Melasma—a stubborn form of skin hyperpigmentation—continues to challenge dermatologists and patients alike. Fortunately, in 2025, scientific advances have brought more effective and personalized treatment options than ever before. From cutting-edge laser therapies to dermatologist-formulated topical regimens, this comprehensive guide explores the best melasma treatments available today, how to choose the right solution for your skin type, and why clinics like ROHTO AOHAL CLINIC in Vietnam are leading the way in evidence-based care.
Many women experience melasma, a common skin issue marked by dark patches.
Melasma is a chronic skin condition characterized by brown or gray-brown patches on sun-exposed areas, especially the face. It most commonly affects women, particularly those with medium to darker skin tones, but can appear in men as well. The condition can be epidermal (superficial), dermal (deep), or mixed—impacting treatment decisions significantly.
Melasma does not have a single cause but rather arises from multiple interrelated triggers:
Hormonal changes: Pregnancy, birth control pills, and hormone replacement therapy can stimulate melanin overproduction.
Ultraviolet (UV) exposure: Sunlight is a powerful melasma trigger that stimulates melanocyte activity.
Genetics: A family history of melasma increases susceptibility.
Heat and visible light: Not just UV, but infrared and blue light can worsen melasma.
Other contributors: Medications like anti-seizure drugs, thyroid dysfunction, and chronic inflammation can all play a role.
Melasma is notoriously persistent. Even after successful treatment, it often returns without consistent maintenance. Because it affects pigment cells in the deeper dermis, superficial creams alone rarely offer a lasting solution. Management requires a strategic and ongoing approach, including professional intervention and daily sun protection.
Individuals with higher Fitzpatrick skin types (IV to VI) are at greater risk of developing melasma and post-inflammatory hyperpigmentation (PIH). Treatment must be adapted accordingly to avoid worsening the condition.
It’s crucial to differentiate melasma from other skin disorders like PIH, lentigines, or freckles. Dermatologists use tools such as Wood’s Lamp or VISIA analysis to determine melanin depth and formulate appropriate strategies. Self-diagnosis often leads to ineffective or even harmful product choices.
Tailored regimens, prescribed by professionals, consider skin type, depth of pigmentation, and sensitivity. In contrast, OTC products are one-size-fits-all and may lack potency or safety for persistent melasma. A personalized plan offers greater safety and results.
Top dermatologists combine various modalities for optimal results:
Topical depigmenting agents
In-clinic dermatological procedures
Oral therapies and supplements
Lifestyle and UV protection measures
Melasma is multifactorial and requires a layered approach. Combining, for example, a mild laser with antioxidant serums and topical agents addresses pigment production, distribution, and skin resilience simultaneously. Studies have shown combination therapy reduces recurrence significantly compared to monotherapy.
Long considered the gold standard, hydroquinone works by inhibiting tyrosinase, the enzyme responsible for melanin synthesis. In 2025, HQ is often prescribed in short cycles (8–12 weeks) and followed by maintenance treatments. Regulatory limits apply in many countries due to potential side effects with long-term use.
These ingredients are milder alternatives to HQ. Azelaic acid reduces inflammation while inhibiting tyrosinase. Kojic acid, derived from fermented rice, also brightens the skin effectively. Niacinamide, a form of vitamin B3, supports skin barrier health and reduces pigment transfer.
Tretinoin and other retinoids speed up cell turnover and improve absorption of other activities. They also stimulate collagen and reduce fine lines, which may accompany melasma.
This novel agent has become a game changer in melasma care. It reduces vascular and inflammatory pathways in melanin production. Available in creams and serums, it is ideal for maintenance after laser or oral therapy.
Glycolic and salicylic acid peels exfoliate the top layer, lifting superficial pigment. Dermatologists adjust the strength to match skin tolerance. When performed under supervision, results are visible within weeks.
PicoSure Laser: Ultra-short pulse lasers shatter pigment particles with minimal heat, ideal for mixed melasma.
Q-switched Nd:YAG: This remains a cornerstone laser for dermal melasma due to its deep penetration and safety for darker skin tones.
Fractional lasers (Er:YAG, CO₂): Used cautiously due to risk of PIH but helpful in specific cases under controlled conditions.
Microneedling creates microscopic channels that enhance serum penetration and stimulate healing. When combined with brightening agents, it offers synergistic results.
IPL targets pigment and redness. However, it is not always recommended for darker skin types due to a higher risk of rebound pigmentation.
One of the most promising oral treatments. Taken at low doses (250–500 mg/day), it has been shown to reduce melasma severity significantly. However, due to its potential to affect blood clotting, medical supervision is essential.
Polypodium leucotomos extract: Offers systemic UV protection, reducing oxidative stress and inflammation.
Glutathione: Supports skin lightening by converting melanin to a lighter form. While popular, its effectiveness varies.
Darker skin produces more melanin and is more reactive. This increases the risk of PIH, especially after aggressive treatments. Lighter skin types may tolerate stronger peels and IPL, while darker tones need gentler alternatives.
Misapplied lasers, harsh exfoliants, and even physical trauma can worsen melasma. This is why dermatologist oversight is essential—especially for types IV–VI.
Low-energy Q-switched lasers
Azelaic acid and tranexamic acid
Gentle peels
Oral antioxidants
Sunscreen is non-negotiable. Broad-spectrum SPF 50+ with zinc oxide and iron oxides is essential daily.
Avoid midday sun. Wear wide-brimmed hats, long sleeves, and UV-filtering sunglasses.
Stick to maintenance regimens. Use antioxidant-rich serums, gentle exfoliants, and continue pigment control agents in cycles.
Prevention is as critical as initial treatment in managing melasma long-term.
Founded by Rohto Pharmaceutical Japan, ROHTO AOHAL CLINIC is known for its integration of Japanese skincare precision and Vietnamese dermatology insights. With branches in HCMC and Hanoi, the clinic offers comprehensive melasma diagnosis and treatment using VISIA analysis, medical lasers, and prescription-strength topical regimens.
Each treatment begins with a deep analysis using VISIA to evaluate pigment type and depth. Doctors tailor the combination of therapies based on severity and skin sensitivity. The clinic avoids over-treatment and focuses on gradual, lasting results.
BBL (Broadband Light): Used for mixed pigmentation and redness.
Melasma treatment at ROHTO AOHAL CLINIC is carried out by qualified doctors and technicians.
Q-Switched Laser: Targets dermal melanin.
Microneedling with RF: Improves product absorption and collagen renewal.
Prescription Treatments: Include hydroquinone, retinoids, tranexamic acid, and supportive skincare.
Thousands of Vietnamese and international patients report visible improvement within 4–6 sessions with minimal side effects.
Professional, highly-trained doctors with Japanese and Vietnamese licensing.
Scientific approach using data-driven protocols and VISIA tracking.
Transparency in pricing, progress, and aftercare, earning high patient satisfaction.
Post-treatment maintenance programs tailored to prevent relapse effectively.
Topicals: Azelaic acid, niacinamide, licorice extract, arbutin
Sunscreens: Mineral-based with iron oxides (e.g., ISDIN, EltaMD, SkinCeuticals)
Serums: Containing tranexamic acid (e.g., SkinCeuticals Discoloration Defense)
Introduce new products gradually. Apply daily, especially sunscreen. Consistency ensures efficacy.
Avoid lemon juice, undiluted essential oils, or unregulated peels. See a dermatologist if pigmentation worsens or spreads.
|
Factor |
In-Clinic Treatments |
At-Home Options |
|
Effectiveness |
High for stubborn or deep melasma |
Moderate for early-stage cases |
|
Speed of Results |
Faster (within 4–8 weeks) |
Slower (8–16 weeks or more) |
|
Cost |
Higher per session |
More affordable long term |
|
Supervision Needed |
Yes (dermatologist required) |
No, but guidance recommended |
|
Relapse Risk |
Lower with combination maintenance |
Higher without sun protection |
Q: Is melasma curable or just manageable?
A: Melasma can be managed effectively but is rarely cured permanently. Maintenance is key.
Q: How long does it take to see results?
A: Topicals: 2–3 months.
Laser: Visible results within 3–6 sessions.
Oral therapy: 8–12 weeks with doctor’s monitoring.
Q: Does melasma from pregnancy go away?
A: It may fade postpartum, but many women experience recurrence without sun protection.
Q: Are natural treatments helpful?
A: They may assist in prevention or mild cases but lack clinical evidence for deep melasma.
Melasma requires more than one product or treatment. It needs long-term commitment, medical insight, and lifestyle adjustments. Seek certified dermatologists, like those at ROHTO AOHAL CLINIC, who can offer a clear diagnosis, evidence-based therapies, and sustained support.
Your clearest skin begins not with a miracle cream—but with science, patience, and daily sun protection.
ROHTO AOHAL CLINIC - CONTACT INFORMATION
Branch: 02 Pham Dinh Toai, Vo Thi Sau ward, District 3, Ho Chi Minh City
☎ Phone: (028) 3930 9555
Branch: 207/4 Nguyen Van Thu, Da Kao Ward, District 1, Ho Chi Minh City
☎ Phone: (028) 3827 9737
Branch: 50 Nguyen Thi Thap, Tan Hung Ward, District 7, Ho Chi Minh City
☎ Phone: (028) 6686 8048
Branch: 136 Trieu Viet Vuong, Nguyen Du Ward, Hai Ba Trung District, Ha Noi City
☎ Phone: (024) 3375 5588
Email: info@rohtoaohalclinic.com.vn
Business License No. 3700239769-001 issued on 04/07/2014 by Ho Chi Minh City Derpartment of Planning & Investment
Managed by: BRANCH NO. 2 OF ROHTO-MENTHOLATUM (VIETNAM)
