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What's the Difference Between Melasma and Sun Spots?

Sun Spots St. Louis
Sun Spots St. Louis

If you've noticed new spots on your face, you may be wondering what’s causing them. The two most common culprits are melasma and sun spots. But how can you tell these skin conditions apart? As dermatologists at Mid-County Dermatology in St. Louis, we frequently help patients diagnose spots on their skin. Here's what you need to know about melasma vs. sun spots and how your St. Louis dermatologist can treat them.

What is Melasma?

Melasma is a common skin condition that causes brown or grayish patches on the face. The word "melasma" means mask-like in Greek, which describes the facial distribution of this condition. While melasma can affect both men and women, it is much more common in women. In fact, 90% of cases occur in women. Melasma frequently emerges during:

  • Pregnancy

  • Hormone therapy like birth control pills or hormone replacement

  • Thyroid disease

  • Family history of melasma

Sun exposure often exacerbates existing melasma. Stress and changes in estrogen levels may also trigger melasma outbreaks. Melasma tends to appear symmetrically on areas of the face exposed to the sun, especially:

  • Cheeks

  • Bridge of the nose

  • Forehead

  • Upper lip

  • Chin

The patches have irregular, blurred borders and are often darker than the surrounding skin. Melasma can be mild with barely noticeable discoloration or cover large areas of the face. See your St. Louis dermatologist if you notice new onset of facial hyperpigmentation for proper diagnosis and treatment.

What are Sun Spots?

Sun spots, also called solar lentigines or liver spots, are flat, tan or brown spots that arise on sun-exposed areas of skin. They form due to accumulated ultraviolet (UV) light damage over time. Sun spots typically emerge in adulthood and increase with advancing age as UV exposure accumulates. They can range in color from light tan to dark brown. These spots usually develop on areas of frequent sun exposure like the:

  • Face

  • Chest

  • Shoulders

  • Arms

  • Hands

  • Legs

In contrast to melasma’s blurred borders, sun spots have clearly defined edges that are easily distinguishable from normal skin. They are also round or oval in shape rather than large patches. Sun protection starting early in life is the best way to prevent sun spots from forming. Check with your St. Louis dermatologist if you notice any changing moles or spots on your skin.

Differences Between Melasma and Sun Spots

While both melasma and sun spots appear as facial pigmentation, there are some key differences:


  • Irregular, blurred borders

  • Symmetrical patches

  • Grayish-brown, tan, or blue-black color

  • Affects women much more often

  • Associated with hormonal changes

  • Worsens with UV light exposure

Sun Spots

  • Clearly defined, sharp borders

  • Round or oval spots

  • Tan or brown color

  • Affects men and women equally

  • Caused by lifetime UV exposure

  • Not related to hormones

Some patients can have both melasma and sun spots concurrently. Your dermatologist will examine your skin under magnification to determine the specific type of hyperpigmentation.

Treatments for Melasma and Sun Spots

The good news is that modern dermatology offers effective treatments for both melasma and sun spots.

For melasma, options include:

  • Strict sun avoidance and protection

  • Hydroquinone creams to fade discoloration

  • Chemical peels

  • Microneedling

  • Laser therapy

  • Prescription retinoids

To remove sun spots, your dermatologist may recommend:

  • Cryotherapy to freeze spots off

  • Laser therapy to target pigmentation

  • Chemical peels

  • Dermabrasion

  • Topical bleaching creams

In addition to treating existing spots, daily broad-spectrum sunscreen and protective clothing are vital to prevent new melasma or sun spots from developing. Schedule a visit with your dermatologist in St. Louis to discuss the best treatment options to fade these facial spots and help your skin look its best.

Why Choose Mid-County Dermatology?

You deserve expert dermatology care when dealing with facial pigmentation like melasma or sun spots. Mid-County Dermatology has provided leading medical, surgical, and cosmetic dermatology to St. Louis area patients for over 40 years.

Our experienced dermatologists offer cutting-edge therapies to treat all skin conditions. We'll take the time to evaluate your individual situation, explain your options, and custom tailor a treatment plan for your needs and goals.

Our office provides personalized care in a comfortable, welcoming environment. We accept most major insurance plans for medical dermatology services like melasma and sun spot treatment.

If you're looking for a compassionate, expert St. Louis dermatologist to diagnose facial spots, call Mid-County Dermatology today. Discover the latest therapies to help your skin look its healthy best.

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