A: Hyperpigmentation (fancy term for dark spots) is caused by excess melanin in the skin. And laser—either the Q-switched ruby or alexandrite—is the most effective way to get rid of it, says Anne Chapas, MD, clinical assistant professor of dermatology at NYU School of Medicine. The treatment leaves a small scab where the spot was; this disappears in a couple of weeks. Generally one or two treatments are needed, at $400 to $700 per session. If your spots are diffuse (like a Milky Way splash across your cheeks or chest), Chapas recommends the new Fraxel dual laser. One or two treatments, at $750 to $1,500 each, should do the trick. (And for that kind of money, let's hope so.)
Keep in mind: Unless you wear a broad spectrum sunscreen every day, rain or shine, you'll be looking at new age spots no matter how often you visit the dermatologist.