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Freckles vs Melasma

Freckles and melasma present as dark spots on the skin. Distinguishing the two is important in terms of cause, treatment, and prognosis.

CLINICAL PRESENTATION

Freckles are small, flat, brown spots that are usually round, have well-defined borders, and appear on sun-exposed areas of the skin such as the face, arms, and shoulders.  In contrast, melasma is a larger, irregularly-shaped patch of darkened skin that usually occurs on the face, and typically has a symmetric distribution.

CAUSE

Freckles are caused by exposure to UV radiation from the sun. On the other hand, melasma is multifactorial - hormonal changes such as in pregnancy or intake of oral contraceptive pills, as well as sun exposure.

DIAGNOSIS

Both freckles and melasma are diagnosed by their clinical presentation and distribution on the skin.

TREATMENT

Freckles can be prevented by avoiding sun exposure and wearing protective clothing and sunscreen. Melasma on the other hand is more difficult to treat than freckles and options include: Topical lightening agents, chemical peels, laser therapy.  Oral medications may also be necessary.

SPECIFIC DERMATOLOGIC TREATMENTS

Topical agents such as hydroquinone, arbutin, retinoids are commonly used for both freckles and melasma. However, melasma may require higher concentrations of lightening agents.  Lasers such as Q-switched ND:Yag Laser and Fractional Laser can be both effective for freckles and melasma. Chemical peels and microdermabrasion are more commonly used for freckles while combination treatments are required for melasma.


To know more about how to properly manage your freckles or melasma, come and visit a board-certified dermatologist at any of the HOO Dermatology branches near you. Contact the HOO Factor hotline at 0917 576-2326.