How Do I Know the Difference Between Sun Damage and Melasma?

Question

I understand Melasma is untreatable (except for bleaching creams) but sun damage can be removed by fraxel lasers and/or photo facials. Both are large brown spots.

Harold J. Kaplan, MD · Answer

Hi NYDawl.  There are some differences between Melasma and sun damage that you may be able to spot yourself, while others will only be seen by your physician.

	First, sun damage is usually very random when it comes to location on the face.  There is tyipcically no symmetry or order in regard to location.  The spots are different sizes and locations and the spots tend to be smaller than the patches of pigment associated with Melasma.  

	Melasma on the other hand is usually very symmetrical in nature.  For example if a patient has Melasma on one cheek, they almost always have it on the other.  Same for the forehead and upper lip.  Melasma typically has very defined borders whereas sun damage can sometimes be fuzzy or not well defined around the borders of the spots.  Melasma tends to happen in large patches and sun damage more so in smaller spots.  Finally, we evaluate patients with a wood's lamp (UV) light so that we can see the pigment as it appears beneath the surface of the skin.  This allows us tomore easily pick out Melasma from sun damage.

Joseph Serota, MD, FACS · Answer

A lot of my patients have a difficult time seeing the difference between sun damage and melasma, so you are not alone!  Sun damage has a smaller, more random pattern on the skin, and is generally more superficial, whereas melasma looks almost like a shadow and covers a larger area.  When you actually see pictures (check some out online) you can tell the difference but it can be difficult without doing some research or having a professional diagnose you. 

	Sun damage can be more easily remedied than melasma, as there is not a "cure" for melasma.  Melasma is hormone-induced, and sun damage is caused by previous years in the sun.  You can certainly quiet the melanocytes that cause melasma to look more prominent with in-office treatments by a doctor (or experienced aesthetician), or you can use creams that contain retinols and hydroquinone. 

	Sun damage responds well to IPLs, lasers, or chemical peels on MOST skin types.  As always, before signing up to receive any treatments, do your research and make certain your skincare professional is experienced.   I hope this helps!

Mary P. Lupo, MD · Answer

Your dermatologist will know the difference, but there are distinct patterns to melasma, while sun damage is ill-defined and diffuse. You are correct: If you begin regular sun protection, a skin care program and procedures such as peels and lasers can give you permanent improvement. Melasma, on the other hand, is more of an inherited, medical problem that oftern recurs even after successful treatment.

Peter A. Aldea, MD · Answer

As our skin is bombarded by the sun's rays, including ultraviolet A and B, damage takes place and manifests itself in many ways. We refer to that grab bag of changes as sun damage (among them flaky, wrinkly skin with loss of elasticity and increase incidence of blotchiness and of a variety of benign, precancerous and cancerous lesions).

	On the other hand, melasma refers to the facial hyperpigmentation of the cheeks which is seen with hormonal changes (birth control pills, pregnancy) and others.

	As to :"How do I know the difference between sun damage and Melasma?" - your Plastic surgeon will know.

How Do I Know the Difference Between Sun Damage and Melasma?

Answers (4)

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