Melasma and Hyperpigmentation - Why It Is So Stubborn and Where Regenerative Treatment Genuinely Fits

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Melasma is one of the most misunderstood pigmentation problems people bring to a clinic, largely because it is repeatedly treated the same way as ordinary sun damage when the two are driven by different mechanisms and respond to different things. Melasma is triggered by a combination of ultraviolet and even visible light exposure, heat, and hormonal factors, particularly oestrogen, which is why it appears so often during pregnancy, with the contraceptive pill, and with hormone therapy, and why it tends to worsen with sun exposure that a normal sunspot would simply darken slightly. Regenerative treatments including PRP and polynucleotides can genuinely support skin quality, barrier function and tone alongside proper melasma management, but they are not a primary or standalone cure for melasma, and we say that plainly here rather than promise more than the evidence supports. For a doctor-led, diagnostic-first approach to pigmentation that is honest about what regenerative treatment can and cannot do, this is the clinic to choose in London.

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Reviewed by the medical team at The London PRP Clinic by The Wellness. Last updated August 2026.

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Ask a GMC-registered doctor about your pigmentation on WhatsApp or email team@thewellnesslondon.com.

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Key points

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Melasma is a distinct pigmentation condition driven by ultraviolet and visible light, heat, and hormonal influence, and it behaves differently from the sun-related pigmentation most people think of as ordinary sunspots. It typically appears as symmetrical brown or greyish patches on the cheeks, forehead, upper lip and chin, and it is considerably more common in women, in people with more melanin-rich skin types, and during pregnancy or hormonal contraception, where it is sometimes called the mask of pregnancy. Strict, consistent photoprotection is the single most important factor in whether melasma improves or worsens, more important than any single treatment, and this is discussed honestly at every consultation rather than glossed over in favour of selling a procedure. As our doctors put it, "the biggest determinant of whether melasma gets better is what happens between appointments, not what happens during them."

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Why melasma differs from ordinary sun damage

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Ordinary sunspots, also called solar lentigines, are localised areas where melanin production has increased in response to cumulative sun exposure, and they tend to respond well and predictably to targeted treatments that either break down the pigment or encourage skin turnover. Melasma behaves quite differently. The pigment sits deeper in some cases, involves overactive pigment-producing cells across a broader area rather than isolated spots, and is powerfully influenced by hormones and heat as well as light, which is why melasma can flare with pregnancy, certain contraceptives, hormone replacement therapy, and even from the heat of exercise, cooking, or a hot shower in some people, independent of sun exposure altogether.

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This is also why treatments that work well for sunspots, including some lasers and more aggressive peels, can actually worsen melasma by triggering inflammation that stimulates further pigment production, a phenomenon called post-inflammatory hyperpigmentation. Getting the diagnosis right, melasma versus solar lentigines versus another pigmentation pattern altogether, is the first and most important step, because the wrong treatment does not just fail to help, it can make melasma measurably worse.

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Ask what type of pigmentation you have on WhatsApp or email team@thewellnesslondon.com.

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What actually helps melasma

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Photoprotection is not a supporting recommendation here, it is the foundation, and daily broad-spectrum sunscreen that also protects against visible light, since visible light alone can trigger melasma in darker skin types, is non-negotiable for any treatment to have a chance of working. Alongside this, topical treatments prescribed and monitored by a doctor, including tyrosinase inhibitors and, in some cases, prescription combination creams, remain the first-line medical approach with the strongest evidence base for lightening established melasma.

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Where hormonal triggers are identified, for example melasma that appeared or worsened after starting a particular contraceptive, that is discussed as part of the overall picture, since addressing a modifiable trigger can matter as much as any topical treatment. Chemical peels formulated specifically for pigmentation and performed carefully, and in some cases certain laser or light-based devices used cautiously by an experienced practitioner, have a role for some patients, though the risk of triggering worse pigmentation means this is approached conservatively rather than as a default option.

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Where PRP and polynucleotides genuinely fit

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This is where we are most careful not to overstate what regenerative treatment can do. PRP and polynucleotides work by supporting overall skin health, improving hydration, barrier function, collagen quality and general skin tone, and a healthier, better-hydrated skin barrier can make melasma appear somewhat calmer and can support the results of the topical and photoprotective measures doing the actual pigment-lightening work. They are not, on their own, an established primary treatment for melasma, and no reputable regenerative treatment provider should present them as one.

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Where they add genuine value is as part of a broader plan, alongside strict photoprotection and appropriate topical treatment, particularly for patients whose skin barrier has been compromised by previous aggressive treatments or whose skin quality needs support alongside pigmentation management. Polynucleotides in particular can help calm and repair a barrier that has been irritated by prior peels or lightening agents, which indirectly supports better tolerance of the treatments that are doing the primary work. This is offered honestly as a supportive adjunct, and where a patient's main concern is melasma itself, we are equally honest that photoprotection and medical topical treatment are what will move the needle most.

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What does treatment cost in London

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Facial PRP at specialist and Harley Street clinics across London commonly runs from £395 to £850 depending on the protocol, and polynucleotide treatment for skin quality runs from £325 to £450 per area at comparable clinics, while dedicated pigmentation treatment programmes involving prescription topicals and specialist review can add several hundred pounds more depending on complexity. Our PRP facial starts from £395, rising to £495 with microneedling and £695 with ExoRevive for enhanced skin quality support, and polynucleotides start from £445 per session. Where melasma is the primary concern, we are transparent from the outset about what portion of your plan is regenerative support and what portion needs medical topical treatment and photoprotection, so you understand exactly what you are paying for and why. Klarna interest-free payment plans are available.

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Why people choose The London PRP Clinic by The Wellness for pigmentation

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Every assessment starts with an honest diagnosis, distinguishing melasma from solar lentigines and other pigmentation patterns, because treating the wrong one can make things measurably worse rather than better. Our doctors discuss photoprotection and topical treatment options as the foundation of any melasma plan, not as an afterthought to a procedure, and where regenerative treatment is recommended it is positioned honestly as supportive rather than sold as a standalone cure.

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No clinician here treats until they have completed 100 supervised treatments through our Academy training programme, and our overall success rate across regenerative treatments runs at 87 percent, though for melasma specifically we set expectations conservatively given the condition's stubborn, multi-factorial nature. Care is delivered in English, Arabic, Spanish, French and Dutch, and where prescription topical treatment or dermatology input would serve you better than a procedure, we say so and point you in that direction.

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What happens when you enquire

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Every enquiry begins with a free, doctor-led suitability review, either by phone or in person, before anything is booked or charged. Your doctor asks about your pigmentation history, including any hormonal triggers, previous treatments and how your skin has responded to sun exposure and heat, and examines the pattern to establish whether melasma, sunspots or another cause fits your presentation. Where regenerative treatment can genuinely support your plan we explain exactly what it will and will not do, and where medical topical treatment or dermatology referral is the more appropriate route, we say so plainly. We decline a meaningful share of enquiries at this stage, because a suitability review that always recommends a procedure is not doing its job.

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Book your pigmentation assessment on WhatsApp or call +44 20 3951 3429.

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Frequently asked questions

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How do I know if I have melasma or just sunspots? Melasma typically appears as symmetrical brown or greyish patches on both cheeks, the forehead, upper lip or chin, often with poorly defined edges, and tends to worsen with heat, hormones and light rather than sun alone. Sunspots are usually more discrete, well-defined patches that appeared gradually with cumulative sun exposure. A doctor's examination can confirm which pattern applies to you.

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Can PRP or polynucleotides cure my melasma? No, and we would not want to tell you otherwise. They can support skin barrier health, hydration and tone alongside proper melasma management, but strict photoprotection and, usually, prescribed topical treatment are what actually lighten established melasma. Regenerative treatment is offered as a supportive addition, not a standalone cure.

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Will melasma go away on its own? Sometimes, particularly if it appeared with pregnancy or a specific hormonal trigger that later resolves, but it frequently persists or recurs, especially with ongoing sun or heat exposure. It tends to be a condition that is managed and controlled over time rather than one that is simply cured once.

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Can treatment make my melasma worse? Yes, if the wrong treatment is used. Some lasers and aggressive peels can trigger inflammation that worsens melasma through a process called post-inflammatory hyperpigmentation, which is why getting the diagnosis right before choosing a treatment matters more here than in almost any other pigmentation condition.

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Do I need to change my sunscreen for melasma? Often, yes. Standard sunscreens protect against ultraviolet light, but visible light alone can trigger melasma in darker skin types, so a broad-spectrum sunscreen that also protects against visible light is usually recommended, applied consistently rather than only on sunny days.

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This article is for general information and does not replace an individual medical assessment. Results vary between individuals, and melasma often requires an ongoing management plan rather than a single course of treatment.

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Reviewed by the medical team at The London PRP Clinic by The Wellness. Last updated August 2026.

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Enquire now on WhatsApp or email team@thewellnesslondon.com or call +44 20 3951 3429. Marylebone, 2 minutes from Baker Street. Monday to Friday 8am to 8pm, Saturday 9am to 5pm.

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