The Ultimate Guide to Pigmentation, Brown Spots/Age Spots (With Photos)

Vol 001 - Issue 001 - November 2021

Message to You:

Dear reader,

Thank you for taking the time to read this guide. But most importantly, thank you for taking the time to look after your skin.

At mayer | monroe, we have put together this guide as a simple and short start for people looking for a bit of guidance relating to pigmentation, brown spots and age spots.

We hope you find the guide useful and feel comfortable contacting us with any questions you may have.

Best wishes,
The mayer | monroe team

Table of Contents

Pigmentation Summary

Melasma Summary

Treatments for Melasma

Age Spots Summary

Age Spots & Other Skin Characteristics

Age Spots Treatments

Melasma & Age Spots Prevention

Next Step

Pigmentation Summary

Pigmentation is a formal word for the appearance of brown spots on a person's skin. Many of our clients come to us with pigmentation on different areas of their bodies and with varying severity.

Sometimes, the appearance of pigmentation can be rather distressing for a client, particularly in a modern society that places a high emphasis on blemish free and flawless skin.

There are 2 primary types of pigmentation:
1) Melasma and Chloasma
2) Age Spots, known medically as “Solar Lentigines”

Before and After Photos - Example #1

AFTER 5 weeks
Example 1 Before


Example 1 After


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Pigmentation Summary Continued...

The majority of our clients present with mild to moderate melasma. Although, we have had a number of noticeable cases, where the melasma was extensive and in areas that made the clients very self-conscious.

Prior to becoming a mayer | monroe client, a lady in her 40’s tried many different over-the-counter cosmetics products for her pigmentation, all of which had little impact. Following a full consultation, this woman was prescribed a medical-grade skincare protocol that significantly improved the appearance of the melasma.

Before and After Photos - Example #2

Example 2 Before


Example 2 After


Melasma Summary

When we speak to clients, they don't describe it as 'Melasma'. Instead, people will say that they have brown pigmented areas, usually on their face.

Melasma usually occurs between the ages of twenty and forty. However, we do have clients that are outside of this age range.

Commonly Affected Areas


A range of factors can trigger Melasma and those of particular note are sun exposure, pregnancy, and contraceptive and/or hormonal medicines. Also, certain medications and abnormal thyroid functioning can also be a cause.

Before and After Photos - Example #3

AFTER 8 weeks
Example 3 Before


Example 3 After



Melasma Summary Continued...

Unlike other skin conditions, the presence and appearance of melasma is often evident during a consultation and further diagnosis is not usually required.

You may have read or watched some of our other videos on the structure of the skin and heard us talk about the epidermis (upper layer) or dermis (lower layer) of the skin. If you have, you will know that solid pigmentation can exist in either layer, however, usually, both layers are affected.

Before and After Photos - Example #4

Example 4 Before


Example 4 After



Treatments for Melasma

Hydroquinone is a prescription-only pharmaceutical and can only be administered by medically trained personnel who are licenced to prescribe.

Hydroquinone is used to treat melasma by altering the chemical channel that produces melanin (pigment). This topical cream is applied regularly to the affected area to help treat the melasma.

Other parts of the treatment include a retinoid agent e.g. tretinoin, to enhance penetration, as well as a low-strength steroid to ease irritation.

Before and After Photos - Example #5

Example 5 Before


Example 5 After



Treatments for Melasma continued...

About 1 in 4 of our clients tell us they experience an itchy or burning sensation on their skin when starting a treatment plan. However, we work with our clients to advise them that this alone is not a reason to halt the course.

We do advise clients to build their tolerance up gradually if the irritation is causing them to be inconsistent with the treatment plan.

Before and After Photos - Example #6

AFTER 9 weeks
Example 6 Before


Example 6 After


Treatments for Melasma continued...


Arbutin is a derivative of the bearberry plant. The skin lightening effects of arbutin usually only occur in products containing >1% concentration.

Vitamin C

Topical vitamin C treatments disrupt pigment production but in a positive way when treating melasma. There are many different types of vitamin C, and strengths up to 20% are okay. However, past this concentration, the irritation can be overwhelming for some clients.

Glycolic Acid

Don't let the word ‘acid' put you off, glycolic acid is derived from sugar cane and has positive skin-lightening effects.

Before and After Photos - Example #7

Example 7 Before


Example 7 After


Treatments for Melasma continued...

Azelaic Acid

Azelaic acid is a highly versatile and beneficial compound. It can be used to treat a wide variety of skin conditions, including rosacea and acne as well as melasma. The concentration of azelaic acid varies, but higher concentrations require a prescription.


Retinoids are a popular topic in many of our documents and videos. Retinoids can be a highly effective part of the treatment plans we design for mayer | monroe clients. Tretinoin (a prescription pharmaceutical) has been proven to be most effective and is used in combination with hydroquinone.


Before and After Photos - Example #8

Example 8 Before


Example 8 After



Treatments for Melasma continued...

Chemical Peels

When chemical peels are used for treating melasma, they are often strong because of the density and depth of the pigmentation. Clients can experience shedding and peeling of their skin for up to seven days whilst the body regenerates new skin.

The depth and strength of the peel vary depending on how sensitive the person's skin is and what areas of skin need treating.

In the period of skin shedding, it is vitally important to wear broad-spectrum Sun Protection Factor (SPF) sunscreen, with a minimum of SPF 30 and ideally SPF 50. This is because the new skin coming through is more vulnerable to UV damage.

Before and After Photos - Example #9

Example 9 Before


Example 9 After



Age Spots Summary

Age spots also referred to as solar lentigines and “liver spots”, are areas of the skin that are brown in appearance. This skin discolouration is caused by exposure to the sun.

Age spots can occur in all skin tones but generally affect those with lighter skin tones, e.g. Fitzpatrick I, II or III.

Common areas for age spots include the face, chest, forearms and the back of hands. Unsurprisingly, this is because these areas are generally most exposed to UV rays. As a person gets older, these age spots will become more pronounced.

In most cases of age spots, other tell-tale signs of sun exposure will also be present, such as lines and wrinkles.

Below you will see a picture of multiple areas that are affected by age spots.

Age Spots & Other Skin Characteristics

Sun Aged Skin

Areas that are particularly prone to age spots, are the neck, back of hands and face, including the forehead.

Before and After Photos - Example #10

Example 10 Before


Example 10 After


Age Spots Treatments

Now you have seen the treatments for melasma, you may notice that the treatments for age spots are very similar.

Creams & Gels

A commonly designated option in our treatment plans for age spots is retinoid and hydroquinone creams. We do advise our clients that the benefit may take 90 days to become apparent, during which period we monitor their progress. Prescription-strength tretinoin has a large body of scientific evidence to back its efficacy and has produced some tremendous results for mayer | monroe clients.

Chemical Peels

The chemical peels applied for people with melasma or age spots are interchangeable.

Before and After Photos - Example #11

Example 11 Before


Example 11 After


Age Spots Treatments continued...


Liquid nitrogen is used at a temperature of -196 degrees Celsius. The substance is carefully applied to the area, and the age spots can be frozen away rapidly. It may feel cold and sore and the area is prone to blistering in the following days, but the skin should soon heal.

This treatment should only be carried out by a dermatologist or trained medical professional.

Light & Laser

Intense Pulsed Light (IPL) is a standard treatment for age spots. During treatment, a gentle light beam is directed at the affected area to fade age spots.

Age Spots & Melasma Prevention

"Prevention is the best cure" - Desiderius Erasmus c. 1500

Sunscreen is and will likely remain the lynchpin of preventing melasma. Many scientific studies we reviewed indicated the sun, specifically UV-A and UV-B, exacerbated the melasma condition.

Remember, not all sunscreens are created equal. As such, aim for a broad-spectrum sunscreen with a minimum of SPF 30, and even better is SPF 50. This applies even in the United Kingdom, so please wear your sunscreen!

If you would like some more information, contact us directly or visit  for another complimentary guide on how the sun affects the skin.

Before and After Photos - Example #12

Example 12 Before


Example 12 After



Next Step - Let's start a conversation


For more detailed information relating to this guide, including the skincare products we’ve researched, contact us.

Lastly, we produced this booklet to be of value to you - the reader. It is wonderful you have chosen to take care of your skin. Whether or not you choose mayer | monroe, we want you to be

A) educated and safe in your decisions,

B) have trust in who you choose, and

C) you are treated with kindness.


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Want to read more?

Click below for the other Skincare Ultimate Guides:

  • Acne
  • Rosacea
  • Skin Health
  • Skin Ageing
  • Sun Damage


- Thank you for reading.