It's difficult to determine by the photo you submitted whether this is sun induced or melasma. It appears to be sun induced based on the diffuse manner of pigmentation. However, if there are patches of hyperpigmentation it could suggest melasma (horomone induced). If you present patches on your cheeks, upper lip and/or forehead it is mostly likely hormone induced hyperpigmentation. If this is the case, you want to avoid aggressive treatments such as laser and IPL (photorejuvenation). If it is diffuse hyperpigmentation (brown spots) then you have multiple options available for you. These options include but not limited to Fraxel, IPL, TCA peel and/or Vampire facial with kojic acid.If it appears to be hormone induced (melasma) then your safest options are moderately aggressive chemical peels and medical grade serums that suppress hyperpigmentation. Aggressive treatments can aggravate the condition.I hope this information is helpful and as a reminder, the best way to avoid hyperpigmentation is to apply sunscreen daily.Regards,Jose L. Ruiz, M.D.
