment that uses a wider range of wavelengths than laser, which uses a single wavelength. This broader range of wavelengths is useful for treatment of pigmentation as well as other skin issues such as small blood vessels and wrinkles.

BBL treatments

BBL (broad band light) is a proprietary form of intense pulsed light which has further advantages over laser and standard IPL:

  • High energy output with efficient cooling: treatments are often quicker and less painful
  • “In motion” treatment means that the operator can in many cases treat large areas of skin in a smooth gliding movement rather than a series of “stamps”. This technique also speeds up and reduces pain associated with treatment, particularly in comparison with conventional laser hair removal.
BBL is especially useful for treating pigment spots caused by sun exposure, known as lentigines, or “age spots”.

Other benefits of BBL treatment include:

  • Treatment of lesions that are red or pink in colour, such as small capillaries (sometimes called “broken blood vessels”), angiomas and the redness of rosacea
  • BBL can also work like a hair removal laser, but it can be quicker and less painful than a laser
  • Treatment of fine wrinkles and loose skin
Because it works on pigmentation and other signs of ageing such as visible vessels and wrinkles, BBL is an effective and useful general skin rejuvenation treatment.
Before and after 2 BBL treatments for facial pigmentation
Before and after 2 BBL treatments for facial pigmentation

In most cases there is some improvement after a single BBL treatment session, but we normally recommend a course of three treatments at our clinic. Pricing is highly variable according to the number of treatment sessions and the area(s) of skin treated. Call us to arrange a free consultation with our registered nurse or dermal therapist in our Melbourne CBD clinic so we can determine if BBL treatment is right for you.

Other pigmentation treatment options

IPL and laser pigmentation removal treatments don’t work for all forms of pigmentation; in some conditions, the exposure to bright light can even make the pigmentation worse. For pigment that does not respond well to laser or BBL treatment, other options are available.

Lightening creams

Lightening creams are often used for melasma or large areas of hyperpigmentation. Some can be purchased from a pharmacy or shop without a prescription. These include low concentrations of:

  • hydroquinone
  • azelaic acid

Prescription lightening products tend to have a higher success rate but there might be side effects such as skin inflammation. The most effective is Kligman’s formula, which contains a strong concentration of hydroquinone in combination with tretinoin and a topical steroid. Because of the potential side effects, it must be prescribed after a consultation with a doctor.

For better results, Kligman’s formula can be used in conjunction with IPL or laser pigmentation removal treatment.


Retinoids are a common component in anti-ageing cosmetics, also available from a shop or pharmacy without a prescription.

At Spot Check Clinic, as part of a medical or cosmetic consultation we often prescribe tretinoin for the treatment of sun-damaged and ageing skin. Tretinoin stimulates the growth of new skin cells and is useful for managing wrinkles and thin skin. Tretinoin and other retinoids lighten pigment but work best in combination with other treatments.

Topical products

Topical products such as vitamin C and vitamin B3(niacinamide) have been shown to reduce skin pigmentation. These are best used in combination with other topical treatments.

Chemical peels

A chemical peel is an acidic solution applied to the skin. It causes the top layer of skin to peel off, revealing smoother and lighter skin. Chemical peels are useful for improving general skin colour and tone.

Photodynamic therapy

At Spot Check Clinic we perform PDT (photodynamic therapy) which is a specialised treatment for sun damaged skin and some skin cancers. It causes significant irritation, redness and discomfort for up to two weeks aftertreatment. As well as successfully curing large areas of solar keratoses and certain skin cancers, it has a significant skin rejuvenation effect. Treated skin is significantly smoother and clearer, and there is often lightening of pigment.

Due to the expense and side effects of photodynamic therapy, it’s used primarily in the treatment of skin cancers and severe sun damage rather than as a first line treatment for pigmentation.


Cryotherapy, or freezing, is useful for isolated spots of pigment, such as a single lentigo.

It is effective, inexpensive and can be done in seconds during a medical consultation. Unfortunately, it can often cause colour change(either hyperpigmentation or excessive loss of pigmentation) in the treated area.


Dermabrasion can be a useful treatment if the skin is scarred due to acne. It mainly works to smooth the surface of the skin, but it can also work for skin pigmentation removal.

Finding the right treatment option for your skin

Selecting the right treatment for unwanted skin pigmentation is best done in consultation with an experienced doctor. Your consolation would normally include an examination and medical assessment to determine the cause of pigmentation as well as medical issues which might affect treatments.

Because skin pigmentation often occurs because of sun exposure, people with pigmentation may have a risk of skin cancer. At Spot Check Clinic we routinely assess skin cancer risk and can perform a screening examination for skin cancer if required.

We can offer most of the pigmentation treatments described above, including combinations of IPL and prescription medications to achieve the maximum effect.

Pigmentation issues are treatable

The first steps in all pigmentation treatments are:

  • Minimise sun exposure, use a high SPF sunscreen, and keep affected areas shaded from the sun with clothing, hats, sunglasses orby seeking a shady spot when outside
  • Maintain good skin condition by moisturising regularly and avoiding irritants as much as possible.

Depending on the cause of your pigmentation, multiple treatments can be effective.

Laser and IPL treatments provide excellent results quickly if they are used on the right skin type and for the right type of pigmentation.

Topical products such as lightening creams, retinoids and other active “cosmeceuticals” are a vital component in any pigmentation treatment plan.

If pigmentation is part of a broader picture of sun damage, treatments should focus on preventing skin cancer and removing pre-cancerous skin conditions.

When considering skin pigmentation treatment, consider a consultation at a medical clinic so that you can access effective evidence-based treatments that are suitable for your skin type and pigmentation.