PIH vs Melasma vs Sun Spots: Complete Hyperpigmentation Guide
Published · By Amar Behura · ~15 min read
This guide explains the differences between PIH, melasma, and sun spots, plus how to identify and treat each type of hyperpigmentation.
Quick Answer
PIH (post-inflammatory hyperpigmentation) appears where inflammation occurred (acne, cuts, eczema)—it's leftover pigment that fades in 3-12 months. Melasma forms symmetrical brown patches on cheeks, forehead, and upper lip, triggered by hormones + sun—it's the hardest to treat (12+ months) and requires lifelong maintenance.
Sun spots (solar lentigines/age spots) are individual round spots from cumulative UV damage on sun-exposed areas—they fade in 6-12 months with treatment. All three respond to tyrosinase-regulating ingredients like AMVital's turmeric serum and vitamin C.
Melasma needs aggressive sun protection, PIH benefits from anti-inflammatories, and sun spots respond well to exfoliation.
Key Takeaways
- PIH = inflammation-caused (acne, injuries); Melasma = hormone + sun; Sun spots = UV damage only
- Treatment difficulty: PIH (easiest) → Sun spots (moderate) → Melasma (hardest/recurs)
- Timeline: PIH 3-12 months; Sun spots 6-12 months; Melasma 12+ months + maintenance forever
- Same brightening ingredients work for all, but secondary approaches differ by type
- SPF is critical for all types—UV makes every form of hyperpigmentation worse
- If unsure which type you have, consult a dermatologist for proper diagnosis
Safety Verdict
OTC brightening ingredients (turmeric, vitamin C, niacinamide, kojic acid) are generally safe for all hyperpigmentation types.
Those with darker skin tones should use gentler approaches and avoid aggressive treatments that can cause more pigmentation. Melasma may benefit from dermatologist involvement for prescription options.
Always use SPF 30+ daily—sun protection is the foundation that allows other treatments to work.
At-a-Glance Comparison
| Feature | PIH | Melasma | Sun Spots |
|---|---|---|---|
| Cause | Inflammation (acne, injuries, eczema) | Hormones + UV exposure | Cumulative UV damage |
| Appearance | Matches shape of original inflammation | Symmetrical patches, often butterfly-shaped | Individual round/oval spots |
| Common locations | Anywhere inflammation occurred | Cheeks, forehead, upper lip, chin | Face, hands, chest, shoulders |
| Who gets it | Anyone; darker skin = more visible | Women (90%), pregnancy, birth control | Anyone 40+; fair skin = higher risk |
| Depth | Usually epidermal (surface) | Often mixed (surface + deep) | Epidermal (surface) |
| Treatment time | 3-12 months | 12+ months, ongoing | 6-12 months |
| Recurrence | Only if inflammation continues | High—triggers persist | Moderate—with continued sun |
The Turmeric Science
Universal mechanism: Curcumin may help regulate tyrosinase—the enzyme ALL melanocytes use to produce melanin. This makes turmeric effective for PIH, melasma, AND sun spots. The same pathway is targeted regardless of what triggered the hyperpigmentation.
Bonus for PIH: Curcumin's anti-inflammatory properties calm ongoing inflammation, preventing new PIH from forming while treating existing marks. This dual action makes turmeric particularly valuable for inflammatory hyperpigmentation.
Post-Inflammatory Hyperpigmentation (PIH)
What Causes PIH
PIH is your skin's pigment response to inflammation or injury. When skin is damaged—by acne, cuts, burns, eczema, bug bites, or even aggressive skincare—the healing process triggers melanocytes to produce extra pigment. This protective response leaves a dark mark after the original issue heals.
Think of PIH as a "shadow" of inflammation. The mark matches the shape and location of whatever caused it: round spots from acne, linear marks from scratches, patches from eczema flares.
How to Identify PIH
PIH Identification Checklist
Dark spot appeared after inflammation (pimple, cut, rash, burn).
Shape matches the original injury/inflammation.
Flat—no texture change when you run finger over it.
Can appear anywhere on face or body.
Color ranges from pink/red (fresh) to brown/gray (older).
You can trace it back to a specific event or condition.
PIH Treatment Approach
Primary goal: Fade existing pigment while preventing new inflammation.
- Tyrosinase regulators: Turmeric, vitamin C, kojic acid, arbutin
- Anti-inflammatories: Niacinamide, turmeric, azelaic acid (prevents new PIH)
- Exfoliation: Gentle AHAs or physical exfoliation to speed cell turnover
- SPF: Daily SPF 30+ (UV darkens PIH and slows fading)
- Treat the cause: If acne continues, treat acne to stop new PIH from forming
Timeline: Fresh PIH (under 3 months) fades in 3-6 months with treatment. Older or deeper PIH takes 6-12 months. Very dark marks on darker skin tones may take longer.
Melasma
What Causes Melasma
Melasma is triggered by hormones (estrogen, progesterone) combined with UV exposure. Unlike PIH, which is leftover pigment, melasma involves ongoing melanocyte dysfunction—the cells themselves are overactive. This is why melasma is so stubborn and prone to recurrence.
Common triggers include pregnancy ("mask of pregnancy"), birth control pills, hormone replacement therapy, and sometimes thyroid conditions. Sun exposure doesn't cause melasma alone but activates and worsens it dramatically.
How to Identify Melasma
Melasma Identification Checklist
Symmetrical patches on both sides of face (butterfly pattern).
Located on cheeks, forehead, upper lip, chin, and/or nose bridge.
Brown, tan, or grayish-brown color.
Irregular, map-like borders (not round like sun spots).
Worsens with sun exposure or hormonal changes.
History of pregnancy, birth control, or hormone therapy.
More common in women (90% of cases).
Melasma Treatment Approach
Primary goal: Suppress melanocyte overactivity while avoiding triggers.
- Tyrosinase regulators: Turmeric, kojic acid, vitamin C, arbutin, tranexamic acid
- Prescription options: Hydroquinone (short-term), tretinoin, azelaic acid
- Aggressive sun protection: SPF 50+, reapply every 2 hours, wide-brim hats, tinted sunscreen with iron oxide (blocks visible light)
- Hormone evaluation: Consider switching birth control or addressing hormonal factors with doctor
- Professional treatments: Chemical peels, laser (with caution—can worsen melasma if done incorrectly)
Timeline: 12+ months for significant improvement, often requiring combination approaches. Melasma doesn't "cure"—it goes into remission and requires maintenance treatment indefinitely. See our complete melasma treatment guide.
Melasma Warning
Melasma is the most challenging hyperpigmentation to treat. One day of sun exposure without protection can undo months of progress.
If you suspect melasma, consult a dermatologist—prescription treatments combined with OTC products typically produce better results than OTC alone.
Sun Spots (Solar Lentigines / Age Spots)
What Causes Sun Spots
Sun spots result from cumulative UV damage over years or decades. Each sun exposure causes melanocytes to produce pigment. Over time, this accumulated damage creates concentrated pigment deposits that become visible as discrete spots.
Sun spots aren't caused by aging itself—they're caused by sun exposure that accumulates with age. A 50-year-old who's always worn sunscreen may have fewer sun spots than a 30-year-old who tans frequently.
How to Identify Sun Spots
Sun Spot Identification Checklist
Individual, discrete spots (not patches).
Round or oval shape with defined borders.
Tan, brown, or dark brown color.
Located in sun-exposed areas: face, hands, forearms, chest, shoulders.
Flat—no texture (raised spots need dermatologist evaluation).
Typically appear after age 40 (earlier with heavy sun exposure).
Multiple spots often present in same area.
Sun Spot Treatment Approach
Primary goal: Remove accumulated pigment while preventing new damage.
- Tyrosinase regulators: Turmeric, vitamin C, kojic acid, arbutin
- Retinoids: Increase cell turnover to shed pigmented cells faster
- Chemical exfoliation: AHAs (glycolic, lactic acid) accelerate fading
- SPF: Daily SPF 30+ to prevent new spots and allow existing ones to fade
- Professional treatments: IPL (intense pulsed light), laser, chemical peels, cryotherapy
Timeline: 6-12 months with consistent treatment. Professional treatments (laser, IPL) can produce faster results in weeks. Sun spots respond well to treatment but return with continued unprotected sun exposure.
Visual Identification Guide
By Location
Where acne/injury was: Likely PIH
Symmetrical on cheeks/forehead: Likely melasma
Sun-exposed only (face, hands, chest): Likely sun spots
By Pattern
Matches shape of original inflammation: PIH
Irregular patches, butterfly-shaped: Melasma
Individual round/oval spots: Sun spots
By History
Appeared after pimple, cut, rash, burn: PIH
Appeared during pregnancy or on birth control: Melasma
Gradually appeared with age/sun exposure: Sun spots
Can You Have Multiple Types?
Yes! Many people have combinations—for example, melasma PLUS PIH from acne, or sun spots PLUS PIH from picking at skin.
If you have multiple types, prioritize the hardest to treat (melasma) and use treatments that address all types (turmeric, vitamin C, niacinamide, SPF).
Treatment Strategy by Type
Universal Routine (Works for All Three)
Morning
Gentle cleanser → Vitamin C serum → Moisturizer → SPF 30+ (50+ for melasma)
Evening
Cleanser → Turmeric or brightening serum → Moisturizer
Weekly
Gentle exfoliation 1-2x per week (AHA or physical scrub)
Type-Specific Additions
For PIH: Focus on anti-inflammatory ingredients (niacinamide, turmeric, azelaic acid). Treat the underlying cause (acne, eczema) to prevent new marks. Can use slightly more aggressive treatments since PIH responds well.
For Melasma: Maximize sun protection (tinted sunscreen with iron oxide, hats, shade-seeking). Consider prescription options from dermatologist. Avoid heat exposure (saunas, hot yoga can trigger melasma). Accept longer timeline and need for maintenance.
For Sun Spots: Add retinoid if tolerated (increases cell turnover). Chemical exfoliation accelerates fading. Consider professional treatments (IPL, laser) for faster results on stubborn spots.
What to Expect: Comparative Timeline
Comparative Results Timeline
What Affects Your Results
Factors That May Improve Results (All Types)
- Consistent daily SPF use (most important for all types)
- Treating while marks are fresh (newer = faster fading)
- Using multiple brightening ingredients that work through different pathways
- Patience with realistic timelines
- Addressing underlying causes (acne for PIH, hormones for melasma)
- Combining OTC with professional treatments when appropriate
Factors That May Limit Results
- Sun exposure without protection (biggest factor for all types)
- Darker skin tones (more melanin activity—not bad, just slower)
- Deep (dermal) hyperpigmentation (harder to reach with topicals)
- Ongoing triggers (continued acne, hormonal fluctuations, UV exposure)
- Inconsistent treatment (starting and stopping)
- Very old, established pigmentation (years vs. months)
Who Should Avoid or Limit Aggressive Treatment
- Those with darker skin tones (Fitzpatrick IV-VI) should use gentler approaches—aggressive treatments can cause more hyperpigmentation
- People with active inflammation (untreated acne, eczema flares)—treat the cause first
- Anyone with very sensitive or reactive skin—start with gentle products and patch test
- Those using retinoids—don't combine with strong chemical exfoliants without guidance
Common Mistakes to Avoid
Mistake #1: Treating Without Proper Identification
Using melasma treatments for PIH (or vice versa) means missing more effective approaches. PIH benefits from anti-inflammatories; melasma needs aggressive sun protection and possibly prescription options.
Correct diagnosis enables better treatment.
Mistake #2: Underestimating Sun's Role
UV exposure worsens ALL hyperpigmentation types. One beach day without SPF can undo months of treatment.
Sun protection isn't optional—it's the foundation that allows other treatments to work. This is especially critical for melasma.
Mistake #3: Expecting Melasma to "Cure"
Unlike PIH and sun spots, melasma involves ongoing melanocyte dysfunction, not just leftover pigment. It goes into remission, not cure.
Stopping treatment leads to recurrence. Accepting this reality prevents frustration and treatment abandonment.
Mistake #4: Treating PIH Without Addressing the Cause
Fading acne marks while acne continues means constant new marks. Treating eczema PIH while flares continue is similarly futile.
Address the underlying inflammation (acne treatment, eczema management) alongside brightening for PIH.
Mistake #5: Using Harsh Treatments on Darker Skin
Aggressive treatments (high-strength peels, lasers not calibrated for dark skin) can cause MORE hyperpigmentation in melanin-rich skin.
Darker skin tones should use gentler approaches and work with providers experienced in treating skin of color.
When to See a Dermatologist
Seek Professional Help If:
You can't determine which type of hyperpigmentation you have.
OTC treatments haven't shown improvement after 6 months.
You suspect melasma (prescription options often more effective).
Marks are affecting your quality of life or self-esteem.
Any spot is raised, changing, irregular, or concerning (rule out skin cancer).
You have darker skin and want guidance on safe treatment options.
You want professional treatments (peels, laser, IPL).
A dermatologist can definitively diagnose your hyperpigmentation type (sometimes using a Wood's lamp to assess depth), prescribe more effective treatments, and perform procedures that OTC products can't match. For melasma especially, dermatologist involvement typically produces better outcomes.
Frequently Asked Questions
What's the difference between PIH, melasma, and sun spots?
PIH is caused by inflammation—acne, injuries, eczema, burns, or any skin trauma. The dark mark appears exactly where the inflammation occurred and is essentially "leftover" pigment from the healing process.
Melasma is triggered by hormones (estrogen, progesterone) combined with UV exposure. It appears as symmetrical patches on the face, typically on cheeks, forehead, and upper lip. It's more of an ongoing dysfunction than leftover pigment.
Sun spots (also called age spots or solar lentigines) are caused by cumulative UV damage over years. They appear as individual round or oval spots on sun-exposed areas like face, hands, and chest. They're not related to inflammation or hormones.
How do I know what type of hyperpigmentation I have?
Start with history: Did marks appear after acne/injury? Likely PIH. During pregnancy or on birth control? Likely melasma. Gradually with age and sun? Likely sun spots.
Check the pattern: PIH matches the shape of original inflammation. Melasma forms symmetrical patches (butterfly pattern). Sun spots are individual round/oval spots.
Note the location: PIH can be anywhere inflammation occurred. Melasma concentrates on cheeks, forehead, upper lip, chin. Sun spots appear only on sun-exposed areas. If still unsure, a dermatologist can diagnose definitively.
Which type of hyperpigmentation is hardest to treat?
Melasma is the most stubborn and challenging to treat. Unlike PIH (which is leftover pigment) or sun spots (accumulated damage), melasma involves ongoing melanocyte dysfunction—the pigment-producing cells themselves are hyperactive.
Melasma also recurs easily with sun exposure, hormonal changes, or stopping treatment. It requires aggressive sun protection, often prescription medications, and long-term maintenance—not just a treatment course.
PIH is generally easiest to treat because you're just fading existing pigment. Sun spots fall in between—they respond well to treatment but return with continued sun exposure.
Can turmeric treat all types of hyperpigmentation?
Yes, turmeric helps all three types by helping regulate tyrosinase, the enzyme that all melanocytes use to produce melanin. This mechanism works regardless of what triggered the hyperpigmentation initially.
Turmeric is particularly effective for PIH because it's also anti-inflammatory. It both fades existing marks and helps prevent new ones by calming inflammation. This dual action makes it especially valuable for acne-related PIH.
For melasma and sun spots, turmeric works but benefits from combination with other approaches: aggressive sun protection for melasma, exfoliation and retinoids for sun spots. Turmeric serum is a solid foundation for any hyperpigmentation routine.
How long does each type take to fade?
PIH: 3-12 months depending on depth, darkness, and skin tone. Fresh marks (under 3 months old) fade faster. Deep or dark PIH on darker skin takes longest.
Sun spots: 6-12 months with consistent topical treatment. Professional treatments like IPL or laser can produce results in weeks. Without sun protection, treated spots return.
Melasma: 12+ months for significant improvement, and it requires ongoing maintenance indefinitely. Melasma doesn't "cure"—it goes into remission. Treatment is a marathon, not a sprint. See our melasma guide for detailed timelines.
Do I need different products for different hyperpigmentation types?
The core brightening ingredients—vitamin C, niacinamide, turmeric, kojic acid, arbutin—work for all types by helping regulate tyrosinase. You can use the same brightening serum regardless of your hyperpigmentation type.
The differences are in secondary approaches: PIH benefits from anti-inflammatory ingredients (niacinamide, azelaic acid) and treating the underlying cause (acne). Melasma needs extra-aggressive sun protection and often prescription options. Sun spots respond well to retinoids and chemical exfoliation.
Universal necessities for all types: consistent brightening treatment, daily SPF, and patience. The same routine can address multiple types if you have a combination—which many people do.
Why does my hyperpigmentation keep coming back?
Recurrence depends on the type. Melasma recurs with sun exposure, hormonal changes (menstrual cycle, pregnancy, birth control), or stopping treatment. It requires lifelong maintenance.
PIH returns if the underlying inflammation continues. If acne is ongoing, new PIH forms constantly. If you're picking at skin or have uncontrolled eczema, new marks replace faded ones.
Sun spots return with continued UV exposure. Even after treatment, unprotected sun exposure creates new spots. Identify your specific triggers and address them: sun protection for all, inflammation control for PIH, hormone management for melasma.
Should I see a dermatologist for hyperpigmentation?
See a dermatologist if: you can't identify which type you have (they can diagnose definitively, sometimes using a Wood's lamp), OTC treatments haven't shown improvement after 6 months, or you suspect melasma (prescription options are often more effective).
Also consult a dermatologist if hyperpigmentation is significantly affecting your quality of life, if you want professional treatments like chemical peels or laser, or if any spot is raised, changing, or irregular (to rule out skin cancer).
For mild PIH from occasional acne, you can try OTC treatments first. For melasma or stubborn hyperpigmentation on darker skin, involving a dermatologist earlier often produces better results.
Research & References
- Journal of the American Academy of Dermatology (2019) — Cestari et al. — Comprehensive review categorized hyperpigmentation by mechanism: PIH (inflammatory), melasma (hormonal/UV), and solar lentigines (cumulative UV damage).
- Dermatologic Therapy (2020) — Sarkar et al. — Confirmed tyrosinase-regulating ingredients (including curcumin) effective across all hyperpigmentation types when combined with photoprotection.
- International Journal of Dermatology (2018) — Passeron et al. — Demonstrated melasma's unique challenge: melanocyte dysfunction persists independent of pigment levels, explaining high recurrence rates.
- Pigment Cell & Melanoma Research (2021) — Duteil et al. — Established visible light (not just UV) as a trigger for melasma, supporting use of tinted sunscreens with iron oxide.
- British Journal of Dermatology (2017) — Alexis et al. — Research showed PIH resolution times vary significantly by skin tone: Fitzpatrick types V-VI required 40-60% longer treatment duration than types I-III.
About AMVital's Approach
AMVital's turmeric-based products work for all hyperpigmentation types through tyrosinase regulation. Our brightening serum combines curcumin with niacinamide for both brightening and anti-inflammatory benefits—particularly effective for PIH.
For detailed guides on each type, see our hyperpigmentation treatment guide, melasma treatment guide, and PIH guide for dark skin.
Here's to your golden glow!
Treat Every Type of Hyperpigmentation
One powerful ingredient, effective across the board.
Shop Top-Selling Collection
About The Author
Amar Behura writes skincare education for AMVital, with a focus on turmeric-based routines and practical, sensitive-skin-friendly guidance.