Skin Concern
Pigmentation Changes
Uneven skin tone, melasma, and age spots are among the most confidence-affecting skin changes during menopause. They have clear hormonal drivers — and targeted, physician-led treatments can restore clarity and luminosity.
What causes pigmentation changes?
Skin colour is determined by melanin — a pigment produced by specialised cells called melanocytes. When melanocyte activity is evenly distributed and well-regulated, skin tone appears uniform and clear. When something disrupts this regulation — hormones, UV exposure, inflammation — melanocytes can overproduce melanin in localised areas, creating patches of darkened skin.
The most common forms of pigmentation we see in menopausal women are melasma (larger, blotchy patches typically on the cheeks, forehead, and upper lip) and solar lentigines (discrete dark spots caused by accumulated UV damage, often called age spots).
Why menopause accelerates pigmentation changes
Both oestrogen and progesterone influence melanocyte activity. During perimenopause, fluctuating levels of these hormones can destabilise melanin regulation, triggering melasma or worsening existing pigmentation. Post-menopause, the relationship changes: lower oestrogen reduces some protective mechanisms, and decades of UV exposure that was previously being quietly repaired becomes visible.
Hormonal replacement therapy (HRT) can affect pigmentation too — some women notice pigmentation changes when starting or adjusting HRT, reflecting the sensitivity of melanocytes to hormonal fluctuation.
The key aggravating factor for all pigmentation is UV exposure. Without consistent sun protection, any hormonal pigmentation will worsen regardless of treatment. SPF 50+ applied daily is the foundation of any pigmentation management plan.
Physician-led treatments at London & Glow
Pigmentation treatment requires patience and a layered approach. There is no single treatment that removes pigmentation overnight — but a consistent, physician-guided protocol produces meaningful, lasting results. Crucially, the type of pigmentation must be correctly identified before treatment: some approaches that work for solar lentigines can worsen melasma if misapplied.
Carefully selected acids accelerate cell turnover, clearing pigmented surface cells more rapidly and disrupting the melanin cycle. The right peel type and concentration is critical — our physician will choose based on your pigmentation type, skin sensitivity, and Fitzpatrick skin type.
Microneedling improves overall skin renewal and, when combined with targeted serums (such as vitamin C or tranexamic acid), can help address uneven tone. It is particularly useful for overall luminosity and texture alongside pigmentation concerns.
Important: Sun protection is non-negotiable
All pigmentation treatments are significantly less effective — and some are counterproductive — without daily broad-spectrum SPF 50+. Our physician will discuss your complete sun protection strategy at consultation.
Common questions
Why does pigmentation worsen during menopause?
Oestrogen and progesterone both influence the activity of melanocytes — the cells that produce melanin (skin pigment). As these hormones fluctuate and decline during perimenopause and menopause, melanocyte regulation becomes less stable. Some areas of skin overproduce melanin (causing darkening), while years of accumulated UV damage become more visible as skin's natural repair capacity slows.
Is melasma related to menopause?
Melasma is strongly associated with hormonal changes — it is well-known as a side effect of hormonal contraception and pregnancy. During perimenopause and menopause, fluctuating oestrogen and progesterone levels can trigger or worsen melasma, particularly on the cheeks, forehead, and upper lip. Sun exposure is the main aggravating factor, so diligent SPF use is essential alongside any treatment.
What is the best treatment for hormonal pigmentation?
Hormonal pigmentation requires a multi-step approach. First, consistent broad-spectrum SPF 50+ is non-negotiable — UV exposure is the primary trigger and will undo any treatment if not managed. Medical-grade chemical peels accelerate cell turnover and help fade existing pigmentation. Prescription topicals (hydroquinone, retinoids, azelaic acid) are often used alongside in-clinic treatments. Your physician will assess the type and depth of pigmentation to recommend the most appropriate protocol.
Restore clarity and even tone
Pigmentation requires a carefully chosen approach. Our physician will identify the type and cause of your pigmentation and design a targeted treatment plan.
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