Answer:

Melasma's pathogenesis is complex, requiring a multi-modal treatment approach that combines both laser and medication. A doctor will determine the specific treatment regimen based on your melasma type, severity, and skin aging condition.

Medication, including topical creams and oral supplements, forms the foundation of melasma treatment. Topical active ingredients such as hydroquinone, tretinoin, arbutin, azelaic acid, kojic acid, thiamidol, or tranexamic acid work by inhibiting melanin production and reducing its transfer to keratinocytes. Over time, this action helps to fade pigmented patches. This method is simple and cost-effective, requiring consistent application and patience. However, its effectiveness takes time to become apparent, and careful monitoring is necessary to prevent irritation or other side effects.

In some cases, doctors may prescribe oral medication to address melasma from within, particularly when it is linked to hormonal factors or increased melanin synthesis. The use of oral medication must be closely monitored by a doctor to minimize potential side effects.

Conversely, laser therapy offers a high-tech solution that directly targets pigment particles. The laser's mechanism breaks down melanin into minute fragments, which the body then gradually eliminates. This approach can lead to noticeable improvements in a shorter timeframe, especially for patch melasma or superficial pigmentation.

The Fotona StarWalker is an advanced laser system that integrates Q-switched technology with picosecond pulses. It generates ultra-short pulses that break down melanin into ultrafine particles, facilitating their gradual removal by the body. With wavelengths such as 1064 nm and 532 nm, along with its FracTal mode, this laser can effectively treat both superficial and deep pigmentation. Additionally, it supports skin regeneration and stimulates collagen production, resulting in brighter and smoother skin. However, for deep or mixed melasma, relying solely on laser treatment is often not sustainable. If performed incorrectly, it can trigger post-inflammatory hyperpigmentation, causing the melasma to darken.

To ensure an accurate diagnosis and a personalized treatment plan, you should consult a reputable hospital. Effective melasma treatment typically involves a combination of topical and oral medications to stabilize pigment cells, alongside laser or light technology to quickly fade the affected areas. Different types of melasma require tailored treatment strategies: patch melasma generally responds well, while mixed melasma necessitates flexible adjustments throughout various stages. Regardless of the chosen method, consistent sun protection and skin barrier repair with gentle, hydrating products are essential to maintain results and prevent recurrence.

Doctor, Level II Specialist Dam Thi Thuy Hong

Head of Aesthetics Department,

Tam Anh General Hospital Hanoi