There are a number of conditions that people may label as ‘pigmentation’ problems.
Melasma, presents as a symmetrical blotchy, brownish pigmentation usually on the face. The pigmentation is due to overproduction of melanin by the pigment cells. It can lead to considerable embarrassment and distress. It typically starts between 20 and 40. It is much more common in women. Hormonal and genetic factors, and sun exposure at the main causative factors.
In addition to addressing underlying factors, treatments include a number of topical bleaching agents, chemical peels, and sometimes laser and light treatments.
Other causes of pigmentation include solar lentigines. These are especially common on chronically sun-exposed skin, especially the face, hands, and also forearms. These can usually be greatly improved with a variety of treatments including intense pulse light therapy, laser (ablative and non-ablative), localized chemical peels, and cryotherapy. Depending on a variety of factors, your dermatologist can guide you to the best choice for your lesions.