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Brown Spots, Age Spots, Sun Spots

What is hyperpigmentation?

Melanin is the substance that gives skin color. Sun exposure stimulates production of melanin that results in a suntan. Hyperpigmentation is a condition characterized by the production of excessive melanin and results in brown spots on the skin.

Brown spots include age spots, sun spots, and melasma. Hyperpigmentation can affect any area of the body, but is most common on the face, hands, forearms, neck and chest – the areas that are exposed to the sun the most.

What causes hyperpigmentation?

Excess melanin production can develop in response to sun exposure, acne, medical conditions, medications and hormone imbalances.

Age spots (solar lentigines)

Age spots and liver spots are synonymous. They are flat pigmented spots on sun exposed skin. Age spots are common; 90% of people with light complexion over the age of 60 have age spots. They result from sun damage, which may have occurred in the past and doesn’t present for many years after exposure. Age spots typically appear on the face, hands, forearms, chest, back and shins.

Common treatments include:

  • Chemical peels
  • Photofacial
  • Laser
  • Topical creams

Board certified cosmetic dermatologist Dr. Rachel White has found that a combination of treatments is the best approach, in addition to, the daily use of sunscreen.

Post-inflammatory hyperpigmentation (PIH)

PIH is hyperpigmentation caused by any inflammatory skin condition, such as, acne, skin infections, eczema and psoriasis. In addition, drugs that cause hypersensitivity to the sun, such as some antibiotics, can cause PIH. PIH is the discoloration left after acne or other inflammatory skin lesions heal. PIH appears as pink, red, purple, or brown flat discolored areas. Exposure to the sun worsens PIH. People with medium to dark complexions are more prone to PIH. PIH discolorations may fade but often take a long time to do so.

To control your risk for PIH, the first step is to treat the underlying inflammatory condition. Avoiding sun exposure is also vital. However, if PIH has already developed, there are effective treatment options.

Common treatments may include:

  • Chemical peel agents, such as, alpha hydroxy acids/glycolic acid
  • Hydroquinone
  • Topical retinoids
  • Azelaic acid
  • Microdermabrasion
  • Laser


Melasma is a common condition that most commonly affects women. It is caused and exacerbated by hormones. In pregnancy melasma can present or worsen and is called the “mask of pregnancy”. Melasma can also be caused by birth control pills and hormone replacement therapy.

It appears as brownish- gray patches on the face, often on the forehead, chin and upper lip. Sun exposure can trigger the return of melasma after it has faded. Melasma is difficult to treat and may require maintenance therapy after it clears. Common treatments include topical hydroquinone, topical retinoids, azelaic acid, and cysteamine, as well as, oral medications, and laser treatments.

Schedule a consultation

When you are distressed by pigmented dark spots, sun spots, melasma or acne scarring, professional treatments can help. Dr. Rachel White is a board certified dermatologist and expert in cosmetic and medical dermatology in Buckingham, PA. Contact Dr. White to schedule a consultation to receive an accurate diagnosis and receive a tailored treatment plan to brighten your skin and clear your dark spots.

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