Both freckles and melasma are a result of a genetic predisposition and direct sun exposure. Freckles and melasma normally form on the nose, cheeks, and forehead as a result of pigment-producing cells (the melanocytes) in the skin creating melanin at an increased rate. The color of freckles vary from yellow to red, however, melasma is normally tan or a light brown color.

Unlike what is commonly seen with freckles, melasma can form on the lips and upper lip in large patches. Often times melasma forms in symmetrical shapes on the face. For example, patches may form on both temples or on both cheeks in the same place where as freckles appear randomly on the skin.

Treatments to reduce the appearance of freckles can be quite similar to melasma treatments, for instance laser treatments, bleaching, and products like Peter Thomas Roth Potent Botanical Skin Brightening Gel Complex are often recommended.