Melasma vs PIH vs Sunspots: How to Tell Your Pigment Type

Dark spots are a big concern for many people visiting a skin clinic in Singapore. While “pigmentation” is the general word for any area of skin that looks darker than the rest, not all spots are the same. Treating a sunspot is very different from dealing with melasma or acne marks (PIH).

Knowing exactly what kinds of spots you have is the first step toward clearer skin. At Cutis Medical Laser Clinics, we take a personal approach, using proven methods to identify and treat various skin conditions. Here is a simple breakdown of the three most common types of pigmentation we see in Singapore.

1. Melasma: The “Hormonal Mask”

Melasma is a long-term skin condition that appears as symmetrical, blotchy brown or grey-brown patches. People often call it the “mask of pregnancy” because it’s frequently triggered by changes in hormones.

Key Signs of Melasma:

• Where it is: It almost always shows up on the face, specifically the cheeks, nose, forehead, and upper lip.
• The Pattern: It’s symmetrical. If you have a patch on your left cheek, you’ll likely have one in the same spot on the right.
• The Edges: The borders are usually blurry and “smudged,” blending into your normal skin.
• What makes it worse: Hormonal shifts (like pregnancy or birth control), sun exposure, heat, and even the blue light from your phone or computer.

At our clinic, we notice that melasma can become darker or lighter depending on the weather or the amount of heat you’re exposed to. Because the cells making the pigment are “over-excited,” it needs a gentle, long-term plan rather than one-off, aggressive treatments.

2. PIH (Post-Inflammatory Hyperpigmentation)

PIH (Post-Inflammatory Hyperpigmentation) is a temporary dark mark that appears after the skin has been hurt or irritated. When your skin is wounded, by acne, a bug bite, or even a scratch, it can overproduce melanin while it heals.

Key Signs of PIH:

• Where it is: It can show up anywhere on the body where you had an injury.
• The Pattern: It’s not symmetrical. The shape and size usually match the injury (for example, the exact spot where a pimple used to be).
• The Colour: It can be pink, red, dark brown, or even grey-blue.
• How it acts: PIH usually fades on its own as your skin heals, but it can take months or even years without help.

Many people come to Cutis Medical Laser Clinics for PIH after a bad acne breakout. We usually focus on calming the skin and helping it renew itself faster so the marks fade more quickly.

3. Sunspots (Solar Lentigines)

Sunspots, also known as age spots or liver spots, are caused by years in the sun. Unlike melasma, these have nothing to do with hormones; they are simply a record of sun damage.

Key Signs of Sunspots:

• Where it is: Areas that get the most sun, like your face, hands, and shoulders.
• What they look like: Small, flat, circular or oval patches.
• The Edges: Sharp and clear. Unlike melasma, you can see exactly where a sunspot starts and ends.
• Stability: Once they appear, they don’t usually fade on their own. They might get even darker if you keep staying in the sun without protection.

Since sunspots are usually near the skin’s surface, they often respond well to laser or light treatments.

How We Handle Pigmentation at Cutis

Identifying the right type of spot is vital because the wrong treatment can make things worse. For example, a strong heat-based laser that works for sunspots might actually make melasma flare up.

At Cutis Medical Laser Clinics, every patient gets a detailed skin check. We often use special cameras to see how deep the pigment is.

Possible Treatments:

• Creams: Medical-grade creams that help regulate pigment.
• Chemical Peels: Using specialised liquids to peel away the top layer and reveal fresher skin.
• Lasers: Devices like the Pico Laser use super-fast pulses to break up pigment into tiny bits.
• Sun Protection: Using high-quality sunscreen and antioxidants to protect the skin from further damage.

FAQs

Q: Can I have more than one type at once?

Yes, it’s very common to have both sunspots and melasma, or acne marks on top of sun-damaged skin. We create a custom plan to treat each one safely.

Q: Why does my melasma come back?

Melasma is a “chronic” condition, meaning the cells are always ready to produce more pigment. Even if a laser clears the spots, heat or sunlight can trigger them to return. Sun protection is a lifelong job.

Q: Is sunscreen really that important?

Yes. The sun is the biggest trigger for sunspots and makes both melasma and PIH worse. Without sunscreen, clinical treatments won’t be nearly as effective.

Find Out What Your Skin Needs

If you’re worried about dark spots, a professional consultation is the best way to figure out what you have. At Cutis Medical Laser Clinics, we want to give you the facts so you can make the right choice for your skin.