Pigmentation & Uneven Skin Tone: A Pharmacist’s Guide to Brighter, More Even Skin

By Lauren O’Reilly, Pharmacist 

Disclaimer: This article is for general skincare information and educational purposes only and is not a substitute for personalised medical advice, diagnosis or treatment. If you have persistent or worsening pigmentation, or a new or changing mole or skin lesion, consult your GP. 

Dark spots, lingering marks after breakouts and patches of uneven skin tone are some of the most common skincare concerns I’m asked about. And while pigmentation can be frustrating to treat, the good news is that the right routine can help improve its appearance over time. 

As Millie’s in-house pharmacist, my advice is to start by understanding what may be causing the pigmentation, rather than buying every brightening product you see online. Ingredients such as vitamin C, niacinamide, azelaic acid and retinoids can all have a role, but they work in different ways, and daily sun protection is essential if you want to see results. 

What causes pigmentation on the face? 

Pigmentation occurs when melanin, the pigment that gives our skin its colour, is produced or distributed unevenly. Several factors can contribute, and understanding the type of pigmentation you have can help guide your skincare choices. 

Sun exposure and age-related dark spots 

UV exposure can stimulate melanin production, leading to freckles and darker spots that become more noticeable over time. These are often found on areas regularly exposed to the sun, such as the face, chest and hands. 

Hormonal changes and melasma 

Melasma causes patches of brown or grey-brown pigmentation, often across the cheeks, forehead, upper lip or jawline. Hormonal changes, including pregnancy and some hormonal contraceptives, can contribute, while sun exposure may make it worse. Melasma can be persistent, so it often requires a consistent, long-term approach. 

Post-acne marks and inflammation 

Have you ever had a spot that healed but left a brown mark behind? This is known as post-inflammatory hyperpigmentation. It occurs when inflammation stimulates pigment production, and it can happen after acne, eczema, irritation or other skin injuries. It can affect all skin tones, although darker skin tones may be more prone to persistent dark marks. 

It is also worth distinguishing brown pigmentation from the red or pink marks that can remain after acne. Red marks are often related to lingering inflammation or visible blood vessels rather than excess melanin, so they may respond differently to treatment. 

My advice is to address the underlying concern first. If breakouts are continuing, for example, focus on managing the acne as well as treating the marks it leaves behind. Repeated inflammation can lead to new pigmentation before the old marks have had a chance to fade. 

Skincare ingredients that help with pigmentation 

There is no single ingredient that works for every type of pigmentation. The best option depends on your skin, the cause of the discolouration and how well your skin tolerates active ingredients. 

Vitamin C: antioxidant support and brighter-looking skin 

Vitamin C is an antioxidant that helps protect the skin from oxidative stress and can help improve the appearance of uneven tone. It also plays a role in collagen production. 

It can be a useful addition to a morning routine, particularly if you are concerned about dullness, early sun damage or uneven tone. However, vitamin C formulations vary considerably, and it is not an overnight solution for established pigmentation. 

If your skin is sensitive, introduce it gradually. A product that causes persistent stinging or irritation is unlikely to be a good fit, even if the ingredient list looks impressive. 

Niacinamide: a versatile option for uneven tone 

Niacinamide, a form of vitamin B3, supports the skin barrier and can help improve the appearance of dark spots and uneven skin tone. It is often a useful option for people who want to address pigmentation without immediately turning to a stronger exfoliant or retinoid. 

One product to consider is La Roche-Posay Mela B3 Serum It combines 10% niacinamide with Melasyl, an ingredient developed to target excess pigmentation. It is designed for concerns including persistent dark spots, post-acne marks and uneven tone. 

Although it may suit a range of skin types, the formula also contains fragrance, capryloyl salicylic acid and retinyl palmitate. If your skin is reactive, introduce it carefully and monitor how your skin responds rather than assuming that a product marketed for pigmentation will suit everyone. 

Azelaic acid: useful for acne-prone skin and post-acne marks 

Azelaic acid is another ingredient worth knowing about, particularly if you experience both breakouts and dark marks. It has anti-inflammatory properties and can help improve the appearance of post-inflammatory hyperpigmentation. 

It may be a useful alternative for people who want to address uneven tone while managing blemish-prone skin. As with any active ingredient, the right formulation and frequency of use matter, and some people may experience dryness or irritation. 
 
An example of a product containing azelaic acid is La Roche-Posay Effaclar A.Z. Gel-Cream 40ml, which contains a tri-acid complex with 10% azelaic acid, alongside Salicylic Acid and Hyaluronic Acid. This immediately hydrates while delivering double action against adult breakouts and ageing. It gently exfoliates to reduce the appearance of adult spots and post-acne marks, while addressing fine lines & early wrinkles, in one step. I love that this product has been shown to be effective and appropriate to use on all skin tones and also is suitable for sensitive skin. 

The role of retinoids in pigmentation 

Pregnancy and breastfeeding: If you are pregnant, trying to conceive or breastfeeding, check the product information and consult your pharmacist or GP before introducing skincare products containing active ingredients. Suitability can vary depending on the ingredient, concentration and formulation. Avoid topical retinoids, including retinol and retinal, during pregnancy and when trying to conceive. 

Retinoids are vitamin A derivatives used in skincare for concerns including acne, uneven texture, signs of ageing and some forms of pigmentation. 

Retinol and retinal, also called retinaldehyde, are not identical. Retinol must undergo additional conversion in the skin before becoming retinoic acid, while retinal is one conversion step closer. However, this does not automatically mean that every retinal product is more effective or better tolerated than every retinol product. Formulation, concentration and how your skin responds all matter. 

For someone looking to introduce retinal, Medik8 Crystal Retinal 3 is one example of a lower-strength retinal product. It is an optional step, not a requirement for everyone with pigmentation. 

Start slowly, use it at night and follow with moisturiser. Avoid introducing several new active ingredients at once, as irritation can undermine your progress. Retinoids should also be avoided during pregnancy and when trying to conceive as a precaution. 

One important point: if your skin becomes persistently red, sore or flaky, reduce use or stop the product. Irritation can trigger further pigmentation, especially in skin that is prone to post-inflammatory dark marks. 

Tranexamic acid and kojic acid: targeted options 

Other ingredients, including tranexamic acid and kojic acid, are used in products designed to improve the appearance of stubborn discolouration. 

For a more targeted approach, SkinCeuticals Discoloration Defense combines tranexamic acid, kojic acid, niacinamide and HEPES. It is an option to consider for persistent dark spots and post-acne marks.  

HEPES is an exfoliating ingredient that helps loosen the bonds holding dead skin cells to the skin’s surface, encouraging more even exfoliation. In SkinCeuticals Discoloration Defense, it works alongside ingredients such as tranexamic acid, kojic acid and niacinamide to help improve the appearance of dark spots and uneven skin tone. 

You do not need to use this alongside Mela B3. Both are targeted pigmentation serums, so I would generally choose one to begin with rather than layering multiple treatment products and increasing the risk of irritation and compromising the all-important skin barrier. 

Pigmentation Skin Routine [Sample] 

A good routine does not have to be complicated. In fact, a consistent routine with a few well-chosen products is often more useful than a shelf full of competing actives. Here’s an example, although product suitability will vary from person to person, this is a general routine:  

Morning routine 

1. Cleanse gently. Use a cleanser that removes excess oil and overnight product without leaving your skin feeling tight or stripped. If your skin is dry or sensitive, a gentle cleanse is usually enough. Example: CeraVe Hydrating Cleanser. Avoid over-cleansing or using harsh exfoliating cleansers if you’re already introducing active ingredients to target pigmentation. The aim is to keep your skin comfortable and your skin barrier supported while your treatment does the work. 

2. Apply one targeted treatment. Depending on your skin and goals, this could be a vitamin C serum or a pigmentation serum containing ingredients such as niacinamide like the La Roche Posay Mela B5 Serum mentioned, or CeraVe Skin Renewing 10% Pure Vitamin C Serum combines vitamin C with ceramides and hydrating ingredients. Introduce new products one at a time. 

3. Moisturise if needed. Choose a moisturiser that supports your skin barrier and helps keep your skin comfortable. A healthy barrier makes it easier to tolerate active ingredients consistently. For example, SkinCeuticals Triple Lipid Restore 2:4:2 is a richer moisturiser that helps support the skin barrier, making it a useful option for someone experiencing dryness while introducing active ingredients.  

4. Finish with broad-spectrum SPF 50+. This is the step I would prioritise above adding another serum. Sun exposure can darken existing pigmentation and contribute to new spots, making treatment less effective. 

One option available at Millie’s is La Roche-Posay Anthelios Age Correct SPF50. It provides high-level sun protection and is formulated with additional skincare ingredients. Choose a sunscreen you like wearing and can apply generously every day. 

Evening routine 

1. Cleanse. Remove sunscreen, makeup and the day’s build-up without over-cleansing. 

2. Apply your chosen treatment. This might be your targeted pigmentation serum or, if appropriate for your skin, a retinoid such as retinal. You do not need to introduce both at the same time. 

3. Moisturise. Support your skin barrier, especially if you are using retinoids or other active ingredients. 

If you are new to active skincare, start with the basics and build gradually. More products do not necessarily mean better results. 

Why Pigmentation gets worse in summer… 

…and we often notice it in the autumn! UV radiation stimulates melanin production, which can make existing dark spots more noticeable and encourage new pigmentation to develop. This is particularly relevant for melasma and post-inflammatory hyperpigmentation. 

Visible light can also aggravate certain pigmentary conditions, including melasma. This is one reason why sun protection is such an important part of a pigmentation routine throughout the year, not just when the weather is sunny. 

For best results, use a broad-spectrum sunscreen with SPF 50+, apply enough to cover exposed skin and reapply regularly when outdoors, especially after sweating or swimming. A hat, shade and other sun-protective measures are useful additions. 

For people with melasma or persistent pigmentation, a tinted sunscreen containing iron oxides may offer additional protection against visible light. A conventional untinted SPF 50+ remains valuable for UV protection, but it should not automatically be assumed to provide the same visible-light protection as an appropriately formulated tinted product. 

How long does skincare take to improve pigmentation? 

This is where patience matters. Pigmentation does not usually disappear in a week, and the time it takes to improve depends on its cause, depth and how long it has been present. 

With a well-tolerated routine, you may begin to notice changes over several weeks, but allow around 8–12 weeks or longer to assess whether a skincare treatment is helping. Some marks, particularly deeper or long-standing pigmentation, can take many months to fade and may not clear completely with cosmetic skincare alone. 

Consistency with sun protection is essential throughout this process. If your skin becomes irritated, continuing to push through can make the problem worse rather than better. 

Be cautious of products promising to erase pigmentation in a few days. Meaningful improvement usually takes time, and persistent melasma may need assessment and treatment from a GP or dermatologist. 

When to seek professional advice: 

Not every dark mark is simply a cosmetic pigmentation concern. Arrange an assessment if you develop a new or changing spot, or if a mark changes in size, shape or colour, bleeds, crusts or does not heal. Do not try to treat an unexplained or changing lesion with brightening skincare. 

If pigmentation is persistent, widespread, worsening or affecting your confidence, a GP or dermatologist can help establish the cause and discuss appropriate treatment options.  

My pharmacist’s take: keep it simple and protect your progress 

If pigmentation is your main concern, I would start with three priorities: a gentle routine, one targeted treatment that suits your skin, and daily broad-spectrum SPF 50+. 

Vitamin C, niacinamide, azelaic acid, tranexamic acid, kojic acid and retinoids can all have a role, but you do not need to use them all. Choose based on your skin’s needs, introduce products gradually and give your routine enough time to work. If you’d like a skin consultation, book into our Naas Skin Clinic here. and one of our skin specialists will assess your skin and determine a treatment plan which may include in-clinic treatments and home treatments, as discussed with your specialist, and depending on what is feasible for you.  

Most importantly, do not let the search for brighter skin lead to an irritated skin barrier. A consistent, comfortable routine, layered with daily broad-spectrum sun protection, is a much better foundation for improving uneven tone over time.