Dark patches that don’t fade as expected are often described simply as hyperpigmentation. However, not all pigmentation behaves in the same way. Melasma is a specific type of hyperpigmentation with different underlying causes and treatment considerations. Understanding the difference matters because treatments that improve one type of pigmentation can sometimes make melasma worse.
If you’ve been trying to understand why your pigmentation isn’t responding to brightening products or previous treatments, knowing what type of pigmentation you have is the first step towards choosing the right approach.
Hyperpigmentation is the name given to any area of skin that becomes darker than the surrounding skin because of increased melanin production. It is a broad term rather than a diagnosis, and several different conditions fall within this category.
Although melasma is technically a type of hyperpigmentation, it behaves differently enough that it usually requires a different treatment strategy. Recognising that distinction is one of the most important parts of managing pigmentation successfully.
| Type | Cause |
|---|---|
Sun damage (solar lentigines) | Pigmentation caused by years of ultraviolet (UV) exposure. |
Post-inflammatory hyperpigmentation (PIH) | Dark marks that develop after acne, eczema, injury or inflammation. |
Freckles | Small areas of increased pigment that become more noticeable with sun exposure. |
Melasma | A hormonally influenced form of pigmentation that follows a distinctive pattern and often proves more difficult to treat. |
Unlike many other forms of pigmentation, melasma is driven primarily by internal factors rather than external damage alone.
Hormonal changes play a significant role, which is why melasma commonly develops during pregnancy or while taking the contraceptive pill. Genetics also influence who develops the condition, meaning some people are naturally more susceptible than others.
Sunlight remains an important trigger, but it is not usually the root cause. Heat can also worsen melasma, even without direct UV exposure. As a result, pigmentation often becomes more noticeable during warmer months or after holidays abroad.
Melasma also tends to appear in a recognisable pattern. It is usually symmetrical, affecting both cheeks, the forehead, bridge of the nose or upper lip. This differs from post-inflammatory hyperpigmentation or sun damage, which often appears in isolated patches where the skin has been injured or exposed to UV light.
Another important difference is pigment depth. Melasma may affect the epidermis, the dermis or both. In general, the deeper the pigment sits within the skin, the more challenging it is to treat. Understanding pigment depth helps determine which treatment approach is likely to produce the best outcome.
| Feature | Melasma | Other Types of Hyperpigmentation |
|---|---|---|
| Typical cause | Hormonal and genetic influences | Sun exposure, inflammation or skin injury |
| Pattern | Usually symmetrical | Often irregular or localised |
| Common areas | Cheeks, forehead, upper lip | Anywhere on the face or body |
| Pigment depth | Epidermal, dermal or mixed | Often more superficial |
| Response to sunlight | Worsens readily | Usually darkens with UV exposure |
| Triggered by heat | Commonly | Less commonly |
| Likelihood of recurrence | High without maintenance | Depends on the underlying cause |
While this comparison can help you recognise patterns, self-diagnosis has its limits. Pigmentation can overlap, and more than one type may be present at the same time. A professional assessment remains the most reliable way to determine exactly what you are treating.
Knowing whether pigmentation is melasma or another form of hyperpigmentation directly influences which treatments are appropriate.
Some treatments that work well for sun damage or post-inflammatory pigmentation may not be suitable for melasma. In particular, aggressive resurfacing treatments and certain heat-based procedures can aggravate melasma, causing pigmentation to become more noticeable rather than improving it.
By contrast, pigmentation caused by sun damage or inflammation often responds well to a wider range of treatment options once the underlying trigger has been addressed.
Melasma also requires different expectations. Rather than aiming for a permanent cure, treatment usually focuses on long-term management. Improvements are often very achievable, but ongoing maintenance and sun protection remain important because melasma has a tendency to recur.
Treating pigmentation without understanding what is causing it can lead to disappointing results and, in some cases, worsen the condition.
No two pigmentation concerns are exactly alike, so every treatment plan begins with a detailed consultation.
Dr Duncan Brennand carefully assesses the pattern, distribution and likely depth of pigmentation before recommending a personalised treatment plan. This allows the underlying cause to guide treatment, rather than relying on a one-size-fits-all approach.
Depending on your assessment, treatment may involve medical-grade skincare, chemical peels, Dermamelan®, or other carefully selected options designed to address your specific type of pigmentation. Where appropriate, Dr Brennand will also discuss lifestyle factors, hormonal influences and long-term maintenance to help minimise recurrence.
If you would like to learn more about treatment options, you can also explore our dedicated pages on hyperpigmentation, Dermamelan®, chemical peels and dark circles, which explain each approach in greater detail.
Yes. Melasma is a specific type of hyperpigmentation, but it behaves differently from other forms such as sun damage or post-inflammatory hyperpigmentation. It is influenced by hormonal and genetic factors, often appears in a symmetrical pattern, and has a greater tendency to recur. These differences mean it usually requires a different treatment approach.
Melasma typically appears as symmetrical patches of brown or grey-brown pigmentation across the cheeks, forehead, bridge of the nose or upper lip. Unlike isolated sun spots, the edges are often less defined and the pigmentation tends to cover larger areas of skin.
Melasma develops through a combination of hormonal influences, genetic predisposition and environmental triggers. Pregnancy, the contraceptive pill and hormone replacement therapy are all recognised triggers. Ultraviolet light and heat can also worsen existing melasma, even if they are not the original cause.
Melasma is generally considered a chronic condition rather than one that can be permanently cured. However, the appearance of pigmentation can often be improved significantly with the right combination of treatment, skincare and ongoing sun protection. Long-term maintenance is an important part of managing the condition.
Potentially, yes. Certain aggressive peels or resurfacing treatments may aggravate melasma if they are not carefully selected. This is why an accurate diagnosis is essential before beginning treatment. The most appropriate approach depends on the type and depth of pigmentation as well as your skin type.
Pattern is often the biggest clue. Melasma usually develops symmetrically across both sides of the face, while sun damage tends to appear as individual patches or spots in areas that receive the most UV exposure. However, the two can exist together, so a professional assessment is the most reliable way to identify the underlying cause.
Yes. Although pregnancy and hormonal contraception are well-known triggers, melasma can also affect men and women who have never experienced either. Genetics, sunlight and heat all play a role, and many people develop melasma without an obvious hormonal trigger.
It can. Even after successful treatment, melasma may recur if it is triggered by sunlight, heat or hormonal changes. Daily sun protection and a personalised maintenance plan help reduce the risk of recurrence.
Sometimes melasma improves if the trigger is removed, such as after pregnancy. However, many cases persist without treatment and can return after sun exposure or hormonal changes. For this reason, management usually focuses on long-term control rather than expecting it to disappear permanently.
Melasma and other forms of hyperpigmentation can look remarkably similar, yet they often require different treatment strategies. Understanding what is causing your pigmentation is the first step towards choosing the most appropriate approach and avoiding treatments that may not be suitable.
During your consultation, Dr Duncan Brennand will assess your skin, discuss the factors contributing to your pigmentation and recommend a personalised treatment plan based on your individual concerns. If you’d like to understand your options, you can book a consultation with L’Atelier Aesthetics or contact the clinic to arrange an appointment.
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