Is melasma a superficial skin condition?

Melasma is not merely limited to the superficial layer of the skin; rather, it involves pigment deposition in deeper layers of the skin. It typically presents as symmetrical, irregular patches of light brown to dark brown pigmentation on the face, commonly found on the cheeks, forehead, upper lip, nose, and periorbital areas. The development of melasma is associated with multiple factors, including ultraviolet radiation, endocrine changes (such as hormonal fluctuations during pregnancy), genetic predisposition, and certain chronic diseases. These factors interact and lead to increased activity of melanocytes, resulting in excessive melanin production and deposition at the epidermal-dermal junction and even deeper within the dermis, thereby forming visible pigmented spots. Therefore, treating melasma requires comprehensive consideration of multiple factors and an integrated approach to fade the pigmentation and improve skin quality.