Evidence
What the evidence shows
The classification of melasma as a specific subtype of hyperpigmentation is well-established.
Clinical classification
Well-establishedDiagnostic criteria
Clear and distinctTreatment guidelines
Different for different typesPatient understanding
Often confused
Use this section to decide
Does this advice apply to me?
Find the concern or goal closest to yours, then use the fit signal to decide how much weight to give this guide.If your goal is
HyperpigmentationUse caution- Fit signal
- Limited evidence
General term for skin darkening
If your goal is
MelasmaUse caution- Fit signal
- Limited evidence
Specific type of hyperpigmentation
If your goal is
Key distinctionUsually relevant- Fit signal
- Often useful
Cause, pattern, treatment response
If your goal is
Why it mattersUsually relevant- Fit signal
- Often useful
Different treatments for different types
Research notes already in this guide
- Melasma is classified as a specific disorder of hyperpigmentation in dermatology.
- The diagnostic criteria distinguish melasma from other pigmentation conditions.
- Treatment guidelines separate melasma from other types of hyperpigmentation.
- The distinction is clinically important for treatment selection and prognosis.
Explanation
How it works
The relationship between general and specific terms.
Pigmentation
Any skin color, normal or abnormal.
Hyperpigmentation
Abnormal darkening of the skin - the general category.
Melasma
A specific subtype of hyperpigmentation with distinct features.
Other subtypes
Sunspots, PIH, freckles, age spots - all hyperpigmentation, not melasma.
Practical use
How to use it
Get an accurate diagnosis
See a dermatologist to determine whether your pigmentation is melasma or another type of hyperpigmentation.
Understand the type you have
Treatment and prognosis depend on whether it's melasma, sunspots, PIH, or another condition.
Follow the appropriate treatment path
Different types of pigmentation respond to different treatments. Don't assume what works for one works for another.
Use sunscreen regardless of the type
All hyperpigmentation is worsened by UV exposure. Sun protection is universal.
Safety
Side effects and cautions
- Calling all facial pigmentation "melasma"
Facial pigmentation can be sunspots, PIH, freckles, or other conditions. Melasma is a specific diagnosis.
- Treating melasma like sunspots
Melasma requires a different approach, including ongoing maintenance and trigger management.
- Assuming pigmentation that doesn't respond to treatment is "untreatable"
It might be a different type of pigmentation that requires a different treatment approach.
Fit
Who should be careful
- Self-diagnosis - see a dermatologist for an accurate classification
Helpful context
What else is worth knowing
Which type of pigmentation do you have?
Understanding the type determines the approach.
Consistent with melasma. See a dermatologist for confirmation.
Isolated brown spots on the hands or faceMore consistent with sunspots. Still see a dermatologist for diagnosis.
Dark marks following acne, injury, or inflammationLikely post-inflammatory hyperpigmentation. Different treatment approach.
Worth noting
Small details that can change the answer
- The Umbrella. Hyperpigmentation covers any skin darkening, regardless of cause or pattern.
- Melasma's Place. Melasma is a specific subtype of hyperpigmentation with distinct features.
- Other Subtypes. Sunspots, PIH, freckles, and age spots are all hyperpigmentation - but not melasma.
- Treatment Differences. Different types of hyperpigmentation respond to different treatment approaches.
Melasma is a type of hyperpigmentation - but not all hyperpigmentation is melasma.
Hyperpigmentation is the general term for any skin darkening.
Melasma is a specific condition with hormonal, UV, and genetic causes.
Other types of hyperpigmentation include sunspots, PIH, and freckles.
The distinction matters for treatment - what works for one type may not work for another.
Definition
What is hyperpigmentation?
Hyperpigmentation is a broad medical term for any area of skin that is darker than the surrounding skin. It occurs when melanocytes produce excess melanin, which then accumulates in the skin. The causes are diverse - UV exposure, inflammation, hormonal changes, injury, genetics - and so are the patterns and locations.
- A general term for skin darkening from any cause
- Caused by excess melanin production or accumulation
- Includes many different subtypes and conditions
- Can appear anywhere on the body
- May be temporary or permanent
Definition
What is melasma?
Melasma is a specific subtype of hyperpigmentation characterized by brown to gray-brown patches on sun-exposed areas of the face. It is caused by a combination of hormonal stimulation (estrogen, progesterone), UV exposure, and genetic predisposition. It typically appears bilaterally and symmetrically on the cheeks, forehead, nose bridge, and upper lip.
- A specific skin condition, not a general term
- Hormonal, UV, and genetic drivers
- Appears on the face in a symmetrical pattern
- Chronic and relapsing
- Affects up to 50-70% of pregnant women and 30% of birth control users
Explanation
Key differences between melasma and other hyperpigmentation
Melasma differs from other types of hyperpigmentation in cause, pattern, location, and behavior. Understanding these differences is essential for choosing the right treatment.
Melasma vs. other types of hyperpigmentation
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Questions
Frequently asked questions
Is melasma hyperpigmentation?
Yes - melasma is a specific subtype of hyperpigmentation. It involves excess melanin production that darkens the skin.
Is melasma the same as hyperpigmentation?
Not exactly. Hyperpigmentation is the general category. Melasma is one specific condition within that category.
Is melasma and pigmentation the same thing?
"Pigmentation" is even broader than hyperpigmentation - it refers to any skin color, including normal skin color. Melasma is a specific disorder of pigmentation.
What's the difference between melasma and hyperpigmentation?
Hyperpigmentation is any skin darkening. Melasma is a specific type of hyperpigmentation with characteristic causes, patterns, and behavior.
References
Sources
The notes below are drawn from the evidence already cited in this guide. They are not a complete bibliography.
- Melasma is classified as a specific disorder of hyperpigmentation in dermatology.
- The diagnostic criteria distinguish melasma from other pigmentation conditions.
- Treatment guidelines separate melasma from other types of hyperpigmentation.
- The distinction is clinically important for treatment selection and prognosis.
