What's the difference between pigmentation and melasma?

Both pigmentation and melasma involve extra melanin in the skin, so they can look similar at first glance. The difference is in what triggers them and how they behave over time.

General pigmentation

Sun spots, freckling and patchy discolouration that develop mainly from cumulative UV exposure are usually described simply as pigmentation. These tend to appear on consistently sun-exposed areas such as the face, shoulders and forearms, and they generally respond well to sun protection and, where appropriate, professional treatment.

Melasma

Melasma is a specific form of pigmentation linked to hormonal changes, commonly triggered or worsened by pregnancy, the contraceptive pill, hormone therapy or oestrogen fluctuations, and made worse by UV and even visible light exposure. It typically appears as symmetrical, blotchy patches on the cheeks, forehead, upper lip or chin, and it has a strong tendency to return even after successful treatment, particularly with further sun exposure or hormonal change.

Why the distinction matters

Melasma is generally harder to treat than general sun-related pigmentation and more prone to rebound, so a treatment plan that works well for freckling or sun spots is not always suitable for melasma, and can sometimes worsen it if the wrong approach is used. Getting an accurate diagnosis, rather than assuming any dark patch is the same kind of pigmentation, is an important first step. This is genuinely one situation where a professional assessment makes a real difference to the outcome, rather than trial and error at home.