A Dermatologists’ Guide To Hyperpigmentation vs Melasma: Causes & Treatments
Learn about differences between melasma and hyperpigmentation, what causes them, and how to treat both.
By SunsolveMD Team | 6 Min. ReadJanuary 2, 2023
Hyperpigmentation or melasma?
Hyperpigmentation and melasma are two related but not completely similar skin conditions. Both terms can be easily confused as they refer to a darkening of the skin due to an increase in melanin production. However, there are some key differences between the two. Hyperpigmentation can occur on any body part and is generally uniform in color. Melasma, on the other hand, is a specific type of hyperpigmentation that is caused by hormonal changes, making it more difficult to treat.
While hyperpigmentation's sudden appearance can leave you feeling frustrated, it's actually caused by a number of environmental and lifestyle factors, most of which are easy to address. And with the right combination of preventative measures and targeted treatments, you can easily tackle either and go back to having skin that's even-toned and free from any blotches.
What is hyperpigmentation?
Hyperpigmentation is when there occurs a darkening in the color of the skin. This happens when there is an increase in melanin production by the pigment-producing cells called melanocytes. Several factors could trigger excess melanin production - from sun exposure to trauma, all of which ultimately damage or activate the melanocytes.
What causes hyperpigmentation?
Some common causes of hyperpigmentation include: freckles, tanning, uneven pigmentation due to sun damage, injury or trauma to the skin, certain medications, post-inflammatory hyperpigmentation following acne, and other dermatological conditions. Dermatological conditions such as psoriasis and atopic dermatitis which cause inflammation in the skin often leave behind pigmentation, called post-inflammatory hyperpigmentation.
What is melasma?
Melasma is a distinct disorder that falls under the umbrella of hyperpigmented skin conditions. Here, the excess melanin is deposited throughout the layers of the skin. Melasma shows up as flat, brown patches, mainly over the cheeks and nose. It is seen more frequently in those with the skin of color.
What causes melasma?
While the exact cause of melasma is unknown, understanding the potential causes can help people take steps to reduce their risk.
A genetic predisposition increases the likelihood of developing melasma during your lifetime.
Activates and triggers melanocytes to produce excess pigment which is deposited throughout the layers of the skin. UVA radiation penetrates deep into the skin and stimulates the melanocytes. This excess melanin is then taken up by the surrounding skin cells called keratinocytes. It has been found that apart from UVA radiation in sunlight, high energy visible light (HEV light) and infrared radiation also worsen melasma. HEV light is blue light emitted from indoor sources like lamps, tube lights, and digital screens on our laptops and phones.
Although the face is the most common site that melasma shows up on, it may also affect other sun-exposed areas, such as the arms.
It can occur during pregnancy or result from taking oral contraceptive pills. Women often first develop the signs of melasma during or immediately after pregnancy. That is why melasma is called chloasma or a 'mask of pregnancy'.
How do I treat melasma?
Since sunlight plays a vital role in how melasma begins, wearing a good, broad-spectrum sunscreen with SPF50 is vital to prevent melasma from worsening.
A few things to note about sunscreens if you suffer from melasma:
Mineral (zinc oxide) sunscreens are generally recommended for patients suffering from melasma as they offer broad-spectrum benefits. They contain filters like non-nano zinc oxide and block UV rays and visible light.
Tinted zinc oxide mineral sunscreens have been shown to be beneficial in melasma. Because they contain pigmented filters such as zinc oxides they provide excellent coverage masking the difference between the pigmented patches of melasma and normal skin.
It is a good idea to use sunscreen indoors because windows do not block UV radiation completely and allow visible light to pass through.
SunsolveMD’s Anti Hyperpigmentation SPF50 serum is formulated with a cocktail of clinically-proven skin ingredients to provide a 2-in-1 daily solution for both powerful UV protection and effective skin tone complexion correcting. The formula is infused with SunsolveMD’s Mela-FixTM and fortified with clinically-proven melanogenesis-inhibiting technology to fade the look of dark spots.
SunsolveMD’s The SolveTM harness the free radical quenching power of zinc oxide to shield the skin from harmful environmental factors.
A Combination of Topicals
One of the most popular and effective treatments is a triple combination of tretinoin, hydroquinone and fluocinolone (or another topical steroid). Together, these three ingredients bring about a rapid reduction in melasma in 8-12 weeks. However, these cannot be used for extended periods without a dermatologist's supervision.
Other treatment options include depigmenting agents such as kojic acid and tranexamic acid. Other brightening agents like vitamin C and arbutin are also effective as adjuvant treatments for melasma. A relatively newer ingredient that has been gaining popularity is cysteamine.
Apart from topical medications, certain orally available formulations consisting of tranexamic acid and antioxidants can act as supportive therapy for melasma. You can ask your dermatologist about these treatment options.
Office- based procedures
One of the most popular methods of treating melasma is performed by clinicians:
Glycolic acid, azelaic acid, kojic acid, yellow (retinol) peel, and mandelic acid are some of the chemical exfoliants that can help lighten pigmentation associated with melasma.
Can also help lighten melasma. However, this is only an appropriate option for some skin types.
Your dermatologist can help decide the best procedural treatments for your melasma based on your skin type, the severity of melasma, and other factors. Often, multiple sessions spaced at 3-4 weeks are needed.
Melasma can have a waxing and waning course, with excess sun exposure and hormonal changes potentially worsening it. A combination of the above treatments will be needed for every individual to achieve optimal results. Nevertheless, beginning treatment at an early stage of melasma is vital.
How do I treat hyperpigmentation?
Preventing hyperpigmentation in the skin involves treating the underlying dermatological condition as early as possible. Treating acne early will ensure that it does not result in hyperpigmentation and scarring. Once hyperpigmentation has developed, it must be treated as early as possible to ensure the best outcomes. The longer the duration of the pigmentation, the more stubborn and difficult it tends to be.
When it comes to treatment options, they tend to be similar to that for melasma since both conditions have excess pigment deposited in the skin. Some particularly useful skincare ingredients include glycolic acid, azelaic acid, mandelic acid, and vitamin C.
There are also several different lasers available for hyperpigmentation. Your dermatologist can choose the most appropriate one for you by considering factors such as the site and degree of pigmentation and your skin type.
No treatment plan for hyperpigmentation is complete without suitable sunscreen. This is because any damaged and pigmented skin can develop more stubborn and deeper hyperpigmentation following exposure to sunlight and UV radiation. The general guidelines for sunscreen for melasma mentioned above hold for hyperpigmented skin as well.
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