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

Age spots (solar lentigines)

Age spots are also known as liver spots, Flat, pigmented spots on sun-exposed skin make age spots very common. In fact, 90% or more of light complected people over age 60 have age or liver spots. Sun damage is cumulative, meaning the sun damage to your skin during your youth adds to the sun damage your skin develops as you age. Age spots may not appear for several years after the damage occurred. Age spots typically appear on the face, hands, forearms, chest, back, and shins.

Common treatments include:

• Chemical peels
• Photofacials
• Lasers
• Topical creams

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 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.

Common treatments include:

• Chemical peels
• Hydroquinone, a skin lightener
• Topical retinoids
• Azelaic acid
• Microdermabrasion
• Laser treatments

Melasma

Melasma is a common condition that affects women more often than men. It is caused and exacerbated by hormones. Birth control pills and hormone replacement therapy can also cause melasma.

Melasma presents 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:

• Hydroquinone, a skin lightener
• Topical retinoids
• Azelaic acid
• Oral medications
• Laser treatments