Esty Protocols: Irregular Skin Pigmentation Conditions & Treatments

By Lisa VanBockern and Tina buckley

AT SOME POINT, MOST OF US will experience irregular or uneven skin pigmentation. As an esthetician, this is a common concern we hear from our clients. Pigmentation appears in different forms, and it’s important to recognize the root cause, determine how to treat it, and set expectations for improvement.

Types of Irregular Skin Pigmentation Conditions


Post-inflammatory hyperpigmentation (PIH) is a result of trauma to the skin, such as an acne breakout or an injury to the surface like a cut or scratch. This skin pigmentation condition is normally located within the surface layers of the epidermis and can be treated effectively with a series of brightening treatments, as well as a consistent home care routine.


This develops from hormonal changes in the body, such as a pregnancy, menopause, or the use of birth control or hormone replacement therapy. This skin pigmentation condition presents itself as large, symmetrical patches of pigment with lines of demarcation. Melasma is usually located at the dermal/epidermal junction and the stratum germinativum. It is difficult to treat, as it is deeper in the skin near the dermis and is hormonally driven. We can successfully treat the melasma, but finding the root cause and correcting it (if possible) is the best solution. It is important to know that melasma can return during the warmer months from increased sun exposure, as UVR (ultraviolet radiation) stimulates the generation of pigment.

Solar Lentigos

These are UVR-induced freckles or dark lesions caused by excess sun exposure. They are common in older adults. Intense pulsed light (IPL) works well for Fitzpatrick skin types I–III for freckles; however, darker lesions in adults may need to be removed using cryotherapy. Regular sun protection and home care that includes tyrosinase inhibitors are critical in the correction and prevention of this skin pigmentation condition.

Choose the Right Skin Pigmentation Treatment

Once you determine the type of pigment you are working with, talk with your client about what types of skin pigmentation treatments would be suitable for their lifestyle. Professional options, such as chemical peels, with a consistent home care system can be most effective. Be mindful that each client must qualify for chemical peels. Having an awareness of contraindications for particular treatments can address clients’ concerns and keep them safe.

There are many types of brightening treatments on the market, ranging from mild weekly treatments to more aggressive monthly treatments. Ordinarily, one treatment is not going to remove all the pigment and a series is recommended. Set those expectations with your client, and remember the cell cycle is 28–30 days, so patience is key. If your client can’t have downtime with advanced, aggressive treatments, consider weekly treatments.

Of course, don’t forget that home care is 80 percent of the result! In home care, one product typically won’t lift pigment; your client needs a routine of products:

  • Daily cleanser
  • Regular exfoliant
  • Skin-lightening product containing kojic acid, arbutin, azelaic acid, licorice root, and/or hydroquinone
  • Treatment serum, such as vitamin C serum to influence cellular nutrition
  • Moisturizer for appropriate skin type
  • SPF, the most important element in pigmentation prevention

As you can see, there isn’t one miracle product that will do everything. It’s a combination of products and ingredients working in synergy. Treating the skin pigmentation condition gently on a weekly basis for 6–8 weeks may be the most powerful and most comfortable for your client. A gentle, more progressive approach may be the safest protocol to avoid complications from more aggressive chemical peels and other advanced options. Skin care customization is critical. With a comprehensive consultation, you can confidently decide what works best for you and your client.

Skin Script

Lemon Zest/Honey Facial Protocol

An illuminating facial treatment for normal to dry, mature-looking skin with pigmentation.

When you think of brightening the skin, you likely think of lemons, vitamin C, kojic acid, and arbutin. When you think of hydrating the skin, you probably think of lactic acid, honey, and sunflower oil. You will find all these ingredients in this facial with the exfoliating and brightening effects of Lemon Zest Enzyme and the hydrating, antibacterial
support of Golden Honey Nourishing Mask.

Step 1.


Cleanse once with Green Tea Citrus Cleanser and a second time with Glycolic Cleanser using damp fingers in a circular motion. Remove with aesthetic wipes or sponges.

Step 2.


Apply a layer of Lemon Zest Enzyme to the face, neck, and décolleté with a fan brush. Leave on for 7–10 minutes. Remove with a warm barber towel or cool aesthetic wipes.

Step 3 and 4.


Using your fingertips, pat Peptide Eye Serum on the upper- and lower-eye area. Then, apply Tri-Peptide Eye Cream using a circular massage motion. Apply Citrus-C Nourishing Cream onto the face, neck, and décolleté.

Step 5.


Using your fingertips, apply Golden Honey Nourishing Mask, and massage for 10–15 minutes. Remove with a warm barber towel or cool aesthetic wipes.

Step 6.


Apply Cucumber Toner, either by spritzing the toner into the air so it gently falls on the face, neck, and décolleté or by soaking a cotton round with toner and swiping over the entire face.

Step 7.


Apply Açai Berry Moisturizer over the face, neck, and décolleté. Then, finish by pressing in Sheer Protection SPF 30 and using a lip applicator to apply Mint Lip Hydrator to the lips.

Before and After

Skin Script Before image   Before and After client

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