Brown spots on the skin are a common cosmetic concern. Among the main causes, melasma and solar lentigines stand out. Although similar in appearance, these two skin conditions have distinct origins and characteristics. Understanding their differences is essential for adopting an appropriate preventive and therapeutic approach.

Origins of Melasma and Solar Lentigines

Melasma, also known as «chloasma» or «pregnancy mask,» is hyperpigmentation resulting from hormonal fluctuations. It mainly affects women, particularly during pregnancy or when taking oral contraceptives. Repeated sun exposure can exacerbate this condition. Conversely, solar lentigines, often referred to as «age spots,» are caused by prolonged exposure to the sun's ultraviolet (UV) rays. They usually appear on areas of the skin that are frequently exposed, regardless of gender.

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Distinct Clinical Manifestations

Melasma manifests as diffuse brown patches, often symmetrical, located mainly on the face. Depending on their location, there are three types of melasma:

• Central facial melasma : spots on the forehead, nose, cheeks, and upper lip.
• Melasma : spots on the cheeks and nose.
• Mandibular melasma : spots along the lower jaw.

Solar lentigines, on the other hand, appear as small, well-defined brown spots, mainly on exposed areas such as the face, hands, chest, shoulders, and back.

Aggravating Factors and Preventive Approach to Melasma

Several factors can intensify melasma:

• Hormonal fluctuations Pregnancy, oral contraceptives, or hormone replacement therapy can trigger or worsen melasma.
• Skin irritations Aggressive treatments, such as frequent exfoliation or irritating products, can accentuate hyperpigmentation.
• Sun exposure : UV rays stimulate melanin production, worsening dark spots.

Use a broad-spectrum sunscreen with an appropriate SPF every day, even on cloudy days, and limit your time in the sun, especially between 11 a.m. and 3 p.m.

Therapeutic Approaches

Several cosmetic ingredients have proven effective for treatment:

• Niacinamide (vitamin B3) : Reduces the transfer of melanin to the surface cells of the skin.
• Tranexamic acid : Inhibits inflammatory mediators involved in melanin production.
• Alpha-arbutin : Inhibits the tyrosinase enzyme, reducing melanin production.
• Glycolic acid : Exfoliates the skin, promoting cell renewal and reducing dark spots.
• Azelaic acid : Reduces the activity not only of tyrosinase, but also of melanocytes, the cells that produce melanin.
• Vitamin C : A powerful antioxidant that brightens the complexion and reduces hyperpigmentation.

Dermatological Treatments

For persistent stains, medical treatments may be considered:

• Chemical peels (glycolic acid, trichloroacetic acid)
• Depigmentation laser
• Prescription topical treatments (hydroquinone, retinoids)

It is recommended that you consult a dermatologist for an accurate diagnosis and appropriate treatment plan.

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