Melasma or Tan? How a Dermatologist Tells the Difference

Why brown patches are often misread

In Hyderabad's strong sun, most people get some darkening of the face, especially on the forehead, cheeks and nose. Many assume it is a tan that will go away. Sometimes it is, but patches that stay for months, or keep coming back, are often melasma or another type of pigmentation that needs a different approach.

Tan: what it looks like

• Even darkening over areas exposed to the sun, with a clear line at the collar, sleeves or straps.
• Appears after days in the sun and fades over weeks once the skin is protected.
• Usually affects the arms, neck and hands as well as the face.

Melasma: what it looks like

• Light to dark brown patches with irregular borders, often matching on both sides of the face.
• Common on the cheeks, forehead, upper lip and the bridge of the nose.
• More common in women, and can start or worsen with pregnancy, hormonal pills or thyroid changes.
• Darkens quickly with sun and heat, and tends to return after it lightens.

Other causes of dark patches

Dark marks left after acne or a rash (post-inflammatory pigmentation), sun spots, freckles, reactions to perfumes or cosmetics, and pigmentation from certain medicines can all look similar. Some need treatment of the underlying cause first.

How a dermatologist tells the difference

The dermatologist looks at the pattern and colour of the patches, asks how long they have been there and what makes them worse, and reviews your skin products, medicines and hormonal history. A dermoscope, a handheld magnifying light, or a Wood's lamp examination can show how deep the pigment sits in the skin, which helps in choosing treatment.

Why the right diagnosis matters

A tan only needs sun protection and time. Melasma needs daily sun protection, prescription creams and sometimes procedures, chosen carefully because harsh treatments can make it darker, especially in Indian skin. Using strong lightening creams without a diagnosis is one of the most common reasons pigmentation becomes harder to treat.

Everyday steps that help both

• Use a broad-spectrum sunscreen every morning, including on cloudy days, and reapply when outdoors.
• Add a cap, umbrella or dupatta in the midday sun.
• Avoid scrubbing, steaming and home remedies such as lemon on pigmented skin.
• Do not use creams that were not prescribed for you.

The Skin Sensé is a dermatology clinic in Banjara Hills, Hyderabad, led by Dr. Alekya Singapore, Board-Certified Dermatologist. See also dark spots on the face.