Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 10/01/2020
At first glance, hyperpigmentation and melasma can seem like the same thing. They’re both skin conditions that primarily affect the face. They both cause dark and blotchy patches of skin. They both become exacerbated by spending too much time out in the sun.
Add in the fact that both skin conditions have similar treatments and it becomes easy to mistake hyperpigmentation for melasma and vice versa—something many people affected by discolored skin do every year.
Despite these similarities, hyperpigmentation and melasma are two distinct, different conditions with their own range of symptoms. They also require different treatment approaches for optimal healing and long-term results.
Below, we’ve covered the main differences between hyperpigmentation and melasma, ranging from symptomatic and gender differences to the most effective treatment approaches for each condition.
Hyperpigmentation is a skin condition that causes patches of skin to take on a darker color than the rest of your skin. It’s a very common skin condition that affects tens of millions of people of all ethnicities and backgrounds.
It’s also, in a way, an umbrella term that covers a number of skin conditions that result in patchy or unevenly colored skin — from liver and aging spots, to freckles and melasma.
The visible symptoms of hyperpigmentation can range from small areas of overly darkened skin to large, more obvious hyperpigmented skin.
Liver spots are a common type of hyperpigmentation. These develop as a result of sun damage. Liver spots, or “age spots,” are most commonly found on the face, hands and upper back—all parts of the body that are exposed to significant amounts of UV radiation.
From a physical health perspective, hyperpigmentation is largely harmless. It’s caused by the body overproducing melanin, an important skin pigment that’s responsible for regulating your skin color.
Almost all skin hyperpigmentation is the result of UV exposure. It’s also possible for skin to take on an overly dark, hyperpigmented tone as the result of trauma, such as a severe cut, scrape or other impact that breaks and damages the skin.
However, there’s also what’s called “diffuse hyperpigmentation,” which is generally associated with metabolic causes from certain medications, diseases, infections or even cancer. So, while this hyperpigmentation is technically harmless, it’s indicative of some not-so-harmless medical conditions which should be diagnosed and treated immediately.
There are several effective treatments available for skin hyperpigmentation. Most of the time, topical medications like hydroquinone and tretinoin (often used in combination) are enough to lighten hyperpigmented skin.
Our guide to the different causes of skin discoloration and how to treat them goes into more detail on how tretinoin, hydroquinone and other topical medications treat hyperpigmentation.
More severe hyperpigmentation can be treated using cosmetic procedures such as chemical peeling and microdermabrasion.
Melasma is a skin condition that causes certain areas of your skin to become more pigmented than the surrounding skin. It tends to affect the face, although it’s also possible for melasma to develop on your neck, arms and elsewhere on the body.
At first glance, melasma can look a lot like hyperpigmentation. However, its visible symptoms and its causes are both quite different.
While hyperpigmentation is the result of sun damage, melasma can occur for a large variety of reasons. In fact, scientists still aren’t fully aware of what causes melasma to develop, although there are several well-researched theories. The most common triggers are thought to be:
Hormones. Melasma is more common in women than in men, and seems to develop as a result of high levels of estrogen and progesterone. These hormones may be involved in triggering melasma and causing the development of dark, discolored skin.
Pregnancy. Melasma is most common during pregnancy, potentially because of higher estrogen and progesterone levels.
Genetics. Certain people are more susceptible to melasma than others. Melasma tends to run in families and is more common in people with darker skin tones.
Sun exposure. In addition to hormonal factors, scientists believe that melasma can be triggered by UV exposure. Many people with melasma notice worse symptoms during summer and a reduction in the visibility of their melasma during less sunny periods.
Melasma also tends to affect different parts of the body than hyperpigmentation. Although it’s possible for melasma to appear on any skin that’s exposed to the sun, it usually forms on the cheeks, forehead, upper lip and chin.
It’s also usually symmetrical, with matching patches of discolored, darkened skin appearing on both sides of the face.
Because melasma can be hormonal, it tends to be more challenging to treat and prevent than hyperpigmentation.
The most common treatment for melasma is hydroquinone. Just like with hyperpigmentation, topical hydroquinone can lighten areas of skin affected by melasma, helping them to blend in with the rest of your skin and reducing the contrast between one skin tone and the other.
Hydroquinone is often used in combination with topical retinoids like tretinoin. We’ve covered this in more detail in our guide to tretinoin (Retin-A®) and melasma. Some dermatologists also use corticosteroids to manage and treat melasma.
Cosmetic procedures like chemical peeling and microdermabrasion are also often used to treat melasma. Like with hyperpigmentation, these treatments are usually used for persistent cases that don’t respond well to topical treatments.
From a hormonal perspective, melasma is often caused by medications such as combined oral contraceptive pills. In this case, stopping your birth control or switching to a different method of contraception is often enough to gradually reduce your melasma symptoms.
Melasma affects approximately five million Americans, making it one of the most common skin conditions. It tends to affect women more often than men.
Luckily, melasma doesn’t need to be something that affects you forever. From topical treatments to cosmetic procedures, a variety of options are available to help you treat, manage and control melasma and maintain clear, consistent and discoloration-free skin.
Interested in learning more? Our guide to melasma covers everything you need to know about this common skin condition, from its hormonal and genetic causes to the most effective topical and lifestyle treatments for recurring melasma.