Melasma is a chronic skin disorder that results in symmetrical, blotchy, brownish facial pigmentation. It can lead to considerable embarrassment and distress. This form of facial pigmentation is sometimes called chloasma, but as this means green skin, the term melasma (brown skin) is preferred.
Hyperpigmentation, a broad term that refers to a skin condition in which the skin is discolored or darkened, can be brought on by many different factors. Much like general hyperpigmentation, melasma appears in the form of discoloration on the skin and is exacerbated by exposure to the sun. However, there are actually quite a few differences that set it apart from your run-of-the-mill hyperpigmentation.
While no one should ever feel like they have to hide a skin ailment, it’s important to know the differences between the two conditions if you choose to treat them. A definitive breakdown of melasma and hyperpigmentation, the differences between the two, and how to treat them — as detailed by our trusted dermatologist, Dr. Madeleine Sembrano of St. Luke’s Medical Center.
Hyperpigmentation can refer to any darkening of the skin
Whether you have post-blemish scarring from a stubborn breakout, freckles that expanded into full-blown sun spots from excess exposure, or discoloration caused by a condition like eczema or psoriasis, the discoloration usually all falls under the umbrella of hyperpigmentation. This is because acne, sunlight, skin rashes, and the like have the potential to stimulate melanocytes, the pigment-making cells in the skin, to make a surplus of pigment, “causing them to dump their pigment into lower levels of the skin, like tattoo pigment, where it doesn’t belong,” explains Dr. Sembrano. The deeper the pigment, the tougher it is to treat. Put it this way: A section of skin that’s been consistently exposed to harmful UV rays without the proper protection will be harder to diminish than say, a dark spot leftover from a pimple that you’ve been careful to shield from the sun. In other words, the level of severity varies, but if you spot discoloration on your skin that wasn’t there before, it’s safe to assume it’s hyperpigmentation. But always consult your doctor to be sure, of course.
Melasma is a form of hyperpigmentation that’s more commonly seen in women (especially in those with darker skin tones) and is thought to be triggered by UV exposure, as well as hormonal influences. The latter is what distinguishes it from traditional hyperpigmentation and makes it tougher to treat. “Hormonal influences play a significant role here, as seen by the increased prevalence of pregnancy, oral contraceptive use, and other hormonal therapies,” Sembrano added. The problem is preventing its worsening, especially from the hormonal angle, as it can be hard to remove the instigating factors.
You can usually tell if you have melasma based on its appearance alone. “[It] typically appears as symmetric blotchy hyperpigmented patches on the face, usually the cheeks, bridge of the nose, forehead, chin, and upper lip. While less common, melasma can appear on other parts of the body — especially those more prone to sun exposure (like the neck and forearms) — and many people say their melasma worsens in the summer and improves during the cold holiday season. It may [also] appear during pregnancy or after starting birth control or other hormonal treatments. (Something to consider if you’ve seen discoloration appear shortly after switching up your birth control or undergoing a hormonal change.)
There are a couple of factors that can contribute to the spreading of melasma: visible light and heat. Sembrano recommends using makeup that contains iron oxide to help block visible light. Unfortunately, steering clear of infrared heat proves more difficult, as it can be generated just by being in hot environments such as a sauna, a steamy kitchen, or even at the gym.
Melasma and hyperpigmentation treatments are the same but melasma is harder to get rid of.
As mentioned above, melasma is difficult to treat. This is because, unlike traditional hyperpigmentation, which responds to a variety of over-the-counter products that contain brightening agents like vitamin C, kojic acid, niacinamide, hydroquinone, and azelaic acid, melasma hasn’t seen the same rate of success or consistency.
According to Dr. Sembrano, treatments would usually involve a combination of sunscreen, brightening ingredients, and laser treatments, whereas, for basic hyperpigmentation, she typically uses chemical peels in place of lasers.
Treatment depends on the severity of your melasma. Everyone’s experience will be unique, and no treatment plan will be 100 percent perfect (something Friedman points out) or work the same way for someone else. So whether you have stubborn hyperpigmentation or melasma, be sure to talk with your dermatologist first to figure out the best form of treatment.
You can’t correct or prevent either without sun protection.
We’ve stressed the importance of diligent sunscreen use too many times to count, but that’s because it’s basically the end-all-be-all when it comes to staving off any sun-induced ailment. Melasma is also triggered by hormonal factors, but that does not mean you should slack off on the SPF, as UV rays are still responsible for magnifying the condition.
Apply an SPF 30 or higher, every two hours, even if you’re just going to be inside sitting near a window. It also can’t hurt to double up on the protection with a moisturizer that contains SPF
Bottom line: Hyperpigmentation and melasma happen, but with the proper precaution (read: SPF) the skin conditions can likely be avoided.