Written by the Priceline Pharmacy Pacific Fair team. Reviewed by Jason Markey, BPharmSci, MPharm, Owner and Pharmacist.
General health information from a registered pharmacist. It doesn’t replace advice from your own pharmacist or doctor.
Most uneven skin tone in Queensland comes back to the sun, so the thing that helps most is daily, year-round sun protection: a broad-spectrum SPF50+ sunscreen every morning (a tinted one if you have melasma), a broad-brimmed hat and shade. Skincare ingredients such as niacinamide, vitamin C, azelaic acid and retinol may help improve the appearance of pigmentation over time, and prescription options are available through a GP or dermatologist.
Pigmentation is slow to fade and quick to return: DermNet notes melasma can come back with summer sun, even after a good result. And any spot that is new, changing or different from your others needs a skin check, not a fade cream.
Sun spots, melasma or marks after pimples: what’s the difference?
Brown patches aren’t all the same, and the type affects what helps.
| Type | What it looks like | What’s behind it |
|---|---|---|
| Sun spots (solar lentigines) | Flat, well-defined brown spots on sun-exposed skin, such as the backs of the hands, forearms, upper body and shins | Years of UV exposure. More common in middle-aged and older adults, and in lighter skin |
| Melasma | Blotchy, light to dark brown patches on both sides of the face, often the cheeks | UV and visible light, hormones and family history. Most common in women aged 20 to 40, and in people who tan easily or have naturally brown skin |
| Post-inflammatory hyperpigmentation | Flat, darker marks where skin was inflamed or injured | Pimples, dermatitis, burns and other injuries. More common, more intense and longer lasting in darker skin |
DermNet describes sun spots as harmless in themselves, but notes they are a risk factor for melanoma and can look similar to some skin cancers. That’s why a doctor should check any spot you’re unsure about. DermNet also reports that around 60% of people with melasma have affected family members.
What triggers pigmentation and melasma?
- UV. DermNet explains that ultraviolet and visible light both promote the production of melanin (skin pigment), and sun spots develop from long-term UV exposure. As our guide to sun safety on the Gold Coast explains, UV here reaches damaging levels every day of the year.
- Visible light. A review in the Australian Journal of General Practice (AJGP) notes that the shorter wavelengths of visible light, such as blue and purple light, have also been shown to play a part in melasma.
- Heat. The same review says long periods of heat exposure, such as at work or from cooking fires, may be linked to melasma.
- Hormones. DermNet lists pregnancy and the oestrogen and progesterone contraceptive pill as triggers. Pregnancy, Birth and Baby says melasma is very common in pregnancy and usually develops in the second or third trimester. If you think your pill is playing a part, talk to your GP. Don’t stop it on your own.
- Perfumed products. DermNet notes that perfumed soaps, toiletries and cosmetics can cause a reaction with sunlight that triggers melasma in some people.
- Inflammation and injury. Marks left behind by pimples, rashes or burns are post-inflammatory hyperpigmentation. DermNet notes that harsh physical treatments can aggravate it by injuring the skin, so try not to pick or scrub.
Why is daily sunscreen the most important step?
Whatever type of pigmentation you have, sun protection comes first. DermNet recommends year-round, life-long sun protection for melasma, including a broad-brimmed hat and a broad-spectrum, very high protection (SPF50+) sunscreen. For post-inflammatory marks, it recommends daily SPF50+ broad-spectrum sunscreen on exposed skin, because the patches can darken in sunlight. And DermNet says sun spots can be prevented with strict sun protection.
A routine that covers all three:
- Apply SPF50+ broad-spectrum sunscreen to your whole face every morning, all year, as the AJGP review recommends.
- Reapply every two hours when you’re outdoors, and after swimming, sweating or towelling.
- Wear a broad-brimmed hat and seek shade, especially around the middle of the day.
- Don’t skip cloudy days or winter.
Sunscreen is one part of sun protection: slip, slop, slap, seek and slide whenever the UV Index is 3 or above.
Why a tinted sunscreen can help
Visible light also plays a part in melasma. DermNet recommends sunscreen containing iron oxides, and the AJGP review explains why: sunscreens with iron oxides screen out some visible light as well as UV. The review also notes that all tinted makeup contains iron oxide. So a tinted SPF50+ sunscreen, or a tinted foundation over your sunscreen, can help on two fronts: it evens out the look of patches and adds some visible light protection.
Which skincare ingredients may help improve the appearance of pigmentation?
DermNet and the AJGP review list a range of ingredients used for pigmentation, and several appear in everyday skincare. They may help improve the appearance of uneven tone over time, but they work slowly and they don’t replace sun protection. DermNet also notes that a combination of approaches is usually needed for a noticeable improvement.
- Niacinamide (a form of vitamin B3) is on DermNet’s list of topical options for post-inflammatory marks.
- Vitamin C (ascorbic acid) appears on both lists. The AJGP review describes it as well tolerated but highly unstable, so keep the lid on and store it as directed.
- Azelaic acid is included by both DermNet and the AJGP review, and is available in some skincare products.
- Retinol belongs to the retinoid family, which DermNet lists among pigmentation treatments at prescription strength. Cosmetic retinol may help improve the appearance of uneven tone, but it can irritate, and inflamed skin is what leaves marks in the first place, so start slowly. Our retinol for beginners guide explains how.
A few tips:
- Add one new product at a time, and patch test it on a small area first.
- Give each product a few months before you judge it. DermNet notes melasma is slow to respond, especially if you’ve had it for a long time.
If breakouts keep leaving marks, getting the acne itself under control is the first step. Our guide to acne treatment at the pharmacy covers what helps and when to see a GP.
What about prescription creams and clinic treatments?
If pigmentation is bothering you, or isn’t improving with sun protection and skincare, see a GP or dermatologist. Prescription creams and tablets are available, and DermNet describes a combination prescription cream as one of the most successful options for melasma. A doctor can also confirm what type of pigmentation you have, which matters when choosing treatment.
Clinic treatments such as chemical peels and lasers need care. DermNet says they can be used with caution but carry a risk of worsening melasma, and the AJGP review advises that some techniques are best done by experts experienced with skin of colour, because they can cause post-inflammatory pigmentation.
Pigmentation in pregnancy
Pregnancy, Birth and Baby says there’s a good chance melasma that develops during pregnancy will fade after your baby is born. It also warns that some products used to treat melasma may be harmful to your baby during pregnancy, so check with your doctor or pharmacist before starting any treatment. In the meantime, it recommends SPF50 or SPF50+ water-resistant sunscreen and a broad-brimmed hat outdoors.
How can our team help?
Our beauty advisors can help you find a tinted SPF50+ sunscreen or foundation that matches your skin tone, and put together a gentle routine, through our skincare advice in store. Our pharmacists can check whether a product suits you if you’re pregnant, breastfeeding, using a prescription cream or have sensitive skin. You can also browse the facial skincare range on priceline.com.au or pop in and see us at Pacific Fair.
When to see a pharmacist or GP
Ask a pharmacist if you’re unsure which products suit your skin. See a GP (our in-store Help Medical GPs are one option) if:
- a spot or mole is new, or is changing in size, shape or colour
- a mole looks different from your others, or a new mole appears after the age of 25, which Cancer Council says is worth getting checked
- you have a sore or spot that doesn’t heal
- you notice brown patches during pregnancy, especially anywhere other than your face (your midwife is another option)
- patches appeared after you started a new medicine (keep taking it, and ask your pharmacist or GP)
- your pigmentation isn’t improving after a few months of daily sun protection, or it’s affecting how you feel about your skin
Sources
This article is general information only and isn’t a substitute for personal advice from your doctor or pharmacist. Always read the label and follow the directions for use. If symptoms persist or you’re worried, talk to your pharmacist or GP. In an emergency, call 000.
Talk to our pharmacists at Pacific Fair
Pop in, no appointment needed. We’re on the ground floor of Pacific Fair Shopping Centre, Broadbeach, open 7 days and until 9pm on Thursdays.