Spots 101: Your Ultimate Guide to Differentiating Pigmentation Spots

Raise your hand if you’re ever felt confused by all the skin pigmentation terminology. 🙋‍♀️ We hear you. There are so. many. terms: acne marks, acne scars, post-inflammatory hyperpigmentation, melasma, dark spots, sun spots, and post-inflammatory erythema, just to name a few. They’re all in the same family and have similarities, for sure, but their causes are different and they require different treatments too.

So to help you differentiate between the different types of pigmentation spots, with the help of board-certified dermatologist Ife Rodney, MD, FAAD, we put together a fast-facts guide for your learning pleasure. Consider this your 101 crash course on pigmentation spots and how to brighten skin. Let’s dive in.

Post-inflammatory hyperpigmentation

What is it: Post-inflammatory hyperpigmentation (or PIH for short) are brown spots that appear after any sort of inflammation or trauma to the skin.

What causes it: They are typically caused by acne, rashes (like eczema or psoriasis), bruises, or picking. Darker skin tones are also more prone to hyperpigmentation. “Melanocytes, the cells that make the brown color in the skin, are more reactive and produce more melanin when they are stimulated by inflammation,” Dr. Rodney says.

Treatment options: With PIH, prevention is key which requires addressing the underlying cause of the inflammation, such as acne. By preventing the acne and inflammation, you avoid the dark spots from forming as well. For hyperpigmentation treatments at home, Dr. Rodney recommends ingredients such as licorice root extract and vitamin C, which are available in prescription and over-the-counter products. You can also try in-office dark spot treatments like chemical peels to increase the skin’s cell turnover and fade hyperpigmentation.

RELATED READ: Treating Hyperpigmentation Based on Your Skin Tone

Post-inflammatory erythema

What is it: Post-inflammatory erythema is similar to post-inflammatory hyperpigmentation in that they are both caused by inflammation or trauma to the skin. The difference is that post-inflammatory erythema ranges from pink to red marks instead of brown. The two conditions can show up together or separately.

What causes it: “Erythema occurs when tiny blood vessels in the skin become dilated or enlarged as a result of inflammation,” Dr. Rodney says. “The blood flowing through these tiny vessels gives the red marks its color.”

Treatment options: Like with post-inflammatory hyperpigmentation, preventing the underlying cause (e.g., acne) is important with post inflammatory erythema. If it has already appeared, Dr. Rodney recommends using products with vitamin C. “Vitamin C is an antioxidant that reduces redness by boosting collagen production in the skin and strengthening the blood walls,” she says. #humblebrag alert: Vitamin C is one of the star ingredients in Lightning Wand.

Sunspots

What is it: Sunspots are light brown flat spots that pop up on sun exposed skin such as the face and forearms.

What causes it: As their name suggests, sunspots, Dr. Rodney says, are triggered by chronic sun exposure and sunburns.

Treatment options: If you’ve got sun spots, we’ve got good news for you. Lightning Wand also works brilliantly on sunspots. Dab some of the serum on the dark marks every day, and it’ll help even out your complexion and reveal visibly radiant skin.

Freckles

What is it: Like sunspots, freckles are also light brown flat spots that show up on sun exposed skin.

What causes it: Freckles are also caused by chronic sun exposure and sunburns.

Treatment options: In our opinion, freckles are kind of cute, but if they’re not your fave there are treatments that can help zap them away. Dr. Rodney recommends intense pulsed light laser treatments. “This beam of intense light targets superficial skin discoloration, which temporarily gets darker, then crusts off,” she says. “Chemical peels can also help to turn over the skin layers to give an even complexion.”

Age spots

What is it: Age spots are brown spots on the skin. Dr. Rodney says they may start off as flat but can get darker and become raised as time goes on. Age spots may also flake or crumble off on their own.

What causes it: Age spots are caused by genetics. “They show up anywhere on the body, and usually run in families,” Dr. Rodney says.

Treatment options: Laser treatments and chemical peels can also work on flatter age spots. For thicker age spots, Dr. Rodney advises cryotherapy treatments. “In this procedure, liquid nitrogen (very cold) is sprayed on the individual lesions,” she says.

Melasma

What is it: Melasma vs. hyperpigmentation—what’s the difference? Well, melasma shows up as jagged brown discoloration, typically on the face and sun-exposed areas. It’s more common in women than in men.

What causes it: Dr. Rodney says melasma is triggered by sun exposure and hormonal changes that happen during pregnancy, menopause, or when taking birth control pills.

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