Freckles can appear from a young age, typically isolated, while melasma often results from aging, presenting as patches of varying sizes and colors, both superficial and deep.
Freckles and melasma are conditions characterized by increased pigmentation due to the overproduction of melanin in the skin. Dr. Lê Nguyễn Thủy Vy, Dermatology and Aesthetic Unit at Tâm Anh General Hospital in District 7, Ho Chi Minh City, explains that these skin issues share common causes such as genetics, aging, hormonal disorders, or environmental factors like frequent sun exposure. Areas that are easily exposed to sunlight, such as the face, neck, shoulders, back, hands, and feet, are often affected by melasma and freckles.
Freckles may first appear in childhood. They are usually found in the upper layer of the skin, appearing as small round spots measuring 1-5 mm, similar in size to a pinhead or sesame seed, and can be isolated or clustered into small, well-defined patches. Freckles are more commonly found in individuals with fair skin. Their colors can vary, ranging from black, light brown, dark brown, to yellowish-brown. The intensity of freckles can change depending on sunlight exposure, often fading in winter.
In some cases, freckles may fade naturally. They also tend to decrease as one ages. The appearance of age spots may replace childhood freckles if proper sun protection measures are not taken.
Freckles are small, similar in size to sesame seeds, and usually isolated. (Photo: Tâm Anh General Hospital).
Melasma is a skin pigmentation disorder that occurs when melanin is produced excessively, leading to the formation of dark spots and patches with varying degrees, from light brown to dark brown. Melasma can manifest differently depending on the size, color, and depth of the spots, often appearing on the forehead, symmetrically on the cheeks, chin, and even all over the face, or on the neck, shoulders, back, arms, and hands.
This condition is more prevalent in women aged 20-50, particularly as the skin begins to age significantly, during pregnancy and postpartum, and in the pre-menopausal phase when women are more susceptible to melasma.
Melasma patches on a man’s skin. (Photo: Tâm Anh General Hospital).
According to Dr. Vy, treatments for melasma and freckles have many similarities, but the treatment regimens differ for each area of the skin. Patients should consult specialized dermatology and aesthetic facilities to determine the nature, condition of their skin, as well as the severity of melasma and freckles to receive the best treatment plan.
New, mild, superficial pigmentation spots can typically be treated with topical medications and oral medications. Ingredients that brighten the skin in these medications will inhibit the development of melanin and help fade melasma and freckles. The speed of treatment effectiveness varies depending on the skin condition and the individual’s compliance.
Severe, long-standing pigmentation issues may require treatment in conjunction with modern technologies like laser therapy, chemical or biological skin rejuvenation (chemical peeling), iontophoresis, and mesotherapy with brightening essences. Dr. Vy notes that these methods are highly effective and safe but require multiple sessions and must be performed by licensed medical professionals.
Those undergoing treatment for skin pigmentation should avoid going outdoors during peak sunlight hours from 10 AM to 4 PM. They should regularly apply sunscreen, reapplying every two hours when outside, to prevent ultraviolet rays (UV) from damaging sensitive areas of the skin and to avoid stimulating further melanin production. It’s advisable to protect the body with hats, long-sleeved clothing, masks, gloves, or umbrellas.
