Hyperpigmentation is a common skin condition where the skin produces excess melanin, resulting in dark patches or spots on the skin. On the other hand, melasma is a type of acquired hyperpigmentation characterised by light to brown, symmetrical patches on the face. They usually affect the cheeks, forehead, nose and upper lip.

Understanding the difference between hyperpigmentation and melasma is crucial because they have different causes and treatments. The treatments for these two conditions vary and using the wrong treatment can exacerbate the condition or cause other side effects.

Therefore, it is essential to correctly diagnose the type of hyperpigmentation you are experiencing and seek the appropriate treatment from a dermatologist. Doing so allows you to manage your condition and achieve clearer, even-toned skin effectively.

Causes and symptoms of hyperpigmentation

There are several causes for hyperpigmentation of the skin including:

• Sun exposure: Exposure to the sun's UV rays can result in dark spots, ageing spots and freckles.
• Hormonal changes: Hormonal changes during pregnancy, menopause or due to the use of birth control pills can cause an increased melanin production, resulting in hyperpigmentation.
• Inflammatory skin conditions: Conditions like eczema, psoriasis and acne are considered inflammatory skin conditions and often cause hyperpigmentation when they are healing or have healed.
• Genetics: Some people are more prone to hyperpigmentation due to their genetic history.
• Medications: Some medications like antimalarial drugs, chemotherapy drugs and antibiotics tend to cause hyperpigmentation.

A few common symptoms of hyperpigmentation include:

• Dark spots or patches on the skin
• Uneven skin tone
• Melasma, which causes grey-brown patches on the face
• Freckles
• Ageing spots
• Darkening of the skin around scars or blemishes

Causes and symptoms of melasma

Since melasma is a type of hyperpigmentation, a few causes of both conditions may overlap. Some common causes of melasma include:

• Hormonal changes: Melasma is most often linked to hormonal changes that occur during pregnancy or while taking birth control pills. It can also be caused when undergoing hormone replacement therapy or hormonal imbalances.
• Sun exposure: Sun exposure can trigger or aggravate melasma by increasing melanin production.
• Genetics: People with a family history of melasma are more likely to develop the condition.
• Skin type: People with darker skin types such as those of Hispanic, Asian or African descent, are more likely to have melasma.

Symptoms of melasma vs pigmentation include:

• Dark, irregular patches on the skin, usually on the face, neck, chest or arms.
• The patches can range from light brown to dark brown and be symmetrical or asymmetrical.
• The patches are usually painless and do not itch.
• The patches may become more noticeable after exposure to the sun, hormonal changes or certain medications.
• Melasma is far more common in women than in men.

How are hyperpigmentation and melasma treated?

The treatments for melasma and hyperpigmentation are similar yet different.

Treatment options for hyperpigmentation include the following:

1. Topical treatments

Topical treatments for hyperpigmentation involve the use of creams, serums or gels that contain ingredients that reduce melanin production. Common topical treatments for hyperpigmentation include hydroquinone, retinoids, kojic acid, azelaic acid and vitamin C.

• Chemical peels

This treatment involves the application of a chemical solution to the skin, which helps exfoliate and remove the outer layer of the skin. This reduces the appearance of dark spots. It also encourages the growth of new skin cells.

Chemical peels can be done at a dermatologist's office or with at-home kits.

• Laser therapy

Laser therapy involves the use of intense light energy to break up the melanin in the skin, reducing the appearance of dark spots. This treatment is usually done in a dermatologist's office and may require multiple sessions for optimal results.

• Microdermabrasion

This is a non-invasive procedure that uses a special device to exfoliate and remove the outer layer of the skin. This can help to reduce the appearance of dark spots. It also promotes the growth of new, healthy skin cells.

• Sun protection

One of the most critical steps in treating hyperpigmentation is to protect the skin from further damage. This includes using sunscreen with at least SPF 30 every day, wearing protective clothing such as hats and long sleeves and avoiding prolonged exposure to the sun.

The goal of melasma is the same as that for hyperpigmentation, i.e., to decrease the amount of pigment your body makes and even out the skin tone. Some ways to achieve this are:

1. Using sunscreen with high SPF: Sunscreen with a high Sun Protection Factor (SPF) is an essential part of melasma treatment. Sun exposure can trigger the development of melasma or worsen existing patches.

Therefore, it is crucial to protect the skin from UV radiation by using sunscreen regularly, especially during peak sunlight hours.

• Medications: Topical medications containing hydroquinone, tretinoin and corticosteroids are often prescribed for treating melasma. These medications work by inhibiting the production of melanin and reducing inflammation. However, they may cause side effects such as skin irritation, redness and dryness.
• Dermatologic procedures: Dermatologic procedures may be recommended for people with severe or persistent melasma. Some of these procedures include:
• Chemical peels: Chemical peels involve the application of a chemical solution to the skin to exfoliate the top layer and stimulate cell turnover. This can help reduce the appearance of melasma by removing the darkened skin cells. Chemical peels can be superficial, medium or deep, depending on the depth of the skin layers targeted.
• Micro-needling: This procedure involves the use of a device with tiny needles to create micro-injuries in the skin, stimulating collagen production and skin rejuvenation.

Micro-needling can also be combined with topical medications or growth factors to enhance their effectiveness.

• Laser and light treatments: Lasers and light treatments use energy to target the pigment-producing cells in the skin, reducing the appearance of melasma. These treatments can be effective but may also cause side effects such as redness, swelling and hyperpigmentation.
• PRP (Platelet-Rich Plasma): PRP therapy involves the use of the patient's blood plasma, which is rich in growth factors, to stimulate collagen production and improve skin texture.

PRP can be injected into the skin or applied topically. It may be combined with other treatments such as micro-needling or laser therapy for enhanced results.

Melasma Vs hyperpigmentation: The differences

MelasmaHyperpigmentationA specific type of hyperpigmentation that occurs in patchesDarkening of an area of skin due to an increase in the production of melaninTypically appears on the face, particularly on the cheeks, forehead, nose and upper lip.It can occur anywhere on the bodyUsually larger and more irregularly shaped than other hyperpigmentation forms.Appear as small spots or larger patchesTriggered by hormonal changes such as pregnancy, birth control pills, hormone replacement therapy and sun exposureCaused by various factors including sun exposure, acne, injury to the skin and certain medications  Treatment may involve a combination of topical creams, chemical peels and laser therapy. Underlying hormonal imbalances must be addressed while protecting the skin from further sun damage with the use of sunscreen and protective clothing.Treatment may involve the use of topical creams, chemical peels or laser therapy, depending on the cause and severity of the condition.  

Wrapping it up

Understanding the differences between melasma and hyperpigmentation is essential for effective treatment and management. While both conditions involve the darkening of the skin, melasma is caused by hormonal changes and sun exposure while hyperpigmentation can result from various factors such as acne, injuries and inflammation.

Treatments for both conditions may include topical medications, sunscreen and dermatologic procedures such as chemical peels, micro-needling and laser therapy. It is crucial to consult a dermatologist for a proper diagnosis and treatment plan tailored to an individual's needs.

With proper care, management, hyperpigmentation and melasma treatment, both these conditions can be controlled and individuals can enjoy healthy, even-toned skin.

If you are confused about whether you have melasma or hyperpigmentation, ask our experts at Uncover!

If you are unhappy with your pigmentation or suffer from melasma, consult our expert dermatologists today! At Uncover, we offer a variety of skin depigmentation treatments, scar removal and micro-needling with sessions starting at Rs. 3000.