Melasma vs Sun Spots vs Hyperpigmentation: How to Tell

Melasma, sun spots and other types of hyperpigmentation are all areas of skin darker than your natural tone, but they have different causes and patterns. Melasma forms blotchy, symmetrical patches linked to hormones, heat and light; sun spots are single, sharp-edged spots from years of UV; and other hyperpigmentation, like acne marks, appears where skin was inflamed.

Knowing which one you're looking at helps you care for it the right way. Here's how to tell them apart, a quick side-by-side comparison, and the signs that mean it's time to see a dermatologist.

Is melasma the same as hyperpigmentation?

Melasma is a type of hyperpigmentation, but not all hyperpigmentation is melasma. Hyperpigmentation is the umbrella term for any skin that's darker than the area around it because of extra melanin. Melasma is one specific kind, with its own triggers (hormones, light and heat), its own pattern on the face and a habit of coming back.

Think of hyperpigmentation as the category. These are some of the most common types under it:

• Melasma: hormone- and light-related patches, usually on the face [1]
• Sun spots (solar lentigines): also called age spots or liver spots, from years of UV exposure
• Freckles (ephelides): small, inherited spots that respond to sun
• Post-inflammatory hyperpigmentation (PIH): marks left after acne, bites, rashes or razor bumps [2]

People often say "pigmentation" or "dark spots" to mean any of these. For a closer look at melasma on its own, start with what is melasma.

Melasma vs sun spots (and age spots): what's the difference?

The biggest difference is the pattern. Melasma forms larger, blotchy patches with soft, irregular edges, usually matching on both sides of the face. Sun spots are individual round or oval spots with clearer edges, scattered wherever skin has had the most sun over the years. Sun spots, age spots and liver spots are different names for the same thing.

Sun spots (solar lentigines):

• Flat, tan to dark brown spots with well-defined edges
• Show up on the face, backs of the hands, shoulders, arms and chest
• Build up from years of UV exposure, so they're more common from middle age on, and on lighter skin that burns easily
• Stay about the same all year once they appear

Melasma:

• Blotchy patches, often in a mask-like pattern on the cheeks, forehead, bridge of the nose, upper lip or chin [3]
• Linked to hormones (pregnancy, birth control), heat and visible light as well as UV [3]
• More common in women and in medium to deep skin tones, though it happens on light skin too [1]
• Often looks darker in summer and less noticeable in winter [1]

You can have both at the same time, which is common on sun-exposed skin. A dermatologist can tell you which is which.

Melasma vs freckles: how can you tell?

Freckles are small, flat, light-brown dots that usually appear in childhood, especially on fair skin, and tend to run in families. Melasma usually appears in adulthood and forms larger, connected patches rather than separate dots. Both get darker with sun, but freckles stay as individual spots, while melasma spreads into a blotchy, symmetrical pattern.

A few more clues:

• Freckles are scattered across the nose, cheeks, shoulders and arms, and look lighter in winter.
• Melasma tends to follow the same shape on both sides of the face and often shows up with a hormone change, like pregnancy or starting the pill.
• Timing: if you've had the spots since you were a kid, they're more likely freckles. If blotchy patches appeared in your 20s, 30s or 40s, melasma is more likely.

Melasma vs post-inflammatory hyperpigmentation (acne marks)

Post-inflammatory hyperpigmentation (PIH) is a dark mark that appears exactly where skin was inflamed or injured: a pimple, bug bite, rash, burn or ingrown hair. Melasma doesn't need an injury. It appears on its own, in a symmetrical pattern, because pigment cells are overactive. PIH is often more noticeable and longer-lasting on medium to deep skin tones [2].

Clues that a mark is PIH:

• It sits right where a breakout, scratch or razor bump used to be
• It's a single mark, or a scattering that matches past breakouts
• It's brown, purple or gray rather than red or pink (red marks are often PIE, a different thing; see PIE vs PIH)

PIH usually settles over time, but it can take months. Picking, over-exfoliating and skipping moisturizer can make marks linger, as we explain in 3 everyday habits making your dark marks worse.

How do I know if I have melasma or hyperpigmentation?

Look at the shape, the location and when it appeared. Blotchy, symmetrical patches on the face that showed up in adulthood, especially around pregnancy, birth control or a sunny season, point to melasma. Single sharp-edged spots suggest sun spots, tiny dots you've had since childhood suggest freckles, and marks where breakouts used to be suggest PIH.

Here's a quick side-by-side comparison.

Melasma

• Looks like: blotchy tan, brown or gray-brown patches with soft edges
• Where: both cheeks, forehead, upper lip, nose and chin
• When: adulthood, often with pregnancy, birth control or sunnier months
• Triggers: UV, visible light, heat, hormones and genetics

Sun spots and age spots

• Looks like: single flat brown spots with clear edges
• Where: face, hands, arms, shoulders and chest
• When: gradually, often from middle age
• Triggers: years of UV exposure

Freckles

• Looks like: small, light-brown dots
• Where: nose, cheeks, shoulders and arms
• When: from childhood, darker in summer
• Triggers: genetics plus sun

Post-inflammatory hyperpigmentation (PIH)

• Looks like: flat brown, purple or gray marks
• Where: exactly where skin was inflamed
• When: after a breakout, bite, rash or injury
• Triggers: inflammation

This comparison is a guide, not a diagnosis. Types can overlap, and only a dermatologist can confirm what you have.

Melasma vs melanoma: when should you see a dermatologist?

Melasma is not skin cancer and doesn't turn into it. It's flat and usually appears on both sides of the face [1]. Melanoma is a serious skin cancer that often shows up as a single spot that looks different from your others or changes over time. If you're ever unsure which one you're looking at, see a dermatologist, and don't wait.

Dermatologists use the ABCDEs to describe warning signs of melanoma [4]:

• A is for asymmetry: one half doesn't match the other.
• B is for border: the edges are irregular, ragged or blurred.
• C is for color: several shades of brown, black or tan, or areas of red, white or blue.
• D is for diameter: larger than a pencil eraser, although melanomas can be smaller.
• E is for evolving: the spot changes in size, shape or color.

Also book an appointment for any spot that bleeds, itches, crusts or grows, a new patch on only one side of your face, or a "sun spot" that looks different from the rest. Please don't try to diagnose a changing spot from photos online.

Is care different for melasma and sun spots?

The foundation is the same for every type: daily broad-spectrum sunscreen, because UV can make all of them darker. Melasma needs a little more, because visible light and heat also play a role. That makes a tinted sunscreen with iron oxides, shade and a gentle, low-irritation routine especially important. A dermatologist can suggest prescription options or procedures for any type.

• For every type: broad-spectrum SPF 30 or higher every day, reapplied when you're outdoors, plus hats and shade [5].
• For melasma: add a tinted sunscreen with iron oxides for visible light, and keep skin cool and calm where you can [5]. Our guide to the best sunscreen for melasma explains what to look for.
• For PIH: don't pick, and keep your routine gentle so new inflammation doesn't leave new marks.
• For sun spots: they usually don't go away on their own, so ask a dermatologist about in-office options if they bother you.
• For freckles: nothing is needed beyond sun protection. They're a normal part of many people's skin.

If your patches appeared during pregnancy, our guide to melasma in pregnancy covers what's safe and what to expect. For quick answers, browse our melasma FAQ.

References

1. American Academy of Dermatology. "Melasma: Overview." aad.org
2. Davis EC, Callender VD. "Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color." Journal of Clinical and Aesthetic Dermatology (2010). PMC2921758
3. Ogbechie-Godec OA, Elbuluk N. "Melasma: an up-to-date comprehensive review." Dermatology and Therapy (2017). PMC5574745
4. American Academy of Dermatology. "What to look for: ABCDEs of melanoma." aad.org
5. American Academy of Dermatology. "Melasma: Self-care." aad.org

This article is for general information and isn't medical advice. If you have a skin condition or concern, talk to a doctor or dermatologist.