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Melasma vs Hyperpigmentation: What's the Difference?

Melasma vs Hyperpigmentation: What's the Difference?

A healthy lifestyle and a consistent skincare routine can help you achieve better, more youthful-looking skin. But what if one day you wake up with a skin condition a little more serious than pimples and blackheads? Two of the more often noted skin problems are melasma and hyperpigmentation. But when it comes to melasma vs hyperpigmentation, what’s the difference?

What is Melasma?

Melasma is a condition that causes dark discoloration on your skin. It can present as brown, sometimes bluish-gray, patches, or freckle-like spots. It’s also called the “mask of pregnancy” or chloasma, because it frequently affects pregnant women.

Although it can be easily detected because it usually appears on your face, it is often called hyperpigmentation.

Melasma vs. Hyperpigmentation

Is it necessary to compare these two terms or are they simply the same?

Hyperpigmentation is a general term used for a number of skin conditions wherein a spot or patch of skin is darker than the surrounding skin in that specific area. This is a term used for other skin conditions such as sunspots or freckles, liver spots, and even melasma. Therefore melasma is classified as a type of hyperpigmentation.

Even so, it is different from other forms of hyperpigmentation, mainly because of its cause. In the discussion about melasma vs hyperpigmentation, melasma is not just sun-related, but is caused by hormonal changes within the body. Though not dangerous or itchy, the location of melasma patches can affect one’s confidence or cause discomfort in public.

Types of Melasma

There are several types of melasma.

Epidermal Melasma

There is an increased pigment on the top layers of the skin (epidermis). This type is brownish in color and has a distinct borderline. It also shows clearly under a black light and usually has a positive reaction to treatments.

Dermal Melasma:

With this type, there is an increased pigment on the deeper layers of the skin (dermis). It can be light brown or bluish-gray in color and has no distinct borderline. In addition, it does not clearly show under a black light nor does it manifest a positive reaction to treatment.

Mixed Melasma

This is the most common type of melasma. It has a combination of brown and blue colors, and shows mixed patterns under the black light. It will have a positive reaction to treatments and shows notable improvement.

What Causes Melasma?

People with naturally brown or darker complexion are prone to melasma. It appears more often on women’s skin, between the ages of 20 and 40 years. If you get tan easily, you are likely to have this form of hyperpigmentation. Pregnancy, hormonal therapy, and stress can also trigger melasma. Although not a direct cause, excessive sun exposure should be avoided as it can worsen your condition.

Signs and Symptoms

The best way to look for signs and symptoms of melasma is physical examination. Melasma causes discolorations, usually darker than your skin color. It can be brownish or bluish patches or dots typically seen on your face.

The dark, brown, or bluish patches usually appear on:

  • Forehead
  • Cheeks
  • Bridge of nose
  • Chin
  • Forearms

When discolorations appear, it is best to seek a doctor’s opinion as melasma can stay on your skin as short as weeks or months or in some cases, an extended period of time.

Diagnosis and Treatment

Doctors, specifically dermatologists, can detect melasma through physical examination. But to see how deeply the melasma penetrated the skin, they often use a device called Woods Lamp. It emits a black light that uses long-wave ultraviolet light. This test is done to detect fungal scalp, a potential skin infection, or different forms of hyperpigmentation including epidermal or mixed melasma.

To examine the discoloration even further and rule out other skin conditions, your dermatologist may need to conduct a skin biopsy. They will remove a small bit of skin then they will test the sample for melasma.

Treatment options

But not everyone can afford or have time to visit a dermatologist. Luckily, some cases of melasma fade on their own. This often happens to pregnant women, whose melasma fades after giving birth. Women who stopped taking hormones or birth control pills, notice their melasma fades after.

However, there are other people who have melasma for years or even a lifetime. There are treatments available to manage melasma or even cure it for good:

  • Hydroquinone: It is a common first treatment for melasma and is applied to the skin directly. Its function is to lighten the discolored patch of skin.
  • Tretinoin and corticosteroids: Act as an enhancement to skin lightening. Often called a triple cream.
  • Other topical medicines such as azelaic or kojic acid to help lighten melasma.
  • Medical Procedures: If medicines and creams did not get rid of your skin condition, there are procedures you can undergo that might work. Chemical peels, microdermabrasion, dermabrasion and laser treatment are some of the procedures dermatologists can perform as a treatment for melasma.

Key Takeaways

Melasma vs hyperpigmentation? Most blemishes and skin spots are hidden under heavy makeup, undiagnosed and untreated. Abrasions and discolorations are tended with self-prescribed creams and ointments that may help or could potentially cause more damage. Untreated skin conditions like this can get worse or it can be a dangerous disease disguised as an innocent brownish patch.

When you see some signs of abnormal discoloration on your face or body, seek medical help and stay away from its triggers. Melasma may be painless, usually treatable, and not relatively dangerous, but its mark can stay on you for a few months or even a lifetime.

Learn more about Skin Health here.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Melasma: Who Gets and Causes – American Academy of Dermatology, https://www.aad.org/public/diseases/a-z/melasma-causes#:~:text=Who%20gets%20melasma%3F,more%20likely%20to%20get%20melasma Accessed: January 15, 2021

Treatments for Melasma (darker than normal skin occurring in patches), https://www.cochrane.org/CD003583/SKIN_treatments-for-melasma-darker-than-normal-skin-occurring-in-patchesAccessed: January 15, 2021

Melasma | Dermnet NZ, https://dermnetnz.org/topics/melasma/Accessed January 15, 2021

Melasma: Treatment, Causes and Prevention – Cleaveland Clinic, https://my.clevelandclinic.org/health/diseases/21454-melasma Accessed January 15, 2021

Wood’s lamp examination information | Mount Sinai – New York, https://www.mountsinai.org/health-library/tests/woods-lamp-examination  Accessed January 16, 2021

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Medical reviewed by Hello Doctor Medical Panel
Written by Louis Bienes
Updated Feb 18
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