Brownspots & Hyperpigmentation

There are numerous names for brown spots and a number of causes including Melasma, Chloasma, Age Spots, Inflammatory and Hyper-pigmentation. This page provides a broad overview.


Nearly everyone has some discoloration of the skin

Facial brown spots and discoloration are the top reasons for cosmetic visits to dermatologists in Southern California. Year-round sun and outdoor lifestyle almost guarantees skin mottling and brown facial pigmentation.


Cosmelan Patient Photos Orange County
Total Dermatology Patient treated with Cosmelan

Although you may have tried and failed with previous efforts to erase pigment, the newer technologies over the last 2 years have resulted in some remarkable outcomes – new pigment specific lasers, new topical formulations or blends of laser and topicals.

Effective treatment options for Brown Spots and Hyperpigmentation

*Hispanic, Asian or Middle Eastern skin? Ask about the new eMatrix sublative resurfacing all-skin-type all-skin-color non-laser resurfacing.

How do brown spots and age spots form?

Pigmentation is color in your skin produced by melanin, a natural pigment that also determines eye and hair color. However, if too much melanin is produced in one area, the result is a brown patch on your skin ( brown spot or hyper-pigmentation.)

Types of Hyper-Pigmentation

Main Accordion Title


Melasma or Chloasma: Skin discoloration that appears as blotchy brown spots, often covering cheeks, forehead, or temples. This type of hyper-pigmentation can be hereditary, or triggered by hormonal changes such as pregnancy or menopause. The most common cause of skin discoloration is a result of sun exposure. Taking birth control pills can also cause Melasma.

Age or Liver Spots

Age Spots or “Liver” Spots: Smaller darkened patches usually on older adults who have been exposed to the sun for many years. These spots  can be seen on the face, forearms and backs of hands.

Post Inflammatory Hyperpigmentation

Post-inflammatory Hyper-Pigmentation: This type of hyper-pigmentation results from any inflammatory injury or trauma to the skin.
Some causes of post-inflammatory hyper-pigmentation:

  • Acne — particularly cysts or nodules — often leaves dark discoloration after a blemish heals.
  • Poorly administered chemical peels or  laser surgery can leave behind hyper-pigmentation.
  • Rashes like psoriasis and eczema often darken the skin as well.
  • Even seemingly innocuous things like leg waxing and electrolysis can cause the melanin cells to over react.


More about available treatment for pigmentation

To have skin that is free from brown spots, sun damage, hyper-pigmentation, age spots, and Melasma, a skin rejuvenation program is your first step. Any successful treatment for pigmentation problems will require achieving and maintaining healthy skin through pre-conditioning. Some patients will need only the skin rejuvenation program to have the beautiful skin they always dreamed of. All forms of pigmentation problems begin in the melanin cells beneath the skin’s surface.

Topical Options

Main Accordion Title

Lumixyl System and Lumixyl Pro Infusion

Lumixyl Skin Brightening System:  An all in one skin balancing program which includes all the products you need to begin control of your skin’s coloration.

Silkpeel with Lumixyl Pro Infusion:  Silkpeel uses a diamond-tipped wand to remove surface skin cells. Combined with Lumixyl Profusion, the treatment helps lighten skin discoloration and spots.


Obagi NuDerm Clear (RX): This treatment uses 4% prescription-level Hydroquinone, a skin lightening agent. It is typically combined with Retin-A and /or Alpha Hydroxy Acids. Hydroquinone will suppress melanin production at the cell level, while Retin-A and Alpha Hydroxy Acids exfoliate the top layer of the skin. These products are used at home and are the first step to achieving clear healthy skin.

The exfoliation from a skin rejuvenation program will not penetrate as deeply as a chemical peel or laser treatment and results may take slightly longer if this treatment is used alone. However, used alone or as a pre-treatment plan with another procedure, this type product will bring you beautiful skin, and a healthy skin care regimen to ensure your results will last a lifetime.

Cosmelan Mask

Cosmelan De-Pigmentation Treatment: A “Power-Level” skin rejuvenation treatment for particularly stubborn and dense pigmentation. Cosmelan’s synergistic ingredients work very quickly, resulting in a fast, effective blending and elimination of undesirable pigment. The melanin activity is regulated, causing the pigment producing cells to slow down production and function in a more uniform way.

Cosmelan is “sun-friendly”, an especially appreciated factor for our California lifestyle, and works well even on darker toned Asian and Latin skin. Cosmelan will also produce a slight initial “peel” which helps refinish the skin surface while dramatically diminishing hyper-pigmentation.

Perfecta Laser

Perfecta Laser: New power-level laser blends resistant browns spots and red areas. Special MicroPulse technology treats faster with fewer sessions and dramatically reduces bruising which is common with older systems.

Fraxel DUAL Laser

Fraxel Dual: Through a systematic gentle resurfacing of the skin, Fraxel removes even stubborn melasma and has FDA approval for that particular condition. A series of comfortable laser treatments resurfaces 20 to 25% of the treated area each time. Typically a package of 4 Fraxel treatments are given, from 10 to 14 days apart. Fraxel can be used to treat the face, neck, chest, arms and hands.

Chemical Peels

Chemical Peels: Some pigmentation problems are more serious and therefore must be treated with a chemical peel. A chemical peel is a safe and effective form of treatment for many pigmentation problems.

Skinceuticals Pigment Balancing Peel is a good gentle option. Generally without anesthesia, a chemical compound such as Trichloracetic acid is applied to the face. This application will lead to the removal of the surface layer of damaged and irregularly pigmented skin. After the treatment, the dead skin peels away, allowing healthier, clearer skin to emerge. ViPeel contains a proprietary mix of many peel formulas for a very effective peel response in 7 days.


Microdermabrasion: This treatment is a comprehensive approach to skin care that is non-surgical, safe and effective. The skin is literally “polished” with micro-crystals which are then vacuumed away along with the dull, flaky and discolored skin cells. This technique delivers a gentle abrasion, which efficiently produces satisfying results. Discomfort is minimal and normal activities can be resumed immediately with no downtime. Although microdermabrasion is still an option, most of our patients prefer Silkpeel for it’s gentleness and the infusion of topical treatment serums.

IPL Photofacial

Light Therapy/Photo Facial: Light Therapy is an alternative to addressing the issues of hyper-pigmentation. Light treatments (referred to as IPL, Intense Pulsed Light, Photo Facial or Foto Facial) affect the melanin-producing cells deep within the skin. This totally painless treatment is not only very effective for those aging, unsightly-looking sunspots on hands, but is excellent for irregular pigmentation on face, neck and chest.

The hand piece is placed on the skin over the brown spots or other pigmentation and a bright flash of light is released. This light is absorbed by the pigmented area, which will darken over the next few hours. The area will look a bit “dirty” or dark for about a week, then the exfoliating melanin will slough off leaving clear fresh new skin. Often only one treatment is necessary to create a stunning difference with subsequent treatments keeping new spots from emerging.


Diolite Laser: For specific spot treatments when there are singular or scattered spots that require precisely targeted treatment. The Diolite Laser works by generating an intense beam of light aimed at the exact location of the lesion. The melanin absorbs this light, creating sufficient heat to destroy the lesion, leaving surrounding healthy skin unharmed. This laser is appropriate for flat brown spots from sun exposure, keratoses, freckles or the very small black spots common to Asian or African-American skin.

Maintain your Improvements

How to maintain your improvements

With any treatment of pigmentation problems, sun exposure must be avoided. Age spots and brown patches on the skin have been directly linked to sun exposure. To maintain results from a treatment and to prevent any further pigmentation damage from occurring, use of a physical block sunscreen containing Titanium Dioxide with a SPF of 45 or higher is mandatory. Also, maintenance treatments of the various therapies may be necessary.


During your consultation, Dr. Pilest will be able to determine the best course of treatment for your pigmentation problems. Confused? It’s easy to be overwhelmed by the options. A consultation is an excellent way to get you started on the path to evenly toned and more attractive skin. Call us today for a complimentary consult.

Join our Newsletter &
Receive our Free EBook|

Free Ebook

Request A Consultation