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Causes and Characteristics Hormonal changes (PCOS, pregnancy, and birth control options) Sun exposure Genetic disposition Typical Patterns Symmetrical patches that appear on both sides of the face Recurring and resistant to any general treatments Highly common in women with medium to deeper skin tones Post-Inflammatory Hyperpigmentation (PIH) Post-Inflammatory Hyperpigmentation (PIH) occurs after skin inflammatory conditions like injury, burns, or acne