Melasma is more than excess pigment: it involves low-grade inflammation, a weak skin barrier and vessels under the skin. Knowing this eases worry when it returns.
Many people treating melasma see their skin brighten noticeably, only for the patches to reappear a few months after they stop. According to dermatologists, the reason is that melasma is a problem of the skin's whole environment, not just a matter of color on the surface.
Melasma is a cycle of three factors
Current medical literature describes melasma as a vicious cycle in which three factors interact with one another:
- Microscopic, long-lasting, low-grade inflammation under the skin.
- A weakened protective barrier in the outer layer of the skin (epidermis).
- Pigment cells that are overstimulated.
When the skin barrier is damaged, the environment inside the skin loses its balance, and the skin struggles to protect and repair itself. Inflammatory signals keep being sent out, like constant prompting that pushes the pigment cells to make more melanin than needed. If treatment only tries to suppress melanin without dealing with the hidden inflammation and restoring the skin barrier, the cycle keeps turning and the melasma comes back.
On top of that, as we age, the ability of cells and tissues to repair themselves gradually declines. Damage builds up, inflammation lasts longer, and pigment cells become even harder to keep under control.
Why fading the pigment alone is not enough
The older approach mainly targeted the symptoms: fading the patches, reducing inflammation for a short time, and using cosmetics or creams on the surface. The drawback is that melasma easily returns once treatment stops, while the skin's structure keeps aging.
Biologically, fading the pigment does not stop the inflammatory signals that other cells in the skin send to the pigment cells. Besides microscopic inflammation, the network of tiny blood vessels under melasma patches often grows more than usual and also releases inflammatory substances. These two factors are hard for people to notice themselves, yet they are what keep the pigment cells constantly activated.
Signs that are easy to miss
Microscopic inflammation is almost impossible to see with the naked eye. People usually only notice that their skin:
- Looks less fresh and duller.
- Seems thinner than before.
- Is sensitive and easily irritated.
These changes may suggest that low-grade chronic inflammation is going on underneath. Until the inflammation and the growth of blood vessels are brought under control, any effort to fade melasma will only be temporary.
Each type of melasma needs its own treatment approach
The first and most important step is to identify the type of melasma correctly. Melasma comes in many forms, such as patchy, spotty, deep, mixed or melasma with inflammation. Each form differs in its biology, how deep the damage goes and how it responds to treatment, so there is no single treatment plan that works for everyone.
The current approach combines several goals at once: controlling pigment, reducing microscopic inflammation and restoring the skin's protective barrier, so that the skin gradually regains its ability to protect itself. The specific method should be decided by a doctor after an examination.
Trusted clinic for melasma in Ho Chi Minh City
With nearly 20 years of experience and a team of highly qualified doctors, Ky Hoa Medical Center is a familiar choice for many families in Ho Chi Minh City when they need care for melasma. Here, our Dermatology doctors take time to listen, examine carefully and explain clearly so that you fully understand your condition, then agree together on a treatment and follow-up plan.
The center operates under Operating License No. 00449/HCM-GPHĐ, with a list of medical techniques approved by the Ho Chi Minh City Department of Health (Decision 471/QĐ-SYT), and is a primary care facility contracted with Ho Chi Minh City Social Security, accepting health insurance (BHYT) visits on Saturdays as well. The practising certificates of our 24 doctors are published on our Doctors page.
If you have melasma or it has come back several times, simply walk in during opening hours and take a queue number at Ky Hoa Medical Center, where a Dermatology doctor will examine you, assess your skin and advise on suitable care.
Ky Hoa Medical Center
Address: 266A - 268 3 Thang 2 Street, Hoa Hung Ward, Ho Chi Minh City
Opening hours: Monday to Saturday, 6:30 - 11:30 and 13:00 - 17:00 (closed on Sunday)
Hotline: 028.3868.1097
Source: Suc Khoe & Doi Song (Health & Life) newspaper