Sun damage, patchy pigment, and what I will treat

Chilterns skin has had years of gardens, school sports days and a winter sun that still counts. Patchy colour on the cheek, freckling that has joined up, a chest or a neck that no longer matches. Women come from Berkhamsted, Wendover and Great Missenden asking if NeoGen will lift that. Sometimes yes. Sometimes I want the skin calmer, or the tan gone, before I will touch it.

What the plasma is doing

Nitrogen is turned into plasma and passed over the skin. The heat reaches the layer where collagen is made, and the surface often darkens and then flakes. That flake can take some of the tired, mottled look with it. It is not a bleach, and it is not a promise that every patch of pigment will vanish. Deeper pigment, and pigment that is hormonal, behaves differently from sun damage. I will tell you which I think I am looking at.

A tan is a reason to move the date. I will not treat skin that has just come back from the sun, and I will not treat you if you are still using a self-tan on the area. Tell me about melasma, about pigment you have had treated before, and about any cream your GP or dermatologist has you on. Leaving that out is how people get a darker patch than the one they came in with.

How I decide the area

• Cheeks and a full face, from £750, when the colour and the texture are both the complaint
• Neck, from £450, when the chest-to-jaw mismatch is what you see in a V-neck
• Hands, from £350, when the spots are on the backs of the hands and the face can wait

Afterwards the factor 50 is not optional. Heliocare is the one I use. If you go straight back into the garden in Chesham without it, you are wasting the appointment. Dermalux can help calm redness later, once any flake has finished. It will not replace the plasma if pigment is the thing you mind.