Learn the differences between dark patches, pigmentation, and melasma. Know causes, treatments, and ways to prevent them for healthy skin.
The primary concerns that lead patients to seek care at a dermatologist’s clinic include uneven skin tone and hyperpigmented patches or darkened skin. Although these terms are often conflated and considered interchangeable, they are not. With distinct causes, the three skin conditions, dark patches, pigmentation and melasma have different treatment protocols and preventive strategies.
What causes pigmentation?
Pigmentation refers to any change in skin colour due to excess melanin, the pigment responsible for your skin’s tone. It can be triggered by sun exposure, hormonal fluctuations, inflammation, or even certain medications. “For instance, post-inflammatory hyperpigmentation (PIH) occurs when acne, cuts, or burns heal, leaving behind darker spots”, cosmetic dermatologist Dr Ameesha Mahajan tells Health Shots. Pigmentation can present as small dots, patches, or widespread discolouration, depending on the underlying cause. Diagnosis matters. The dermatologist carefully examines “the pattern of pigmentation, its colour, and the distribution of darkly pigmented skin.”
What leads to melasma?
Melasma is a type of pigmentation typically presenting as symmetric, brownish patches on the face, forehead, cheeks, upper lip, and jawline. Melasma is often associated with hormonal changes. “Women, especially during pregnancy or while on oral contraceptives, are more prone. Ultraviolet (UV) exposure is another major trigger, as sunlight stimulates melanocytes (pigment-producing cells) to overproduce melanin,” says Dr Mahajan. Genetics also play a role, as melasma tends to run in families. Unlike general pigmentation, melasma is chronic and often requires long-term management.
What is the main cause of dark patches?
The term ‘dark patches’ includes melasma, sun-induced pigmented patches, PIH, and skin conditions such as acanthosis nigricans, which can lead to thick, dark skin, especially in body folds. “Good lifestyle habits and a skincare regimen can reduce the appearance of these patches”, says Dr Mahajan. Regular sun exposure without protection, harsh skincare products, and inadequate hydration can exacerbate pigmentation.
Treatment options
Treatment strategies vary. Pigmentation removal requires topical skin brightening products, such as those containing vitamin C and niacinamide, as well as chemical peels. “Melasma can be well managed by combining a high-SPF sunscreen with pigment-inhibiting products, such as those containing hydroquinone or azelaic acid”, says Dr Mahajan. The key factor here is consistent practice, as these treatments or product applications require at least a few weeks to months for fruitful results.
Prevention tips
Prevention is equally important. The dermatologist recommends applying a broad-spectrum sunscreen daily, reapplying every 2-3 hours when outdoors, avoiding outdoor work on peak-sunny days, and choosing gentle skincare products to address inflammatory pigmentation. Melasma that is due to hormonal imbalances needs addressing of the triggering factors, such as pregnancy-related changes, contraceptive use, etc., but prevention is not always possible.
Treatment as per skin type
A clear understanding of skin type, trigger factors, and skin protection habits helps maintain long-term skin health. “Dark patches, pigmentation, and melasma are often confused, but they have different causes and require different management”, says Dr Mahajan. Seeking professional help remains for an accurate diagnosis and a treatment plan. This helps people avoid harmful self-treatment.
