Brown spots from sun damage will be present in a random pattern of small spots of different size and shape, and the borders tend to be fuzzy and ill-defined. Melasma, on the other hand, tends to cover a large area like a shadow. They are symmetrical, in other words appearing similarly on both sides of the face, and borders are well-defined.
The main issue is that brown spots from sun damage and brown spots from melasma are entirely different in origin. Sun damage occurs from years of repeated sun exposure, is highly preventable, and highly treatable. Melasma, on the other hand, is hormonally driven, and tends to run in families. If you are pre-dispositioned to develop it, It becomes more prominent with sun exposure, and It can be treated but with only minimal results, and they tend to recur with time. Dr. Blanks is clear and honest with her clients about what they can expect when they have Melasma.
Sun damage is best remedied using Intense Pulsed Light, or IPL. IPL actually targets those brown spots by bringing them to the surface of the skin and flake off. The advantage is that there is no down time. Just come into the office and you see results. Finally, another option is to have a series of chemical peels that will bring those layers to the surface of the skin and flake off. However, it takes time to see results. As an alternative, a prescription strength hydroquinone cream applied to the area will cause the brown spots to fade.
Another option that we are now able to offer is the ZO® Non-Hydroquinone Hyperpigmentation System. This can dramatically improve your skin and you can read more here.
A good skin care regimen that includes a quality sun block is important for either condition.