What’s the Difference Between Melasma and Sun Damage?

Do you struggle with brown spots on your face? Are you tired of trying to cover them with makeup? If you’re wondering what they are and what you need to do to get rid of them, then this page is very important for you to read. Two conditions, melasma and sun damage, are often confused with one another because they look a lot alike. However, understanding each and distinguishing which one you have is critical because each has a different underlying cause and therefore, very different treatment. Let’s go over melasma first.

Melasma causes facial discoloration of varying shades of brown. It can affect either men or women, but usually affects women much more. The reason melasma happens is that people with it have pigment-making cells (melanocytes) that are overly sensitive to hormonal changes. The melanocytes make way too much pigment (melanin) causing the brown spots to form in response to normal hormonal changes such as pregnancy, menopause and oral birth control pills. Because of this, melasma is considered a chronic skin condition that has no cure.

Melasma treatment is aimed at slowing down this excess melanin production. Over time with treatment, the brown spots will fade and continued treatment is often needed to keep new ones from popping up. Melasma gets tricky to treat because the melanin can be located either in the top layers of skin (the epidermis), down deep (the dermis), or a combination of both. Melanin that is closer to the surface usually is easier to fade than the deeper kind. Special creams that can be used on the skin contain medicine that penetrates and blocks the production of melanin. These products work great, but sometimes can’t get down to the deeper melanocytes to do what they need to do. Lasers, generally don’t work very well on melasma.

On the other hand, sun damage or sun spots (solar lentigines, seborrheic keratosis, freckles, liver spots) are brown spots that are either on or very near the surface of the skin making them a lot easier to treat. A class IV medical laser, such as the q-switched laser, can break up this surface pigment using a very short, powerful burst of light energy. This lets the body clear the smaller pigment particles much easier. Usually, a few treatments to any one area are necessary to get the brown spot to fade completely. But once it’s gone, it’s gone for good, and new, healthy, normally colored skin takes its place.

Here’s a quick breakdown of the main differences between melasma and sun damage just to recap:


  • Varying shades of brown patches on the face, usually the forehead, cheeks, chin and upper lip area
  • Usually very symmetrical on both sides of the face
  • Caused by overly stimulated melanocytes making dense pigmentation that may be on the surface (the epidermis) or deeper in the skin (the dermis)
  • Linked to fluctuations in hormones making it a chronic and recurrent condition
  • Sun, heat and humidity may make it worse, but aren’t the main underlying cause
  • Responds to topical medications with varying success

Sun Damage (Sun Spots, Age Spots, Freckles, etc.)

  • Spots of varying shades of brown can occur randomly all over the face
  • Usually not symmetrical; spots may be patchy or diffusely scattered
  • May also occur with changes in texture in the skin (lines and wrinkles) commonly known as photo-damage when present together
  • Unrelated to hormonal changes. Due strictly to prolonged, excessive sun exposure
  • Can be treated fully and completely with lasers making it a curable condition

We hope that this article has given you some insight into the two very different, look-alike conditions. If you think that you may have either and want to do something to look and feel better, please give our office a call today. We would love the opportunity to introduce ourselves and tell you more about our effective programs for treating both melasma and sun damage.

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