Pigmentation is known by many names, though the official term is hyperpigmentation. 

• Sun spots, brown spots and sun damage 

Most often seen as uneven skin tone, and characterised by uneven brown and tan patches on the face, hands, décolletage and shoulders. It's caused by overexposure to the sun over a period of years and can be identifed in the lower layers of the skin before it's seen on the epidermis. Sun damages is one of the easiest forms of pigmentation to treat.   

• Freckles 

Very small melanin patches, medically termed 'ephelis / ephelides', found on all ages groups, though rarely on infants. They are thought to develop as a result of a combination of genetic tendency (inheritance) and sun exposure. Freckles often fade during the winter months but become more prominent during the summer with increased exposure to the sun. They can be found all over the body but most commonly appear on the face, upper back and shoulders, particularly on people with light skin and hair colouring. 

• Melasma

Tan, brown or grey-brown patches most commonly found on the face, normally in a symmetrical pattern, most notably on the forehead, nose and cheeks. A common skin condition, also called 'chloasma', that affects adults, particularly females, with darker skin tones. Melasma often fades during the winter months but becomes more noticeable during the summer with increased exposure to the sun, but it is not caused by the sun.

• Lentigo and age spots

 A pigmented flat or slightly raised lesion with a clearly defined edge. Lentigines can affect males and females of all ages and races, but are most commonly found on the elderly and often called age spots or liver spots. They are caused by sun damage (including sunburn) indoor tanning and phototherapy. Unlike an ephilis (freckle), it does not fade in the winter months. 

There are many reasons for the occurrence of skin pigmentation including hormonal changes in the body, overexposure to the sun, genetic factors and injury or trauma. 

• Hormonal

Melasma is a very common hormonal pigmentation. Most frequently found in women, the exact cause is not known but several factors have been identified as a contributing factor including hormonal changes e.g. pregnancy or medication; cosmetics e.g. perfume and even some foods e.g. soy milk. 

• Sun damage

Prolonged exposure to the sun with little to no protection to the UVA and UVB infrared rays activates melanocytes in the skin. Melanocytes  are melanin-producing cells located in the bottom layer (the stratum basale) of the skin's epidermis which cause pigmentation.

• Genetic factors

Some, though not all, forms of pigmentation are hereditary either as a result of inherited skin tone or from a genetic disorder.

• Injury / trauma

Known as Postinflammatory Hyperpigmentation, PIH, it is a pigmentation caused by an injury or inflammation of the skin being exposed to sunlight. Though normally temporary, often fading after 18 months, PIH as a result of a sever injury may be permanent without treatment.  Acne and Rosacea can cause Postinflammatory Hyperpigmentation.

It is difficult to prevent pigmentation, particularly if it’s the result of pregnancy or having a genetic condition. But pigmentation caused by the sun’s harmful rays can be prevented and reduced simply by wearing SPF (sun protection factor) every day, avoiding being in direct sunlight for long periods of time and not using sun beds. Remember, a single day of heavy sun can undo months of skin brightening treatments.​