Hyperpigmentation vs. Melasma: How to Tell the Difference

Hyperpigmentation is easy to spot — but what’s less obvious is exactly what type of dark marks you’re dealing with. Figuring out what’s provoking your pigmented patches is important, though, for both treatment and prevention.

We’re taking a closer look at one of the most common — and temperamental — types of hyperpigmentation: melasma. Learn how to tell the difference between melasma and other forms of hyperpigmentation, and what you can do to help manage (or avoid!) the condition.

A woman with melasma hyperpigmentation on her face

3 minute read

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What is hyperpigmentation?

Many of us are familiar with hyperpigmentation: those pink, red, tan, brown or black patches that show up on our skin. It’s the result of excess melanin — the pigments that give our skin (and other organs, like our eyes) their characteristic color.

While melanin itself is useful and protective, too much of it leads to all kinds of common skin conditions, that are typically categorized as:

What’s the difference between hyperpigmentation and melasma?

Melasma is a complex form of hyperpigmentation, because its exact causes are unknown. What we can say for certain: all melasma is hyperpigmentation, but not all hyperpigmentation is melasma. It’s estimated that about five million Americans — the vast majority of them women — experience melasma.

The condition is thought to be triggered most often by:

  • Hormonal fluctuations: why it’s often called “the mask of pregnancy”
  • Sunlight: UV damage can bring on or worsen the disorder
  • Genetics: the condition tends to run in families
  • Skin color: darker skin tones are more susceptible

Though it’s best to consult with your dermatologist to confirm, in the following sections we’ll explain how to determine whether your excess melanin is likely melasma — and what you can do about it.

What does melasma look like?

The simplest way to differentiate melasma from other forms of hyperpigmentation is to look for its typical characteristics:

  • Commonly located on the forehead, cheeks, upper lip; sometimes jaw, neck and forearms
  • A symmetrical pattern of tan, brown, gray/brown macules (aka patches)
  • Areas are flat, painless, and devoid of scales or pimple-like bumps
  • Can worsen or subside depending on varying exposure to triggers

All Bright Niacinamide Brightening Toner for hyperpigmentation by SLMD Skincare

How do you treat melasma?

Let’s get this out of the way: there is no known cure for melasma. And because it’s so finicky, treatments that excel at zapping other forms of hyperpigmentation (like lasers for liver spots), can leave you worse off than where you started.

Here’s the good news: a roster of tried-and-true dermatological ingredients — plus a crop of newcomers — have shown promise in fading melasma’s pesky patches. Plus, depending on the cause, it may spontaneously fade — like after a pregnancy, or stopping oral contraceptives, for example.

Dermatologists will tell you that prevention is the best medicine — but here’s a roundup of potent ingredients proven to minimize melasma in some patients.

Dr. Lee’s last word

As a dermatologist, I treat all types of hyperpigmentation. Melasma is one of the trickier ones — but we do have a lot of options to manage it. I always tell patients to start slowly, and see how their skin responds to some of our over-the-counter regimens. Retinol, hydroquinone, and some of these newer ingredients like kojic acid, can make a big difference, but you have to be patient — and be very diligent with your sunscreen!

—Dr. Sandra Lee

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