More than skin-deep
Pigment isn’t just a surface issue. While UV exposure is the dominant driver, discolouration is frequently amplified by internal factors—especially hormonal shifts and gut-skin crosstalk. Oestrogen/progesterone changes (pregnancy, contraception, HRT, perimenopause) can up-regulate melanogenesis and make skin more reactive to light, which is why melasma so often flares around life stages or medication changes. Meanwhile, gut dysbiosis, low-grade inflammation, and impaired nutrient absorption can weaken the skin barrier and prime post-inflammatory marks to linger. The net effect: even “perfect” skincare won’t fully stabilise pigment if upstream drivers aren’t addressed.
What we do about it
Our approach applies a root-cause lens alongside gold-standard topical care. We take a detailed history (hormones, thyroid, medications, pregnancy/contraception, stress, sleep, previous reactions), map UV behaviours, and screen gut cues (bloating, irregularity, antibiotics history, food triggers). From there, we pair disciplined photoprotection (broad-spectrum SPF 50, daily antioxidants) with targeted actives such as vitamin C, azelaic acid, niacinamide, retinoids, and—where appropriate—prescription depigmenting agents. In-clinic, we sequence treatments thoughtfully (e.g., gentle chemical peels, LED for inflammation control; selective use of lasers/IPL with caution in melasma) and avoid anything that may provoke rebound. On the internal side, we support the gut barrier and metabolic balance: fibre-rich, polyphenol-dense nutrition; stable blood sugar; smart use of probiotics; and referral for hormone/thyroid/glucose review when indicated.
Bottom line
Treating pigment sustainably means synchronising inside and outside. When hormones are steadied, the gut is calm, and daily UV defence is non-negotiable, topicals and treatments work harder—and results hold. If you’re noticing cyclical flares, pregnancy-linked patches, or pigment that won’t shift after breakouts, it’s a signal to look deeper, not just layer stronger acids.
