Brown, patchy spots on your face may look alarming, but they're often caused by a harmless skin condition called melasma. Melasma usually has hormonal causes, such as pregnancy or the use of birth-control pills. Brown spots can also develop after too much sun exposure, so you don't necessarily need to be pregnant to get the condition. For some people, melasma fades on its own after a few months. Often, though, the dark patches won't go away without help. Over-the-counter solutions and prescription treatments can help remove this pigmentation or stop skin from producing excess melanin.
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Apply SPF 30 sunscreen to your skin every day, and stay in the shade whenever possible. Wear a wide-brimmed hat to keep the sun away from your face. Sun exposure can trigger pigment production, which causes brown spots to develop or look worse. Continue to apply sunscreen daily even after melasma spots disappear. If you don't, they will likely come back.
Stop or cut back on using scented cosmetics, toiletries and soaps. For some people, scented products can trigger a phototoxic reaction that may cause melasma or make dark spots worse. This reaction is caused by exposure to the sun's ultraviolet rays. Certain medications may also cause a phototoxic reaction.
Treat dark skin patches every night with a 2- to 5-percent hydroquinone cream. Continue the treatment for two to four months. Hydroquinone is a tyrosinase inhibitor that helps prevent new pigment formation. It may cause skin irritation and redness, especially with long-term use. Some lower-strength hydroquinone creams are available over the counter. You will need a prescription for the strongest creams.
Apply a cream containing azelaic acid, ascorbic acid or kojic acid to discolored skin once per day. These acids inhibit melanin formation, and they're less irritating than hydroquinone. According to a study reported by the Indian Journal of Dermatology, a 20-percent concentration of azelaic acid was as effective as 4-percent hydroquinone for treating melasma.
Treat skin with a glycolic-acid lotion every other night for up to three months. Glycolic acid sloughs off the surface layer of skin, resulting in a lightening effect. Most over-the-counter lotions won't contain more than 10 percent glycolic acid. If you need something stronger, opt for a glycolic-acid chemical peel from a dermatologist.
Use over-the-counter lotions and creams that contain licorice extract, resveratrol, arbutin, mequinol, rucinol or deoxyarbutin. These ingredients may help reduce skin pigmentation.
Talk to a dermatologist about an in-office treatment with fractional lasers, Q-switched ruby lasers or intense-pulsed light therapy. These procedures work by destroying skin pigment in specific areas. In some cases, pigmentation may return.