Melasma, Sunspots or Age Spots? How to Tell Them Apart

The quick way to tell them apart: sunspots are small, sharp-edged and scattered where the sun hits; melasma is larger, soft-edged and symmetrical — usually both cheeks, the forehead or the upper lip — and is driven by hormones as much as sun. Post-inflammatory marks sit exactly where a pimple or injury used to be.

SunspotsMelasmaPost-inflammatory marks
Main driverCumulative sun exposureHormones + sunA past breakout or injury
PatternSmall, sharp-edged, scattered on sun-exposed areasLarger, soft-edged, symmetrical on cheeks, forehead or upper lipSits exactly where the skin was inflamed
BehaviourStable; darkens with more sunWaxes and wanes; prone to recurringFades slowly over months if protected from sun

“Pigmentation” isn’t one thing. The brown patches on your cheeks and the small dark spots on your temples can look similar but be completely different — and they don’t respond to the same approach. Telling them apart is the first real step, so here’s how they differ.

Sunspots

Flat, well-defined brown spots — often on the face, hands and other areas that catch the most sun. They come from cumulative UV exposure and tend to appear from your thirties onward. Edges are usually distinct, and they sit on the surface.

Melasma

Larger, less defined patches, often fairly symmetrical, typically across the cheeks, forehead or upper lip. Melasma is driven by a combination of hormones and sun, is more common in women, and is known for being stubborn and prone to returning — which is why it rewards a careful, patient approach rather than an aggressive one.

“Age spots”

Usually the same thing as sunspots — the term people use for the sun-related spots that become more common with age. Same cause, same category.

Post-inflammatory marks

Not strictly the same family, but often confused with them: the darker marks left after acne or irritation settles. These fade differently again.

Why the difference matters

Each type behaves differently and responds to different approaches. Treating melasma as if it were a simple sunspot, for example, tends to end in frustration. That’s why an accurate read comes before any plan — getting the type right is what makes the difference.

How a doctor tells them apart

A full assessment looks at the pattern, location and history, sometimes with a specialised lamp to see how deep the pigment sits. From there, the plan follows the diagnosis rather than guesswork.

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Frequently asked questions

Is melasma harder to treat than sunspots? Melasma is generally more stubborn and more likely to recur because hormones are involved, so it usually needs an ongoing, careful approach.

Can I have more than one type at once? Yes — mixed pigmentation is common, which is part of why an assessment matters before treatment.

How do I know which one I have? The safest way is to have it assessed; the differences can be subtle, and getting it right shapes everything that follows.


Related reading: What causes facial pigmentation? · Why does pigmentation keep coming back? · Skin at Belief Medical

Written by Dr Sam Lua, Belief Medical — a private GP and aesthetic practice in Singapore. About the practice. Last reviewed: August 2026.

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