Melasma, Freckles or Sun Spots? Types of Pigmentation on Asian Skin and How to Treat Each
Dark patches and spots are one of the most common reasons patients visit us. But "pigmentation" isn't one condition. Melasma, freckles, sun spots, acne marks and Hori's nevus can look similar, yet each one needs a different approach. Treating the wrong type can make it worse.
Here's how to tell them apart, especially on Asian skin, and what actually helps each one.
1. Melasma
What it looks like: brown or greyish-brown patches, usually symmetrical, on the cheeks, forehead, nose or upper lip.
Common triggers: sun exposure, hormones (pregnancy, contraceptive pills) and genetics. It's especially common in Asian women aged 25 to 50.
How it's treated: strict sun protection, prescription skincare and gentle laser such as low-energy pico. Aggressive heat-based treatments can make melasma darker, so it needs a careful, doctor-led plan. Read more on our melasma treatment page.
2. Freckles (Jeragat)
What it looks like: small, flat, light-brown spots scattered across the nose and cheeks that get darker after sun exposure.
Common triggers: genetics and sun.
How it's treated: freckles usually respond well to pico laser, often in a few sessions. See our freckles removal treatment, or read what jeragat means in English.
3. Sun Spots (Solar Lentigines)
What it looks like: larger, well-defined brown spots on the face, hands or arms, usually appearing from your 30s onwards.
Common triggers: years of sun exposure.
How it's treated: sun spots often clear well with pico laser or other targeted lasers.
4. Acne Marks (Post-Inflammatory Hyperpigmentation)
What it looks like: flat brown or dark marks left behind after pimples heal. They are not scars, as the skin surface is smooth.
How it's treated: controlling the acne first is key. Chemical peels, brightening skincare and pico laser can then fade the marks. If the skin is dented rather than dark, see our guide on pico vs CO2 laser for acne scars.
5. Hori's Nevus (ABNOM)
What it looks like: bluish-grey or grey-brown spots on both cheeks, often mistaken for melasma. It sits deeper in the skin and is common in Asian women.
How it's treated: because it's deep, it usually needs laser treatment such as pico, over several sessions. Creams alone won't clear it.
Why a Proper Diagnosis Matters
Many patients have more than one type at the same time, for example melasma with sun spots on top. Each needs different laser settings and skincare. A doctor's assessment helps you avoid wasted sessions and the risk of rebound darkening.
Learn more about our pigmentation treatment options and how pico laser works, or read what works for pigmentation and melasma in PJ.
Frequently Asked Questions
How do I know what type of pigmentation I have?
Look at the shape, colour and location. Melasma forms symmetrical patches on the cheeks, forehead or upper lip. Freckles are small, scattered spots that darken in the sun. Sun spots are larger, well-defined brown spots. A doctor's assessment is the most reliable way to tell them apart.
Can pico laser remove melasma?
Pico laser can lighten melasma when used on gentle settings as part of a plan that includes sun protection and skincare. Melasma can return, so maintenance is usually needed.
Is pigmentation permanent?
Some types, like freckles, sun spots and acne marks, often clear well with treatment. Melasma is a long-term condition that can be controlled but may come back with sun exposure or hormonal changes.
Does sunscreen really help pigmentation?
Yes. Daily broad-spectrum sunscreen is essential for every type of pigmentation, especially in Malaysia's strong sun. Without it, treatment results fade quickly.
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