I've tried creams & 3 IPL treatments for brown spots with no results. Is there anything besides cauterizing I can get done?

Without a photograph and more information it is difficult to give advice as to what your next steps should be.  I would recommend evaluation by a physician who is highly experienced in aesthetic rejuvenation of the skin and understands the nature of the various problems that can be responsible for the production of brown spots.

Brown spots are often difficult to treat which is why we have so many options.  If one option was best then we would all offer it as first line.  For individual brown spots, I often choose treatment with cryotherapy or laser therapy with our ATV laser (that we also use to treat unwanted tattoos). 

The first question is whether you have had a dermatologist diagnose what kind of 'brown spots' you have: lentigines (the flat brown spots that arise from sun exposure also called 'sun spots'), melasma (the 'mask of pregancy' also associated with natural estrogen and taking birth control pills), seborrheic keratoses (the waxy, stuck-on looking brown or tan thin or thick bumps), nevi (what people call 'moles' that can be absolutely normal or dysplastic), or pigmented actinic keratoses (precancerous rough brown and red thin bumps or flat marks).  You also need to make sure you don't have a malignant melanoma.Once you know the spots are benign, the treatment plan depends on the diagnosis. Faint lentigines can be imrproved over time with topical agents like retinoids, ahas and other ingredients.  But more prominent lentigines require a series of IPL or a treatment with a pigment specific laser like the Q-switched Nd:YAG laser. If the background skin needs improvement in color and texture also, then a pigment laser can be combined with fractionated resurfacing like with a fraxel dual thulium.  The thicker seborrheic keratoses generally need a destructive method like cryotherapy with liquid nitrogen or electrodessication.  And remember that some brown spots will return after treatment with sun or just time.  If it returns repeatedly and with darker pigmentation, it is important to see a dermatologist to rule out a malignancy.

A Q Switched laser is know as the best laser to treat pigment.  This is used for individual spots.  If there are many tiny spots, laser resurfacing with the Fraxel 1927 is a great option.  Sometimes I'll use both at the same time.  The lighter spots are harder to remove than the darker spots with the Q Switch because the laser has a harder time seeing the pigment.  Most spots can be removed with these lasers, particularly with the 532 and 1064 Q Switched laser.

It's not possible to say for sure without seeing you, but in general brown spots respond very well to Q-switched laser treatment.  In my office, if we have a patient with brown spots that don't respond to IPL, we usually treat with Q-switched alexandrite or Q-switched YAG laser.  These lasers are non-invasive.  Sometimes a stubborn brown spot needs to be treated more than once.  I would strongly recommend that you see a dermatologist to make sure that the brown spots are properly evaluated and treated.