Pharmacist Do Xuan Hoa from the Medical Information Center at Tam Anh General Hospital, TP HCM, explains that melasma forms when melanin – the pigment determining skin color – is overproduced and unevenly distributed. This leads to dark patches or spots of varying intensity and depth.

Skin has three main layers: epidermis, dermis, and hypodermis. Melanocytes, located at the base of the epidermis, produce melanin to protect skin from sun exposure. Prolonged stimulation causes melanin overproduction. It can accumulate in the epidermis or move to the dermis, resulting in different melasma types based on its location.

Pharmacist Hoa classifies melasma into three groups based on lesion location, each with distinct characteristics:

Superficial melasma develops when melanocytes deposit melanin into the epidermis. It appears as light brown or yellowish-brown patches, typically 1-5 cm in size. These patches often emerge on the cheeks, forehead, chin, or bridge of the nose, with clear borders.

This melasma type spreads easily with sun exposure, hormonal changes during pregnancy or perimenopause, stress, and unsuitable cosmetics. Since melanin is in the epidermis, superficial melasma is a mild form and generally easier to treat than other types.

A doctor at Tam Anh General Hospital examines a patient's skin. Photo: Tam Anh General Hospital.

Deep melasma typically appears on both cheeks and the sides of the nose as small, distinct, dark gray or bluish-black spots with clear borders. This type affects women over 30 or during perimenopause, strongly linked to hormonal imbalances, skin aging, and prolonged sun exposure. As melanin resides deeper in the dermis, deep melasma is challenging to treat and requires extended time for new skin cell regeneration.

Mixed melasma is the most common type, combining superficial and deep characteristics. It presents with both large patches and interspersed small, dark spots, showing uneven coloration such as yellowish-brown, dark brown, and bluish-black areas. It frequently affects the cheeks and bridge of the nose.

Its cause is typically a cumulative effect of factors like hormones, aging, sun exposure, environmental influences, and inadequate skincare routines. This is the most challenging facial melasma to treat because melanin is simultaneously present in multiple skin layers.

Pharmacist Hoa notes that melasma is benign but prone to recurrence if triggering factors like UV radiation and hormonal imbalances are not managed. Applying sunscreen, practicing proper skincare, and consulting a specialist when necessary can help control and reduce melasma spots.

Beyond external skincare, maintaining a healthy lifestyle, ensuring sufficient sleep, staying hydrated, exercising regularly, adopting a balanced diet, and supplementing with natural nutrients can help. These include Pomegranate extract, L-Glutathione, Sakura extract, Collagen, and P.leucotomos (from fern). Such measures can reduce melanin synthesis, improving hyperpigmentation and maintaining healthy, radiant skin from within.

Dinh Dieu