Beverly Hills Dermatology
Hyperpigmentation & Brown Spots in Beverly Hills
Six different conditions produce brown spots, and they do not respond to the same treatment. Correct diagnosis comes first.
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- Years in Practice
- 20+
Overview
Hyperpigmentation means excess melanin, but the reason for that excess varies — and so does the treatment. Melasma is hormonally influenced and driven by both pigment and vascular components; post-inflammatory hyperpigmentation follows any inflammatory insult; solar lentigines are the discrete brown macules of chronic sun exposure; ephelides (freckles) are genetically determined and darken with UV; drug-induced pigmentation follows specific medications; and the diffuse mottling often called age spots reflects cumulative photodamage. Treating all of these the same way is why over-the-counter regimens so often fail.
Dr. Zaks begins by establishing which type of hyperpigmentation you have, since some respond to topical tyrosinase inhibition, some require rigorous sun protection above all, and some — such as melasma — can worsen with overly aggressive treatment. His mainstays are the Cosmelan® depigmentation system, prescription topical regimens, salicylic acid peels, and disciplined daily photoprotection. Darker skin tones require particular caution with lasers, because energy-based treatment can itself trigger pigmentation.
The Six Common Types
Melasma
Symmetric brown to gray-brown patches on the cheeks, forehead, and upper lip, influenced by hormones, UV, and heat. Chronic and relapsing; requires maintenance rather than a one-time fix.
Post-Inflammatory Hyperpigmentation (PIH)
Flat brown marks following inflammation — acne, eczema, injury, or a procedure. More common and more persistent in deeper skin tones.
Solar Lentigines
Discrete, well-defined light-to-dark brown macules on chronically sun-exposed skin such as the face, chest, shoulders, and dorsal hands.
Ephelides (Freckles)
Small, genetically determined tan macules that darken with sun exposure and fade in winter. Best managed with photoprotection.
Drug-Induced Pigmentation
Pigment change caused by specific medications. Identifying the responsible drug — in coordination with your prescribing physician — is essential before treatment.
Age Spots / Diffuse Photodamage
Mottled, uneven pigmentation from cumulative UV exposure, often with associated texture change and actinic damage.
The Treatment Experience
Diagnosis
Dr. Zaks examines the pattern, distribution, and depth of pigment and reviews your medications, hormonal history, and sun exposure to determine the type.
Targeted plan
A regimen is built for your specific diagnosis — the Cosmelan® system, prescription topicals, salicylic acid peels, or a combination — with strict photoprotection in every plan.
In-office treatment
Cosmelan® application or peel sessions are performed by Dr. Zaks. Protocols are kept conservative in darker skin types to avoid provoking more pigment.
Maintenance
Pigment conditions relapse, particularly melasma. Follow-up visits confirm progress and keep you on an effective long-term maintenance regimen.
Important Information
- Peels used in this practice are limited to salicylic acid peels and the Cosmelan® system — no TCA and no glycolic acid.
- Patients with darker skin types require caution with lasers, which can provoke post-inflammatory hyperpigmentation.
- Daily mineral sunscreen at SPF 30+, reapplied, is the foundation of every pigmentation plan. Without it, no treatment holds.
- Visible light and heat, not just UVB, can worsen melasma — mineral sunscreen with zinc oxide or iron oxides at SPF 30+ is recommended.
- Improvement in pigment is measured over months, not days. Consistency matters more than intensity.
Frequently Asked Questions
Why do I need a diagnosis before treatment?
Because the six common types respond differently. Solar lentigines and melasma can look similar to a patient but behave completely differently — and melasma in particular can worsen with treatment that is too aggressive.
What is the Cosmelan® lightening system?
A professional depigmentation system that inhibits tyrosinase, the enzyme required to make melanin. It involves an in-office application followed by a structured home maintenance regimen, and it is one of Dr. Zaks' primary tools for stubborn pigmentation.
How long until I see results?
Meaningful improvement typically takes eight to twelve weeks of consistent treatment, and deeper dermal pigment takes longer. Progress is judged at follow-up visits, not day to day.
Is laser the fastest way to remove brown spots?
Not always, and not safely for everyone. Patients with darker skin types require particular caution with lasers, because energy delivered to pigmented skin can trigger further hyperpigmentation. Dr. Zaks selects the approach with the best risk-benefit profile for your skin.
Will my pigmentation come back?
Melasma is chronic and relapsing, and sun-induced pigment returns with renewed UV exposure. Maintenance treatment and daily photoprotection are what keep results.
Can hormonal birth control cause pigmentation?
Hormonal factors, including oral contraceptives and pregnancy, are well-recognized contributors to melasma. Dr. Zaks will review this with you, and any medication change is coordinated with your prescribing physician.
Patient Reviews
“I have been going to Dr. Zaks for over 4 years. His outstanding skill, great bedside manner, warm personality, and artistry with Botox make me come back again and again!”
“I had Rosacea on my face for over 10 years. Dr. Zaks quickly reduced this embarrassing condition. Nobody else could help me. He's the best Dermatologist in LA hands down!”
“Dr. Zaks did not rush and he gave me 100% attention. He did not try to sell me product or convince me to try aggressive procedures which I appreciated.”
“Doctor took the time to explain the technical aspects of my condition, the treatment options and the expectations.”
About Dr. Boris Zaks, MD
Dr. Boris Zaks personally performs every procedure at Superior Beverly Hills Dermatology — never rotating assistants. He has practiced dermatology in Beverly Hills for more than twenty years.
- Board Certified — American Board of Dermatology (since 2002)
- Medical Degree — UCLA School of Medicine
- Chief Resident — Charles Drew University of Medicine & Science
- B.S. Biology — UCLA, Summa Cum Laude (age 19)
- Medical Board of California Expert Reviewer since 2009
- Super Doctors® 2023, 2024, 2025, 2026 & 2027 (Southern California)
- "Rock Star Dermatologist" — Glamour Magazine
Schedule Your Consultation
435 N. Roxbury Drive, Suite 408, Beverly Hills, CA 90210 · Monday–Friday · (310) 552-3376
Paid parking on-site, or free 2-hour parking at 461 N. Bedford Drive Garage, 1 block away
Areas Served
Patients seek Hyperpigmentation & Brown Spots at Dr. Zaks’s Beverly Hills office from throughout greater Los Angeles: West Hollywood, Bel Air, Brentwood, Malibu, Pacific Palisades, Santa Monica, Westwood, Century City, Culver City, Marina del Rey, Studio City, Sherman Oaks, Encino, Calabasas, Burbank, Glendale, Pasadena, Manhattan Beach, Hermosa Beach, Torrance, Long Beach, Newport Beach, and Irvine.