Bruce P. Robinson, MD
Hyperpigmentation and Melasma affect people of all skin tones and types, often appearing as brown or gray marks on the face and body. These changes in pigmentation can be caused by sun exposure, hormonal shifts, common during pregnancy, inflammation, or even acne. While they’re typically harmless, they can impact your confidence and be difficult to treat without expert guidance. At our practice, we take a customized, science-backed approach to identifying the type of pigmentation and creating a targeted treatment plan that works for your unique skin.
SUN SPOTS:
Also known as liver spots or solar lentigines, sun spots are small, flat brown areas on the skin caused by prolonged exposure to ultraviolet (UV) rays. These spots are marked by an increased number of pigment-producing cells, unlike freckles, which have a normal number of cells that are simply overactive.
Sun spots typically appear on areas that get the most sun exposure, the face, chest, arms, and hands and are especially common in those with lighter skin tones.
Avoiding sun spots completely is nearly impossible. To minimize the risk, we strongly recommend applying a broad-spectrum sunscreen with at least SPF 30, every single day, year-round, regardless of the weather and reapplying every two hours, especially when swimming or sweating.
MELASMA:
Melasma appears as brown patches, most commonly found on the face, especially the cheeks and jawline. It can also show up on the temples and upper lip, where it may resemble a mustache; while it's a common condition, its exact cause remains unclear.
Melasma is influenced by both genetics and hormonal fluctuations. It tends to worsen during times of increased estrogen levels, such as pregnancy or while taking birth control pills. This hormonal link is why melasma is often nicknamed the “mask of pregnancy.” Other contributing factors include heat, ultraviolet (UV) exposure, and blue light from devices like phones, computers, and even indoor lighting.
Melasma is more prevalent in people with melanated skin. For treatment, we recommend using a mix of skin-brightening and lightening products, such as retinoids, antioxidants and hydroquinone. Sunscreen is essential. SPF is non-negotiable, mineral formulas with iron oxides are best, as they also shield against blue light. Even minimal UV exposure can reverse weeks of progress with topical treatments, so daily sunscreen use is critical. There are also in-office procedures, such as peels and lasers, that can help, though it’s important to be treated by a provider who is well versed in treating melasma because it’s easy to exacerbate the condition.
POST-INFLAMMATORY HYPERPIGMENTATION (PIH):
Think of post-inflammatory hyperpigmentation (PIH) as a stain left behind on the skin. Any type of inflammation, whether it’s from a burn, breakout, or other irritation, can leave behind a dark mark in that area. These spots can linger for months or even years, and in some cases, they can be more frustrating than the initial condition itself.
The appearance of PIH varies depending on skin tone. Lighter skin types tend to develop red or pink marks, while deeper skin tones often experience discoloration that’s brown, purple, or even black.
Because PIH (post-inflammatory hyperpigmentation), results from inflammation, we emphasize the importance of treating the root cause first, whether it’s acne, eczema, or another condition. While these dark marks may gradually fade on their own, early intervention often leads to better results.
For quicker results, we recommend targeting hyperpigmentation as soon as it appears, using energy-based treatments tailored to the color of the discoloration.
Lasers use focused light energy to target and break down excess melanin (the pigment responsible for dark spots) in the skin. Your body then gradually clears the pigment particles, resulting in a more even skin tone. We offer a range of advanced laser therapies tailored to the type and depth of discoloration, whether you’re dealing with sun spots, melasma or post-inflammatory hyperpigmentation (PIH) .
Q-switched Nd:YAG Laser: Targets deep pigmentation, including melasma and post-inflammatory hyperpigmentation (PIH), with precision and safety for all skin tones.
Fractional Lasers: These versatile lasers treat pigmentation and improve overall skin quality by stimulating collagen production and resurfacing the skin. Great for PIH (post inflammatory hyperpigmentation), sun damage, acne scarring, uneven tone, and texture.
Each laser treatment is customized to your skin’s needs to ensure safe, effective results. During your consultation, we’ll determine the best approach—often combining laser therapy with topical treatments to maximize improvement and minimize recurrence.
To target brown spots, we use a combination of hydroquinone, kojic acid, vitamin C, and alpha hydroxy acids (AHAs) like glycolic acid. This powerful blend works gently yet effectively to lighten hyperpigmentation while brightening and smoothing the skin. These clinically proven ingredients work synergistically to promote a more even, radiant complexion by visibly reducing dark spots and improving overall skin tone and texture.
We also look for ingredients that inhibit melanin production, such as retinol, which enhances cell turnover, and AHAs, which provide a gentle exfoliating effect to help fade discoloration over time.
Other in-office treatment options include: Glycolic Acid Peels and HydraFacial MD with Brightening Boosters—a targeted super-serum designed to address dullness and uneven texture, even for sensitive skin types.
SHOP HERE: JAS Anti - Aging TRIO, expertly formulated to replenish, exfoliate, and restore your skin’s natural glow. These ingredients work synergistically to visibly brighten, lighten, and tighten the skin for a more even, glowing appearance.
⚠️ Important
Always see a board-certified dermatologist or laser specialist, especially if you have darker skin.
Sun protection is non-negotiable—exposure after treatment can trigger new pigment.
If you are tired of looking older or want the spots removed, schedule a laser consultation and restore your skin to its natural beauty. Our Cosmetic Consultation Reimbursement policy is offered to all patients. Schedule an office visit to discuss your concerns and skincare goals with Dr. Robinson and the office visit cost will be applied to the future cost for the "consulted procedure". The "consulted procedure" must be completed within 30 days of your consult visit.
