What Causes Melasma and Hyperpigmentation?

Melasma can be treated the most effectively with the following:
Hydroquinone
Chemical peels
IPL
Fractionated Laser
As the other physicians have mentioned, however care and consideration must be used for patients with darker skin types as hypopigmentation may occur, creating a whole separate problem.
Consult a board certified dermatologist or plastic surgeon.
Good luck!

Brown spots on the skin—typically on the face, chest, shoulders, and back of hands—can be the direct result of unprotected exposure to the sun. They can also be a result of hormonal changes and are a common skin problem that we, consult many of our patients about.
The flat spots on the skin—also called age spots, sun spots, solar lentigines, or liver spots (even though they have nothing to do with the liver)—are triggered after prolonged sun exposure. When the sun’s UV rays hit the skin, they damage the pigment-producing cells called melanocytes and causing a spike in production of the skin pigment called melanin. They’re common in patients with fair skin, but they can also appear in those with darker skin.
These spots range in color from brown to tan to dark brown based on how much sun exposure you’ve had—and cause your skin to look blotchy, freckled, and uneven. And they vary in size, again depending on how much sun you’ve been exposed to.
Link to hormones: As hormone levels may change during events such as pregnancy or due to birth control pills, brown, uneven patches can appear on a woman’s face when the skin is exposed to the sun. It seems that sunlight triggers the pigment-producing cells in the skin to go into overdrive. Called the melasma, these dark patches may persist and not improve even with bleaching creams.
We commonly treat these brown spots or patches with chemical peels (which exfoliate the outermost layer of skin, removing the dark spots), light therapy and lasers (the energy blasts away pigment).