Are age spots similar to melasma?

I've had many small age spots near the corners of my eyes since I was a child. For the past two years, large age spots have appeared on my cheeks and hands, some as big as my fingertips.

Are age spots similar to melasma, and how are they treated? (Thu Minh, 48 years old, Ho Chi Minh City)

Reply:

Melasma is a skin pigmentation disorder that occurs when melanin pigment is overproduced, leading to the formation of brown patches or spots on the cheeks, forehead, and nose.

Melasma is typically a flat, darker shade of skin, commonly found in women aged 20-50, especially during and after pregnancy. Melasma can lighten or darken over time, often worsening in summer and becoming milder in winter; its appearance varies depending on its size, color, and depth.

Age spots are a specific type of hyperpigmentation, but they differ from melasma. Age spots are larger, approximately 0.5-2.5 cm in size, dark brown or black in color, thickened, and raised above the skin's surface; they usually appear on the face, arms, shoulders, and chest. Age spots typically appear after age 60 and are a sign of aging due to frequent sun exposure. The older you are, the more numerous, darker, and larger the spots become.

Unusual-colored age spots that are itchy, painful, or bleed may be related to skin cancer. If you experience these symptoms, you should go to a hospital with a dermatology or oncology department for proper diagnosis and treatment.

Dark spots and age spots appear on the skin, affecting one's appearance. Photo: Freepik — Dark spots and age spots appear on the skin, affecting one's appearance. Photo: *Freepik*

Melasma and age spots can be treated with various methods such as applying creams, taking medication, chemical peels (skin resurfacing with chemicals), or laser treatments, IPL, electrophoresis, mesotherapy injections, microneedling, etc. However, their characteristics differ, so you should consult a dermatologist or cosmetic skin specialist at a medical facility to determine the nature, condition, and severity of your melasma and age spots in order to receive the best treatment plan. Generally, those with mild hyperpigmentation can use topical creams, oral medications to lighten the skin, or chemical peels.

Treatment for melasma depends on the cause and severity (shallow, moderate, or deep). Melasma caused by hormonal changes, pregnancy or birth control pills, cosmetic use, or sun exposure may improve after childbirth or cessation of exposure to these factors.

For deep or mixed melasma, a combination of methods and multiple treatments may be necessary to achieve effective results. For example, doctors may combine topical and oral medications with methods such as laser treatment to break down melanin into smaller fragments and mesotherapy injections to reduce the production of new melanin and inhibit melanin transport to the skin's surface.

Laser treatment plays a major role in treating age spots. This treatment requires 3-5 sessions, depending on the depth of the age spots. Doctors may also prescribe cryotherapy (applying or spraying liquid nitrogen) to the age spots, topical medications, or chemical peels.

After treatment for melasma and age spots, you must avoid sun exposure by using sunscreen and covering up carefully when going outside. The doctor may also prescribe some skin-lightening products to limit the recurrence of hyperpigmentation.

Master's degree holder, Doctor Vu Thi Thuy Trang
Dermatology and Cosmetic Skin Care
Tam Anh General Hospital, Ho Chi Minh City

Readers can submit questions about dermatology and cosmetic skin treatments here for the doctor to answer.

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