Pigmentation, properly
Can you read pigment on sight?
Seven questions on the five presentations, pigment depth, the melasma drivers, and the calls that stop rebound. Most practitioners read the surface and miss the mechanism. About ninety seconds, no email needed, instant result.
Hyperpigmentation, the answers explained
Hyperpigmentation is excess melanin in the skin, and it presents in five distinct patterns that each need a different plan: post-inflammatory hyperpigmentation, melasma, solar lentigines and photo-induced epidermal pigment, dermal and mixed pigment, and post-inflammatory erythema with its mimics. The quiz above checks the calls that matter most in day-to-day practice: presentation, depth, drivers, and rebound. Below is every question with the answer and why it matters, so you can use it as a quick reference. For the consultation framework, read the hyperpigmentation consultation guide, see the PIH treatment piece, or browse every course.
A structured pigment assessment sorts a new client between five presentations. Which five?
Post-inflammatory hyperpigmentation, melasma, solar lentigines and photo-induced epidermal pigment, dermal and mixed pigment, and post-inflammatory erythema with its mimics
Five presentations, five different plans: PIH, melasma, solar lentigines and photo-induced epidermal pigment, dermal and mixed pigment, and post-inflammatory erythema, which is often treated as pigment and should not be.
Under a Wood's lamp, what separates epidermal pigment from dermal pigment?
Epidermal pigment enhances and looks more defined; dermal pigment does not enhance and its borders blur
Depth decides the plan. Epidermal pigment sharpens under the lamp, dermal pigment stays flat with blurred borders, and a mixed-depth client needs a two-phase plan.
Which three inputs combine to drive the hyperactivated melanocyte in melasma?
Hormonal signalling, light exposure including visible light, and heat or inflammation
Melasma is a driven condition: hormones, light including the visible spectrum, and heat or inflammation. Treat the pigment without addressing the drivers and it comes back.
Why is a clear, untinted SPF often not enough for a melasma client?
Visible light stimulates pigment in melasma-prone skin, and only a tinted SPF with iron oxides blocks it
Visible light drives melasma, particularly in deeper phototypes. An iron-oxide tinted SPF is the working answer, and it is a consultation conversation, not a shelf detail.
A post-acne PIH client still has active breakouts and inflamed skin. When do you start treating the pigment?
After the inflammation is controlled; treating pigment on inflamed skin stimulates more melanin
PIH is inflammation-driven. Work on inflamed skin and you feed the pigment you are treating. Settle the skin first, then address the pigment.
Why is IPL usually the wrong first choice for melasma?
Heat is a melasma driver, so light-and-heat platforms carry a high flare and rebound risk
Melasma is heat-sensitive. IPL can lighten it briefly and rebound it darker. Modality choice follows the presentation, not the platform in the room.
Which set names the five classic rebound triggers after a pigment treatment?
Sun exposure, restarting exfoliants too early, restarting retinoids too early, a hormonal flare, and mechanical trauma
The post-procedure window is where plans collapse. Sun, early exfoliant or retinoid restarts, a hormonal flare, and mechanical trauma are the five to protect against.
Want the full framework behind these answers? Hyperpigmentation Decoded is the complete programme: the five presentations, chromophore depth, the hormonal axis of melasma, active sequencing, in-clinic modalities, and the rebound-prevention protocol, taught by Bernadette Tobin RN, MSc. The quiz is free, takes about ninety seconds, and you do not need an account.