Before
![Uneven Tone Not Shifting?](https://www.monderma.co.uk/wp-content/uploads/2025/04/Middle-aged-mixed-race-woman-after-hyperpigmentation-treatment.jpg" "Uneven Tone Not Shifting?")
After
Dark spots affect around 1 in 3 people over 35, and become more visible with age, often developing after sun exposure.
With steady topical care, their appearance can often be brightened.
Restore a brighter-looking tone in 3 steps
your quick and secure consultation
your hyperpigmentation prescription plan
your formula as your skin improves
Made in a gentle vegan base cream, your hyperpigmentation formula may include up to 3 active ingredients, selected from adapalene, azelaic acid, niacinamide, and tretinoin.
 |
VS | Over The Counter |
|---|---|---|
| Prescription Lightening Agent | Cosmetic Retinol Only | |
| 3-in-1 Active Treatment | 3 Separate Products Needed | |
| Personalised To Your Skin | One-Size-Fits-All | |
| Up To 20× Higher Efficacy | Limited Visible Change | |
| Care From UK-Registered Pharmacists | Standard Retail Product | |
| Dermatology-Grade Standards | Non-Clinical Standards | |
Monderma’s hyperpigmentation formulas are overseen by GPhC-registered prescribers and pharmacists for safe, guided use.
A brighter-looking tone and reduced dark marks are often described over 12 weeks. Mild redness or peeling can occur as the skin adjusts.
Changing skin without the needles!
“I was at a stage where my skin felt quite dull, tired and dry. I forged this part of my daily evening routine and my god…. Thanks for making this for me!!”
Monderma is a skincare saviour
“Small areas of freckling and pigmentation have disappeared, the texture of my skin is smooth and even and my skin looks better now than 10 years ago!”
Personalised hyperpigmentation formulas developed to improve the look of sun spots, lighten the appearance of melasma, and support skin healing after injury.
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Hyperpigmentation affects 1 in 3 people in the UK, mostly those over 35.
Women are more likely to be affected by hyperpigmentation than men.
Darker skin tones are more likely to develop hyperpigmentation, although it also significantly impacts lighter skin tones.
Visible symptoms of hyperpigmentation include spots or patches of skin darker than the surrounding area.
The face is the primary site of hyperpigmentation. It also affects 20% of people on the neck and chest, 10% on the shoulders and back, 30% on the arms, while 10% develop it on the legs.
Hyperpigmentation consists of 3 subtypes:
| Subtype | Description | Common Areas |
|---|---|---|
| Solar Lentigines (liver spots) | Clustered, flat, brown, or black spots | Face, neck, arms, and legs |
| Melasma (the mask of pregnancy) | Symmetrical, flat, brown, or grey-brown patches | Face, neck, and torso |
| Postinflammatory Hyperpigmentation (acquired melanosis) | Raised, red, brown, or black spots, or patches | Injured areas of the body |
Around 50% of people with hyperpigmentation have solar lentigines, 25% develop melasma, and 50% suffer from postinflammatory hyperpigmentation.
The term “hyper” means more, while “pigment” refers to colour.
Hyperpigmentation is caused by excess melanin production, responsible for the colour of hair, eyes, and skin.
This is influenced by:
| Cause | Description |
|---|---|
| Photoageing | Photoageing from exposure to ultraviolet (UV) radiation from sunlight and tanning beds stimulates melanin production, leading to the formation of solar lentigines |
| Injury | Injury from acne, eczema, burns, or wounds triggers inflammation, producing excess melanin and dark spots and patches |
Other factors that can contribute to the development of hyperpigmentation are:
| Contributor | Description |
|---|---|
| Genetics | Genetics means some people are naturally more predisposed, for example, lighter skin tones to solar lentigines, and darker skin tones to melasma |
| Hormones | Hormones fluctuate during pregnancy and can contribute to melasma, while stress, as well as health conditions like Addison’s disease, thyroid imbalances, or insulin resistance can lead to dark skin spots and patches |
| Medications | Medications including heart disease drugs and antibiotics are known to cause dark spots and patches, while hormonal treatments like birth control pills or hormone replacement therapy can contribute to melasma |
Hyperpigmentation is common on darker skin tones, which already have a higher melanin content.
Monderma’s GPhC-registered prescribers evaluate hyperpigmentation by reviewing submitted images or engaging in a video consultation.
This evaluation involves your face and neck, analysing distributions and characteristics for severity, duration, and progression. Your medical history is also considered.
Hyperpigmentation severity ranges from mild to severe:
| Severity | Distribution | Characteristics |
|---|---|---|
| Mild | <19% | Localised to sun-exposed areas |
| Moderate | 20-49% | Noticeable patches of darker skin, more frequent, and larger spots |
| Severe | >50% | Deep, dark patches, and extensive uneven skin tone |
Can hyperpigmentation be mistaken for a different condition?
A differential diagnosis distinguishes hyperpigmentation from other lookalike conditions:
| Condition | Cause | Description | Difference |
|---|---|---|---|
| Acanthosis Nigricans | Insulin resistance, obesity, hormonal issues | Dark, thick, velvety patches in skin folds | Linked to metabolic disorders like diabetes |
| Addison's Disease | Adrenal dysfunction | Generalised skin darkening, especially on folds | Often with fatigue and low blood pressure |
| Erythema Dyschromicum Perstans | Genetic and environmental factors | Greyish or ashy patches on face or neck | More common in darker skin tones |
| Hemochromatosis | Excess iron deposits | Bronzed or darkened skin | Associated with liver disease and joint pain |
| Lichen Planus Pigmentosus | Autoimmune conditions, sun exposure | Dark patches on face and neck | More common in darker skin tones |
| Lupus Erythematosus | Autoimmune response | Dark spots following a red rash on nose and cheeks | Accompanied by joint pain and fatigue |
| Peutz-Jeghers Syndrome | Genetic condition | Dark spots around mouth and fingers | Associated with gastrointestinal polyps and cancer risk |
| Tinea Versicolor | Fungal infection | Light or dark patches on chest and back | Affects melanin production and often recurrent |
If you notice any of these symptoms or have specific concerns, you must speak with your GP for examination. This information is for general information purposes only and does not replace medical advice.
If over-the-counter cosmetics have been ineffective or your skin is at risk of complications, Monderma may suggest a personalised treatment plan.
Monderma’s GPhC-registered prescribers create a monthly hyperpigmentation formula, compounded by our GPhC-registered pharmacy. Your formula is refined based on your feedback, ensuring it remains safe and effective.
Ingredients and their strengths are expertly chosen, with up to 3 of the following included:
| Ingredient | Properties |
|---|---|
| Retinoid | Speeds up skin cell renewal to shrink pores, clear spots, and smooth fine lines |
| Lightening Agent | Reduces melanin to lighten patches of darker skin. |
| Anti-Inflammatory | Blocks irritable molecules to reduce redness, calm inflammation, and lighten patches of darker skin |
| Corticosteroid | Inhibits the production of melanin to reduce swelling and inflammation |
| Antioxidant | Strengthens the skin’s barrier function to lock in moisture and boost suppleness |
SPF 30+ sunscreen is required daily to support a hyperpigmentation formula.
Visible results may appear after 1 week, but lasting results take 8 weeks or longer. It is important to be patient and follow your treatment plan.
For more information on Monderma's ingredients, directions for use, safety information, storage, potential side effects, and reporting, please refer to our information leaflet.
Hyperpigmentation is often persistent, with most people experiencing it throughout life.
Possible complications include:
| Complication | Description |
|---|---|
| Recurrence | Recurrence of PIH can occur if skin inflammation persists, causing pigmentation to worsen over time. Even after treatment, it may return if the underlying cause is not addressed and sun protection is neglected |
| Scarring | Scarring can develop, often due to PIH. Repeated skin injury, irritation, or unprotected sun exposure increases the risk of deeper, long-lasting pigmentation, leading to uneven texture and tone. In some cases, this may be harder to treat than the original hyperpigmentation. Acne-related pigmentation can also signal deeper scarring, requiring more intensive treatment |
| Texture Changes | Texture changes occur when inflammation or injury causes the skin to become uneven, rough, or raised. These changes often accompany dark spots, especially when healing is disrupted by picking or sun exposure. Discoloration and irregular texture together can make hyperpigmentation more noticeable |
| Treatments | Treatments like microdermabrasion, chemical peels, and laser therapy can risk scarring, infection, or worsened pigmentation if not done correctly or without proper aftercare. Inconsistent application or lack of professional guidance with topical treatments and procedures may cause uneven skin tone, while allergic reactions can further irritate the skin and worsen hyperpigmentation |
| Underlying Health Conditions | Underlying health conditions can lead to pigmentation changes, primarily by disrupting melanin production. Inflammatory skin conditions like acne, eczema, and psoriasis can cause PIH. Hormonal imbalances, such as those during pregnancy or from birth control, may trigger melasma. Addison's disease increases adrenocorticotropic hormone (ACTH), leading to widespread skin darkening. Insulin resistance in PCOS often causes dark patches on the neck and armpits. Additionally, metabolic and genetic conditions like hemochromatosis and Peutz-Jeghers syndrome can contribute to increased pigmentation |
| Psychosocial | Psychosocial impacts of hyperpigmentation, especially when prominent or widespread, can lead to self-consciousness and low self-esteem. Many experience anxiety, depression, or emotional distress due to their skin's appearance. Some may avoid social interactions, outdoor activities, or clothing that exposes affected areas, impacting self-expression and quality of life |
Hyperpigmentation typically requires long-term treatment to achieve a clear complexion.