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Melasma or other hyperpigmentation: which pattern is this?
Melasma is symmetric: mirrored brown or gray-brown patches with map-like edges on both cheeks, the forehead, or the upper lip, worse in summer and with heat or hormones. Post-inflammatory marks sit exactly where a spot or scratch was and are scattered, not mirrored. If your patches match side to side, see a clinician: melasma needs prescription management and is easy to make worse with peels and lasers.
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VerdictSymmetric patches
Verdict
Symmetric patchesMelasma is symmetric with map-like edges; other marks are not
Test your skin: AI skin analysis →What melasma looks like
Melasma appears as larger patches rather than discrete spots, brown to gray-brown, with irregular map-like borders. It is characteristically symmetric, showing on both cheeks, across the forehead, along the upper lip, or on the bridge of the nose in a mirrored pattern. The patches merge into one another rather than staying as separate points.
Its triggers are distinctive. Sun exposure, visible light, and heat all drive it, as do hormonal factors including pregnancy and some hormonal medications. It tends to worsen in summer and fade somewhat in winter, and it is persistent and prone to recurrence, which separates it from marks that simply fade out on their own.
What other hyperpigmentation looks like
Post-inflammatory hyperpigmentation is the most common alternative. It appears exactly where something happened to the skin, so each mark traces the outline of a spot, a scratch, a burn, or a patch of irritation. The marks are discrete, asymmetric, and scattered according to where lesions were, not according to any facial pattern.
Sun spots are the other frequent form: small, sharply bordered brown spots on areas with years of accumulated exposure, such as the upper cheeks, nose, forehead, and the backs of the hands. Both types fade over months once the trigger is removed and sun protection is consistent, which melasma typically does not do on its own.
How to tell them apart
Check symmetry first. Cover one half of your face in the mirror, then the other, and compare the two sides carefully. Melasma is strikingly mirrored, with corresponding patches sitting in corresponding places on each cheek or each side of the forehead. Post-inflammatory marks and sun spots are scattered and do not match side to side, because they follow individual events rather than a facial distribution.
Then check origin and edges. Ask whether each mark sits where you had a spot, a scratch, or a burn. If the answer is yes for most of them, it is post-inflammatory pigment. Melasma has diffuse, irregular borders that blend into surrounding skin, whereas sun spots have crisp edges. Heat and summer worsening, and a link to pregnancy or hormonal medication, point toward melasma.
Why it matters
Melasma is a medical condition and is managed rather than cured. It needs a clinician, because effective treatment usually involves prescription options alongside rigorous daily photoprotection, and because melasma is notoriously easy to make worse by accident. Aggressive peels, harsh scrubs, and strong lasers used without proper assessment can rebound the pigment darker than it was before, which is a slow problem to undo.
Today, cover one half of your face in the mirror, then the other, and check whether the patches match. If they do, stop any peel, scrub, or at-home device now, start a tinted mineral sunscreen daily, and book a dermatologist. If they do not match and each sits where a spot was, sunscreen and time fade them over months. The AI skin analysis scores tone evenness from a selfie so you can watch the marks fade, or not. Any patch that is changing shape or growing gets examined promptly.
FAQ
Common questions
Does melasma go away on its own?+
Sometimes after pregnancy or after stopping a hormonal trigger, but often it persists and recurs. It is treated as a long-term condition to manage with daily photoprotection and clinician-guided treatment rather than something that simply clears.
Is sunscreen enough for melasma?+
It is essential but rarely sufficient alone. Visible light contributes as well as UV, which is why tinted mineral sunscreens with iron oxides are often recommended. A dermatologist can advise on what to combine with it.
Why did my dark marks get worse after a peel?+
Inflammation itself can trigger pigment, particularly in deeper skin tones and in melasma. This is the main reason aggressive treatment without professional guidance can leave the skin darker rather than clearer.
Can I diagnose melasma myself?+
No. The pattern described here is suggestive, not conclusive, and other conditions can resemble it. A clinician can examine the skin, sometimes under specialized light, and confirm what it is before treatment starts.