Melasma appears as symmetrical dark patches primarily on the face, such as the cheeks, forehead, bridge of the nose, chin, around the lips, neck, and arms. It's caused by disruptions in melanin production and distribution.

Doctor Quach Thu Trang from the Dermatology Department of Tam Anh General Hospital in Hanoi says melasma is common in women aged 20-50, especially during pregnancy, postpartum, or while using birth control pills. While not physically harmful, melasma can significantly impact a person's self-esteem and mental well-being. With proper care and treatment, melasma can be significantly reduced and stabilized year-round. However, many treatments are ineffective due to the following common mistakes.

Not identifying the root cause

Melasma can be caused by various factors: hormonal imbalances; exposure to sunlight or blue light from electronic devices; chronic stress; genetics; metabolic disorders; or side effects of certain medications. Treating only surface-level symptoms without addressing the underlying cause makes treatment less effective and increases the likelihood of recurrence.

Incorrect treatment methods

There are three main types of melasma: epidermal, dermal, and mixed. Each type has varying depths and pigment levels, requiring different treatment approaches. Dermal melasma (deep melasma) is often difficult to improve with topical products alone. Meanwhile, using laser treatments with inappropriate settings or incorrect techniques for superficial melasma can cause irritation, post-inflammatory hyperpigmentation, and worsen the condition.

Doctor Thu Trang examines a woman. Illustrative photo: Hospital provided

Using products of unknown origin

Using unlabeled cosmetics or untested products can lead to rapid skin lightening due to the erosion of the stratum corneum. This makes the skin thin, weak, prone to capillary dilation, irritation, and can cause the pigmentation to return even darker. Some products may also contain hidden corticosteroids or other harmful ingredients. Melasma treatment should be guided by a dermatologist, using products with clear origins, ingredients, and suitability for individual skin types.

Combining multiple cosmetic products or topical medications with potent ingredients without understanding their mechanisms can overload the skin, causing irritation, contact dermatitis, and leading to more widespread or severe melasma. Common melasma treatment ingredients like hydroquinone, tretinoin, and glycolic acid should be used under the guidance and monitoring of a dermatologist.

Incorrect exfoliation and peeling

Over-exfoliating or using high-concentration peels on skin with existing pigmentation can damage the skin's protective barrier. This can lead to irritation, inflammation, and worsen melasma. Doctor Trang recommends exfoliating 1-2 times a week with gentle products suitable for the skin's condition. Deep peels and chemical peels should be performed by a specialist.

Lack of sun protection

Ultraviolet (UV) rays are a primary factor in stimulating melanin production, the pigment that causes melasma. Use a broad-spectrum sunscreen with an SPF of 30 or higher, applying it 20-30 minutes before going outside and reapplying every 2-3 hours. Use sunscreen even indoors or in a car. Wear a wide-brimmed hat, sunglasses, and protective clothing for added protection.

Focusing only on external skincare

A diet lacking in micronutrients, late nights, and chronic stress can stimulate increased pigmentation. Stress increases cortisol levels, a hormone that can indirectly promote melanin production and contribute to melasma. Maintain a healthy lifestyle by getting enough sleep, drinking enough water, and consuming foods rich in vitamins C and E, zinc, selenium, and antioxidants from vegetables and fruits.

Self-treating with home remedies

According to Doctor Trang, applying lemon juice, apple cider vinegar, toothpaste, or fresh turmeric to fade melasma has not been scientifically proven and may harm the skin. These substances can strip the skin of its natural oils, causing irritation or increased sun sensitivity, making melasma more difficult to manage. Effective melasma treatment requires understanding the mechanisms of hyperpigmentation, selecting appropriate ingredients, and monitoring the skin's response. Improper self-treatment can be costly and time-consuming, with the risk of further skin damage.

Impatience

Melasma is a chronic condition requiring long-term treatment, often lasting several months to over a year, depending on individual skin type and severity. Frequently changing products, interrupting treatment, or combining too many methods simultaneously can weaken the skin, disrupt pigmentation, and reduce treatment effectiveness.

For safe and sustainable melasma treatment, consult a dermatologist for accurate diagnosis of the melasma type, pigment depth, and contributing factors. Depending on the specific case, the doctor may recommend a combination of topical medications, oral supplements, chemical peels, specialized lasers, or mesotherapy. Patients should maintain proper skincare, sun protection, a balanced diet, manage stress, and attend regular follow-up appointments to monitor their skin's response.

Trinh Mai