Melasma vs sun spots vs PIH, told apart quickly
Melasma vs sun spots comes down to pattern and cause. Melasma shows as larger, symmetrical patches driven by hormones and heat. Sun spots are small, defined dots from years of sun. Post-inflammatory hyperpigmentation (PIH) is a flat mark left behind after a breakout or irritation.
All three are forms of hyperpigmentation, which simply means extra pigment sitting in the skin. They look similar in the mirror, but they behave differently and respond to different care. Knowing which one you are looking at is the first step, and it is exactly what we work through together at a consultation.
If you want the wider picture first, our complete guide to hyperpigmentation in Western Sydney sets out how pigment forms and why it lingers.
What melasma looks like, and why it appears
Melasma tends to show as larger patches with soft, blurred edges, often sitting symmetrically across the cheeks, forehead, upper lip or bridge of the nose. It is closely linked to hormones (pregnancy, the pill) and is switched on further by sun, heat and even screen light.
Because it is hormone and heat driven, melasma can come and go, deepen in summer and settle in winter. That pattern is a strong clue. It is also the most stubborn of the three to manage, which is why steady, gentle care and daily sun protection matter more than any single treatment.
What sun spots look like, and why they appear
Sun spots, sometimes called age spots or solar lentigines, are small, flat, clearly defined marks in tan to brown tones. They collect where the sun reaches most: the tops of the cheeks, the hairline, the backs of the hands and the chest.
These are the record of cumulative sun exposure over the years, so they usually build gradually and stay put rather than fading on their own. They are common across Western Sydney skin, where plenty of outdoor time adds up quietly over time.
What PIH looks like, and why it appears
PIH is the flat brown, tan or grey mark left behind after the skin has been inflamed, most often after a pimple, a scratch, a burn or a harsh product. It sits exactly where the original spot was, which is the giveaway.
Unlike a raised scar, PIH is only a change in colour, not texture. It often eases over months as the skin turns over, though deeper marks and darker skin tones can hold pigment for longer. Protecting the area from sun while it settles helps it fade more evenly.
A quick way to compare them
Picture someone in her late thirties who books in unsure about the marks on her cheeks. On a closer look, there are soft symmetrical patches high on both cheeks that worsened after a summer holiday (melasma), a couple of small defined dots near the hairline (sun spots), and a faint brown mark exactly where a breakout cleared last month (PIH). Three different things, one face, and each needs a slightly different plan.
| Feature | Melasma | Sun spots | PIH |
|---|---|---|---|
| Shape | Large patches, blurred edges | Small, defined dots | Marks matching a past spot |
| Pattern | Often symmetrical | Scattered on sun-exposed areas | Wherever skin was inflamed |
| Main trigger | Hormones, heat, sun | Cumulative sun exposure | Past breakout or irritation |
| Behaviour | Comes and goes with seasons | Builds slowly, stays put | Often eases over months |
How we approach pigment at Skin Essentials
Every plan starts with working out which type (or types) of pigment you have, because the approach is different for each. Results vary from person to person, so we build the plan around your skin rather than a fixed menu.
For many clients, professional pHformula skin resurfacing is designed to help soften the look of pigmentation over a course, and we are the only clinic in Western Sydney to stock pHformula. Gentle, barrier-friendly options like LED light therapy can support the skin alongside it. Whichever path suits you, daily sun protection is the non-negotiable that makes everything else work harder. If a mark is changing in a way that seems unusual, we will always suggest you see a GP or dermatologist first.
You might also find our sister piece on building a daily sun protection habit a useful next read.
The short version: melasma is large hormonal patches, sun spots are small sun-made dots, and PIH is the mark left after a breakout, and each responds best to its own tailored plan.
Frequently asked questions
Can you have melasma, sun spots and PIH at the same time?
Yes, it is very common to have more than one type of pigmentation together. Many clients arrive with a mix, which is why we assess your skin closely at a consultation before suggesting anything, so the plan fits what is actually there.
Does pigmentation go away on its own?
Some does and some does not. PIH often eases over months as skin renews, while sun spots and melasma tend to persist or return without ongoing care and daily sun protection. Results vary, so a tailored plan helps.
Is skin resurfacing safe for melasma?
It can be suitable for some people, but melasma is heat and light sensitive, so it needs a careful, gentle approach. pHformula resurfacing is tailored to your skin at a consultation, and we never rush it. Results vary from person to person.
Why does my pigmentation get darker in summer?
Sun and heat both stimulate pigment, so most types deepen with more exposure, and melasma especially. Consistent daily SPF and sensible sun habits are the single most useful thing you can do to keep marks from worsening.
How long before I see a change in pigmentation?
It varies with the type of pigment, your skin and the plan, and pigmentation is usually a slow, steady process rather than a quick one. We will give you an honest, realistic idea of timing at your consultation.
Not sure which type of pigmentation you are seeing? Book a consultation with Ann, Kirstie or Linda, and we will look closely at your skin and build a gentle plan that is genuinely yours. You can get in touch with our St Marys clinic whenever you are ready.
