Melasma vs Sun Damage
Melasma is a soft-edged brown patch that is roughly symmetrical across the face. It fades and returns. Sun damage is separate, sharply edged brown spots that build up over years on the skin the sun reaches. They do not fade in winter. Edges and symmetry tell them apart: blurry and mirrored is melasma, sharp and scattered is sun damage.
What it is
Pigment-making cells in the skin switch on too easily and lay down extra pigment. Sun, heat and hormonal changes all push them.
Each spot is a small area where repeated ultraviolet light has left the pigment cells permanently overproducing.
What it looks like
Broad areas of fairly even brown, usually symmetrical across both cheeks, the forehead or the upper lip.
Round or oval spots, a few millimetres to about a centimetre, scattered with normal skin in between.
Colour
Pigment sitting deeper in the skin looks greyer or slate-coloured, and that kind is the harder one to lighten.
Older spots are darker. The colour is even across each spot.
Shape and edges
Patches fade gradually into normal skin. There is no line where they stop.
Each spot has a clean border, like a large freckle drawn with a pen.
Where it shows up
Cheeks, forehead, upper lip and jawline, sometimes the forearms and neck. Cover half your face in a mirror. If the two sides broadly match, that is melasma.
Face, backs of the hands, forearms, chest and shoulders. The pattern follows exposure rather than symmetry, so drivers often have more on one side.
What makes it worse
Including hormonal changes from hormonal birth control. Heat on its own is a trigger, so saunas, hot kitchens and a sunny car window all count.
Nothing else adds spots. Each summer of unprotected exposure adds to the running total.
What it does over time
It lightens in winter and with treatment, then comes back with sun, heat or a hormonal change. It rarely clears once and stays clear.
Spots do not fade in winter and do not clear on their own. New ones keep appearing while the exposure continues.
How it is treated
Daily broad-spectrum sunscreen, ideally tinted with iron oxides, is the treatment that matters most, and melasma comes back without it. Hydroquinone, azelaic acid, tranexamic acid and gentle peels lighten it. Lasers are used cautiously.
Cryotherapy, lasers and intense pulsed light clear individual spots well, often in one or two sessions. Hydroquinone and retinoids fade them more slowly. Sunscreen stops new ones forming.
Edges and symmetry decide it
Melasma has no edge you can point to: The colour fades gradually out into normal skin. It looks like a stain that soaked in, not a mark that was drawn on.
Sun spots have an edge you can trace: Each one stops cleanly, with normal skin between them, and you can count them.
Symmetry is the second test: Cover half your face in a mirror. If the pattern on one side broadly mirrors the other, that points to melasma. Sun spots land where the exposure landed, so they are usually uneven between the two sides.
The seasons behave differently
Melasma fades and returns: It lightens through the winter and darkens again from spring onward. Any treatment that works has to be kept up, because it comes back without sun protection.
Sun damage stays put: A sun spot in January looks the same as it did in July. Spots that disappear over the winter are freckles, not sun damage.
They often sit on the same face
Plenty of people have both: Years of sun leave sharp spots on the temples and cheekbones while a soft patch of melasma sits across the upper cheeks. They are treated differently, so they get treated separately even in the same appointment.
The wrong treatment sets melasma back months: Lasers, intense pulsed light and cryotherapy remove sun spots quickly. Aimed at melasma, that same heat and light can darken it instead. That is the practical reason to sort out which one you have before booking anything light-based.
Sunscreen is the one step that helps both: It fades neither on its own, but it stops new sun spots forming and it is the single most effective thing for melasma.
See a doctor if
A spot is changing in shape, colour or size
One spot looks clearly different from all the rest
A dark spot bleeds, itches, crusts or will not heal
A flat brown patch on the face is slowly widening with an uneven edge
A brown patch keeps spreading despite daily sunscreen
You want light-based treatment and are not certain which one you have
