Melasma vs. age spots: similar look, different fix

Brown patches are not all the same, and the most common mistake in pigment care is treating melasma as if it were an age spot.

Age spots (solar lentigines) are discrete, stable, and sit relatively superficially. They tolerate lasers well. Melasma is diffuse, hormonally influenced, often symmetric across the cheeks or forehead, and reaches deeper and more reactive layers. Hit melasma with an aggressive laser and it frequently rebounds darker, the pigment cells respond to the heat as another insult.

Melasma is managed, not cured: gentle topicals (tranexamic acid, azelaic acid, low-dose hydroquinone cycles), strict visible-light sun protection, and patience. Age spots can be cleared more decisively. Telling them apart sometimes requires a dermatologist's exam and occasionally a Wood's lamp. The cost of guessing wrong is months of worsened pigment, which is why the diagnosis is worth more than any single treatment.

Related reading: Hydroquinone vs. Kojic Acid for Age Spots: Which Brightening Agent Actually Works?.