Freckles, sun spots and melasma: What’s the difference and how to keep your complexion clear

Did you know that the dark spots and patches you see on your skin aren’t the same? Freckles, sun spots, post-inflammatory marks and melasma are actually different types of hyperpigmentation.

According to Dr Liew Hui Min, consultant dermatologist, SOG Health – HM Liew Skin & Laser Clinic, what we refer to as "pigmentation" is actually the colour (the amount of melanin) in the skin. Hyperpigmentation is an increase in colour and hypopigmentation is a decrease in colour, while depigmentation means a loss of colour.

NOT ALL BROWN SPOTS ARE THE SAME

1. Freckles  

According to Dr Rachel Ho, an aesthetic doctor with La Clinic, freckles are typically located on sun-exposed sites of the skin, such as the nose and cheeks, and their margins are not well defined.

And though it is due to an overproduction of melanin on the surface of the skin (the epidermis), it does not lead to an increase in pigment cells, said Dr Liew. And its appearance may fade with less exposure to UV.

2. Sun spots

Also known as solar lentigines, these are frequently found in older people. “They tend to appear as flat, well-circumscribed dark spots, varying from skin-coloured and tan to dark brown or black shades,” shared Dr Ho.  

With sun spots, Dr Liew explained that there is an increase in the number of pigment cells on the surface of the skin surface and thus, are more permanent, so they won’t fade even when UV exposure is reduced.

3. Post-Inflammatory Hyperpigmentation (PIH)  

Ranging from hues of yellow to brown, these develop after a skin injury. “Post-inflammation hyperpigmentation occurs because the injury or inflammation causes an increase in the formation and/or redistribution of melanin in the skin,” explained Dr Ho. She also added that darker skin tones are more prone to PIH.

The causes behind PIH include acne, scratches, cuts, abrasions, eczema and even infections.

4. Melasma

Often seen as a bilateral, blotchy, brownish facial pigmentation, these patches are irregular shaped and can appear on the cheeks, forehead and chin, shared Dr Ho.

And though melasma is commonly associated with women in their 20s to 40s, it can occur in men too.

The causes behind it are complex, including sun exposure, genetic predisposition, pregnancy and hormone supplements like oral contraceptives.

“Melasma is the most challenging to treat because of its multi-factorial etiology and its tendency for recurrence,” said Dr Ho. And it’s due to an increase in melanin not only on the top layer of the skin, but in the middle portion of the skin layer (dermis) as well, added Dr Liew.

BEST WAYS TO LIGHTEN HYPERPIGMENTATION

Unfortunately, hyperpigmentation spots and patches cannot be completely removed or erased as there is a high risk of recurrence, said Dr Liew. However, they can be lightened and the results maintained.

At the doctor’s clinic, chemical peels and laser treatments such as Pico and Q-switch Nd YAG lasers are recommended for freckles, sun spots and PIH. These short pulses of laser energy shatter and fragment dark spots, which are then easily removed by your body’s lymphatic system, explained Dr Ho.

However, Dr Liew added that with PIH, it would be best to address the underlying causes, like acne or eczema, prior to any treatment.

As for melasma, topical skincare products can sometimes work better than laser treatments, shared Dr Liew.

For homecare, look for:

Retinoid: Inhibits the transfer of melanin to the surface and facilitates melanin dispersal. “It helps with PIH, especially in skin with acne conditions, and is also a good combination treatment with hydroquinone,” said Dr Liew.

Retinoids can also help increase cell turnover and the shedding of dead skin cells to help reduce the appearance of hyperpigmentation, shared Dr Ho. Though Dr Liew cautioned that it can be irritating for dry, sensitive skins.

Exfoliating acids (AHAs and BHAs): Removes dead skin and allows skin to regenerate for a brighter, more even skin tone. The downside: Due to the acids’ high irritability effect, it can worsen hyperpigmentation if used too often or in too high concentrations.

Hydroquinone: An active that interferes with melanin production, Dr Liew shared that it is the most effective in combating hyperpigmentation. Unfortunately, it is commonly associated with irritation and dryness, and “is not recommended for long-term treatment use due to the risk of ochoronosis (permanent bluish-grey darkening of the skin)”.

Azelaic acid: A tyrosinase (an enzyme that encourages melanin production) inhibitor, it helps keep skin even. And while useful for addressing PIH, Dr Liew explained that it has a risk of irritation and may not be suitable after an eczema flare-up. Plus, the irritation can sometimes lead to an uneven skin tone as well.

Vitamin C (L-ascorbic acid): Helps block a melanin-producing enzyme and is also antioxidant-rich, which prevents fine lines, wrinkles and rough skin texture. It’s suitable for most skins, though it may irritate sensitive or rosacea- and eczema-prone skins.

6 SAFE SUN PRACTICES

• Avoid going out in the mid-day sun, especially between 10am to 4pm.
• Always apply sunscreen, at least SPF30 and with a good UVA rating, daily – even when you’re staying indoors.
• When participating in outdoor sports and swimming, re-apply sunscreen every two hours or each time you towel dry.
• Wear UV protective clothing or opt for wide brimmed hats and long sleeves.
• Consider oral sunscreen supplements. However, these supplements do not replace your sunscreen, so it’s best to have both.

PRODUCTS TO CONSIDER FOR A CLEAR COMPLEXION

AHC Safe On Light Sun Serum SPF50+/PA++++, S$39.90

A clear gel that’s packed with sun protective properties, alongside ellagic acid, arbutin, vitamin C, glutathione and tranexamic acid to reduce signs of ageing and hyperpigmentation at the same time.

Available at Shopee.sg from the official AHC site.

Farmacy Honeymoon Glow AHA Resurfacing Night Serum, S$104

Infused with a 14 per cent blend of AHAs, BHAs and flower acids, this night serum gently sloughs off dead skin cells to erase the look of dark spots and fine lines for a smoother, softer and more even-toned complexion. It also contains honey extract and hyaluronic acid to prevent dryness.

Available at www.sephora.sg

Noble Panacea The Vitamin C Booster, S$253 (box of 30 doses)

Together with the brand’s OSMV technology that protects and delivers the active ingredients where and when it’s needed, this vitamin C booster combines nine sources of vitamin C, including 20 per cent pure L-ascorbic acid, to target signs of ageing and reduce hyperpigmentation while visibly enhancing complexion’s glow.

Available at www.tangs.com

Dermalogica Dynamic Skin Retinol Serum, $165

With a 3.5 per cent retinoid complex comprising retinol, a time-released retinol and a retinol booster, it works hard to reverse signs of ageing, refine skin texture and even the skin tone. The addition of beta-glucan and squalene also makes this gentle enough for nightly use too.

Available at www.dermalogica.com.sg

Heure Flawless Serum, S$190

A multi-level serum that works on the eight stages of melanogenesis (the process of producing melanin pigments). The blend of encapsulated actives in the SPHR complex and a new-gen melanin regulator controls excess melanin production to improve skin’s luminosity and clarity.  

Available at www.heurebeauty.com and www.sephora.sg