PIH vs Melasma vs Sun Spots: Complete Hyperpigmentation Guide

Published · By Amar Behura · ~14 min read

This guide explains the differences between PIH, melasma, and sun spots — the three main types of hyperpigmentation — plus how to identify and treat each one.

Reviewed by: John C. Ferguson, MD, FACS — Cosmetic Surgeon Updated

Quick Answer

PIH is leftover pigment from inflammation (acne, cuts). Melasma is hormone-plus-sun-triggered patches. Sun spots are cumulative UV damage spots.

All three respond to brightening ingredients like those in AMVital's turmeric serum. PIH fades in 3-12 months, sun spots in 6-12 months, and melasma takes 12+ months with ongoing care.

Key Facts

PIH Cause Inflammation (acne, injuries, eczema) — leftover pigment
Melasma Cause Hormones + UV exposure — overactive pigment-producing cells
Sun Spot Cause Cumulative UV damage over years/decades
Treatment Difficulty PIH (easiest) → Sun spots (moderate) → Melasma (hardest)
Universal Requirement Daily SPF 30+ for all types — non-negotiable

Key Takeaways

  • PIH = inflammation-caused; Melasma = hormones + sun; Sun spots = UV damage
  • Treatment time: PIH 3-12 months; Sun spots 6-12 months; Melasma 12+ months
  • Same brightening ingredients target all three types
  • Secondary care differs: soothing for PIH, strict SPF for melasma, exfoliation for sun spots
  • SPF is critical for every type — UV makes all hyperpigmentation worse
  • If unsure which type you have, a dermatologist can diagnose definitively

Safety Verdict

OTC brightening ingredients (turmeric, vitamin C, niacinamide, kojic acid) are generally safe for all types.

Those with darker skin tones should use gentler approaches — aggressive treatments can cause more pigmentation. Melasma often benefits from dermatologist care.

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, butterfly-shaped Individual round/oval spots
Common locations Anywhere inflammation occurred Cheeks, forehead, upper lip, chin Face, hands, chest, shoulders
Who gets it Anyone; more visible on darker skin Women (90%), pregnancy, birth control Anyone 40+; higher risk with fair skin
Depth Usually surface (epidermal) Often mixed (surface + deep) Surface (epidermal)
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 the enzyme that all pigment-producing cells use to make melanin. This makes turmeric helpful for PIH, melasma, AND sun spots. The same pathway is targeted regardless of what triggered the dark marks.

Bonus for PIH: Curcumin's soothing properties calm ongoing redness. This helps prevent new marks from forming while treating existing ones. This dual action makes turmeric especially valuable for discoloration from inflammation.

Dark Marks from Healed Acne and Injuries (PIH)

What Causes PIH

PIH is your skin's pigment response to damage. When skin is hurt by acne, cuts, burns, eczema, or harsh skincare, the healing process triggers extra melanin. This leaves a dark mark after the original issue heals.

Think of PIH as a "shadow" of damage. The mark matches the shape of whatever caused it: round spots from acne, lines from scratches, patches from eczema flares.

How to Identify PIH

PIH Identification Checklist

Dark spot appeared after a pimple, cut, rash, or burn.

Shape matches the original injury. Flat with no texture change.

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 redness.

  • Brightening agents: Turmeric, vitamin C, kojic acid, arbutin
  • Soothing ingredients: Niacinamide, turmeric, azelaic acid (prevents new marks)
  • Gentle exfoliation: AHAs or physical exfoliation to speed cell turnover
  • SPF: Daily SPF 30+ (UV darkens marks and slows fading)
  • Treat the cause: If acne continues, stop new marks from forming

Timeline: Fresh PIH (under 3 months) fades in 3-6 months. Older or deeper marks take 6-12 months. Very dark marks on darker skin may take longer.

From Our Community

"I had dark spots all over from years of acne. After using turmeric serum consistently for three months, the fresh marks are almost gone and the older ones are much lighter."

— Aaliyah R., verified customer

Melasma: The Hormone-Driven Type

What Causes Melasma

Melasma is triggered by hormones (estrogen, progesterone) combined with UV exposure. Unlike PIH, which is leftover pigment, melasma means the pigment-producing cells themselves are overactive. This is why melasma is so stubborn and comes back easily.

Common triggers include pregnancy ("mask of pregnancy"), birth control pills, and hormone replacement therapy. Sun exposure does not cause melasma alone but worsens it greatly.

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 with irregular, map-like borders.

Worsens with sun exposure or hormonal changes. More common in women (90% of cases). History of pregnancy, birth control, or hormone therapy.

Melasma Treatment Approach

Primary goal: Calm overactive pigment cells while avoiding triggers.

  • Brightening agents: Turmeric, kojic acid, vitamin C, arbutin, tranexamic acid
  • Prescription options: Hydroquinone (short-term), tretinoin, azelaic acid
  • Strict 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 — incorrect laser can worsen melasma)

Timeline: 12+ months for real improvement. Melasma does not "cure" — it goes into remission. It needs ongoing maintenance.

See our melasma treatment guide for details. For post-pregnancy melasma, gentle approaches work best.

Melasma Warning

Melasma is the hardest type to treat. One day of sun without protection can undo months of progress.

If you suspect melasma, see a dermatologist. Prescription treatments combined with OTC products usually produce better results than OTC alone.

Sun Spots (Age Spots / Solar Lentigines)

What Causes Sun Spots

Sun spots result from years of UV damage. Each sun exposure triggers melanin production. Over time, this builds up into visible concentrated spots.

Sun spots are not caused by aging itself — they come from accumulated sun exposure. A 50-year-old who always wore sunscreen may have fewer spots than a 30-year-old who tans often.

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.

Flat with no texture (raised spots need a dermatologist). Typically appear after age 40, earlier with heavy sun exposure.

Sun Spot Treatment Approach

Primary goal: Remove built-up pigment while preventing new damage.

  • Brightening agents: Turmeric, vitamin C, kojic acid, arbutin
  • Retinoids: Increase cell turnover to shed pigmented cells faster
  • Chemical exfoliation: AHAs (glycolic, lactic acid) speed up fading
  • SPF: Daily SPF 30+ to prevent new spots
  • Professional treatments: IPL (intense pulsed light), laser, chemical peels

Timeline: 6-12 months with consistent treatment. Professional treatments can produce faster results. Sun spots respond well but return with continued unprotected sun exposure.

How to Identify Your Type

By Location

Where acne/injury was: Likely PIH. Symmetrical on cheeks/forehead: Likely melasma. Sun-exposed areas only: Likely sun spots.

By Pattern

Matches original damage shape: PIH. Irregular butterfly-shaped patches: Melasma. Individual round/oval spots: Sun spots.

By History

After a pimple, cut, rash, or burn: PIH. During pregnancy or on birth control: Melasma. Gradually with age/sun exposure: Sun spots.

For a deeper guide to identifying your dark spot type, see our detailed breakdown. Also see our PIH guide specifically for dark skin.

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 ingredients 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 soothing ingredients (niacinamide, turmeric, azelaic acid). Treat the underlying cause (acne, eczema) to stop new marks from forming.

For Melasma: Maximize sun protection (tinted sunscreen with iron oxide, hats, shade-seeking). Consider prescription options from a dermatologist. Avoid heat exposure (saunas, hot yoga can trigger melasma).

For Sun Spots: Add retinoid if tolerated. Chemical exfoliation speeds fading. Consider professional treatments (IPL, laser) for stubborn spots.

Learn more about safe brightening ingredients for skin of color and the difference between brightening and whitening.

From Our Community

"I thought all my dark spots were the same but they were actually melasma plus PIH. Once I started treating both with turmeric serum and strict sunscreen, I finally saw real improvement after years of frustration."

— Denise M., verified customer

What to Expect: Comparative Timeline

Comparative Results Timeline

Month 1: PIH may show early fading. Melasma and sun spots unchanged. Building routine and SPF habits.
Month 2-3: PIH noticeably lighter. Sun spots beginning to respond. Melasma may show subtle change with strict sun protection.
Month 4-6: Fresh PIH significantly faded. Sun spots showing real improvement. Melasma progress visible if treatment is consistent.
Month 6-12: Most PIH resolved. Sun spots continuing to fade. Melasma showing good improvement but still needs ongoing treatment.
Month 12+: PIH treatment complete (unless new redness). Sun spots largely faded with maintenance. Melasma in remission but needs indefinite care.

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 the underlying cause (acne for PIH, hormones for melasma)

Factors That May Limit Results

  • Sun exposure without protection (biggest factor for all types)
  • Darker skin tones (more melanin activity — not bad, just slower response)
  • Deep pigmentation (harder to reach with topical products)
  • Ongoing triggers (continued acne, hormonal changes, UV exposure)
  • Inconsistent treatment (starting and stopping reduces results)

Who Should Avoid or Limit Aggressive Treatment

  • Those with darker skin tones should use gentler approaches — aggressive treatments can cause more pigmentation
  • People with active acne or eczema flares — treat the cause first
  • Anyone with very sensitive or reactive skin — start gentle 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 soothing ingredients; melasma needs strict sun protection and possibly prescription options.

Correct diagnosis leads to better treatment choices.

Mistake #2: Underestimating the Sun's Role

UV exposure worsens ALL types. One beach day without SPF can undo months of treatment.

Sun protection is not optional — it is the foundation. This is especially critical for melasma.

Mistake #3: Expecting Melasma to "Cure"

Unlike PIH and sun spots, melasma means the pigment-producing cells are overactive, not just leaving behind pigment. It goes into remission, not cure.

Stopping treatment leads to return. Accepting this prevents frustration and quitting.

Mistake #4: Treating Marks Without Addressing the Cause

Fading acne marks while acne continues means constant new marks. Treating eczema marks while flares continue is the same problem.

Address the underlying redness (acne treatment, eczema care) alongside brightening for PIH.

Mistake #5: Harsh Treatments on Darker Skin

Strong peels and lasers not calibrated for dark skin can cause MORE pigmentation in melanin-rich skin.

Darker skin tones should use gentler approaches. Work with providers experienced in treating skin of color.

When to See a Dermatologist

Seek Professional Help If:

You cannot determine which type you have.

OTC treatments show no improvement after 6 months. You suspect melasma (prescription options are often more effective).

Marks are affecting your quality of life. Any spot is raised, changing, or irregular (to rule out skin cancer). You have darker skin and want guidance on safe options.

A dermatologist can confirm your type (sometimes using a Wood's lamp), prescribe stronger treatments, and perform procedures OTC products cannot match. For melasma especially, dermatologist care typically produces better outcomes.

Frequently Asked Questions

What's the difference between PIH, melasma, and sun spots?

PIH forms where skin was inflamed — acne, cuts, rashes. The dark mark matches the injury shape.

Melasma comes from hormones plus sun exposure. It forms symmetrical patches on cheeks, forehead, and upper lip.

Sun spots come from years of UV damage. They appear as round, individual spots on sun-exposed areas like face and hands.

How do I know what type of hyperpigmentation I have?

Check your history first. Marks after acne or injury? Likely PIH. Patches during pregnancy or on birth control? Likely melasma. Gradual spots with age and sun? Likely sun spots.

PIH matches the shape of original damage. Melasma forms butterfly-shaped patches. Sun spots are individual round spots.

A dermatologist can confirm with a Wood's lamp exam.

Which type of hyperpigmentation is hardest to treat?

Melasma is the most stubborn type. The pigment-producing cells themselves are overactive, not just leaving behind extra pigment.

Melasma recurs easily with sun, hormonal changes, or stopping treatment. It needs long-term maintenance.

PIH is easiest — you are fading leftover pigment. Sun spots are moderate — they respond to treatment but return with continued sun exposure.

Can turmeric help all types of hyperpigmentation?

Yes. Curcumin may help regulate the enzyme that makes melanin. This works for all three types since all involve excess melanin production.

Turmeric is especially helpful for PIH because its soothing properties calm the redness that causes new marks.

For melasma and sun spots, turmeric works best combined with other approaches like strict sun protection.

How long does each type take to fade?

PIH: 3-12 months. Fresh marks fade faster. Deep marks on darker skin take longest.

Sun spots: 6-12 months with consistent treatment. Professional treatments can speed this up.

Melasma: 12+ months for real improvement, with ongoing maintenance needed. Melasma goes into remission but does not fully cure.

Do I need different products for different types?

Core brightening ingredients work for all types. Vitamin C, niacinamide, turmeric, and kojic acid all target the same enzyme.

The differences are in secondary care. PIH benefits from soothing ingredients and treating the cause (like acne). Melasma needs aggressive sun protection and sometimes prescription options.

Sun spots respond well to retinoids and exfoliation.

Why does my hyperpigmentation keep coming back?

Recurrence depends on type. Melasma returns with sun, hormonal shifts, or stopping treatment. It needs lifelong care.

PIH returns if the cause continues — ongoing acne means ongoing new marks.

Sun spots return with continued unprotected sun exposure. The key for all types: identify your triggers and address them. SPF daily is non-negotiable.

Should I see a dermatologist for hyperpigmentation?

See a dermatologist if you cannot identify your type, if OTC treatments show no improvement after 6 months, or if you suspect melasma.

Also consult one if marks affect your quality of life or if any spot is raised, changing, or irregular.

For mild PIH from occasional acne, OTC treatments are fine to start. For melasma or stubborn marks on darker skin, a dermatologist produces better results.

Research & References

How to Cite This Page

Behura, A. (2026). "PIH vs Melasma vs Sun Spots: Complete Hyperpigmentation Guide." AMVital Blog. Retrieved from https://amvital.com/blogs/blog/hyperpigmentation-types-pih-melasma-sun-spots-guide

About AMVital's Approach

AMVital's turmeric-based products work for all hyperpigmentation types by helping regulate the enzyme that makes melanin. Our brightening serum combines curcumin with niacinamide for both brightening and soothing 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.

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Amar Behura

About The Author

Amar Behura writes skincare education for AMVital, with a focus on turmeric-based routines and practical, sensitive-skin-friendly guidance.

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