Through an understanding of the image formation process, diagnostically important facts about the internal structure and composition of the skin lesions can be derived from their colour images. A physics-based model of tissue colouration provides a cross-reference between image colours and the underlying histological parameters. This approach was successfully applied to the analysis of images of pigmented skin lesions. Histological parametric maps showing the concentration of dermal and epidermal melanin, blood and collagen thickness across the imaged skin have been used to aid early detection of melanoma. A clinical study on a set of 348 pigmented lesions showed 80.1% sensitivity and 82.7% specificity.