[Doctor's Column] Why do melasma reappear even after treatment? It's not the pigment itself, it's the skin's environment!

Why do freckles reappear even after treatment? It's not the pigment, it's the skin environment. Every time you look in the mirror, those freckles stand out. You've probably experienced the frustrating experience of thinking they've faded, only to find them suddenly resurface. Why do freckles recur even with laser treatment and consistent whitening treatments? Many people think freckles are simply pigmentation, but recent dermatological research understands them as a change in the skin's overall environment. Therefore, treatments that only remove visible pigmentation can have limitations. Freckles are caused by a "four-step system." Freckles aren't caused by a single factor. They appear as a series of overlapping changes within the skin. Stage 1 | Light Stimulation: UV rays and even visible light directly stimulate melanin cells in the skin. → Sunlight turns on the pigment factories. Stage 2 | Hormonal Signals: Female hormones like estrogen activate melanin production pathways. → Internal signals continue to direct pigment production. Stage 3 | Changes in the Dermal Microenvironment: Aging or photoaged dermis secretes growth factors that stimulate pigmentation. → The "soil" within the skin changes, facilitating pigment production. ▲ Stage 4 | Basement Membrane Collapse: As the basement membrane weakens, pigments sink down to the dermis and become fixed. → This stage deepens freckles and makes treatment difficult. Fringe blemishes aren't simply a pigmentation issue; they stem from changes in the skin's environment. ▲ Why aren't simple whitening or toning treatments enough? Fringe-prone skin isn't simply a condition of excessive melanin. ▲ The dermal structure is weakened, ▲ inflammation and vascular stimulation are repeated, and ▲ an environment that continuously produces pigmentation is maintained. Removing the pigment alone may temporarily lighten the blemish, but it's likely to return. ▲ The key to freckle treatment is "normalizing the skin environment." Fringe treatment requires an approach that stabilizes the skin's environment to prevent pigmentation from forming alongside the removal of pigment. ▲ Collagen toning: This gradually stabilizes the skin's environment without overstimulating the dermis, reducing the risk of recurrence. ▲ Pico Toning: This treatment relatively precisely organizes the epidermal pigmentation that has already appeared. The effect and maintenance are better when used in conjunction with a stable dermal environment. ▲ Skin Booster: This is an auxiliary treatment that helps restore damaged dermis and relieve inflammation, thereby increasing the skin's 'base strength'. ▲ Daily care is also part of the treatment. ▲ UV protection is basic, and if possible, physical blocking with hats and parasols. ▲ Avoid habits that increase skin temperature, such as saunas and hot washing. ▲ Reduce excessive friction when washing your face or applying makeup. These small differences in habits can greatly affect the recurrence of melasma. ▲ A final line from an expert 📣 Pico Toning, collagen toning, and skin booster are treatments that each have different roles. It is important to consult a medical professional after comprehensively considering the type of melasma and skin condition to choose the right treatment. ※ This article introduces general information related to melasma treatment. It does not recommend any specific procedure or guarantee its effectiveness, and is not a substitute for professional diagnosis or consultation. Maypure Clinic Deokcheon Branch Director Eunhye Moon · Graduated from Pusan ​​National University School of Medicine · Resident at Seoul Asan Medical Center · Regular member of the Korean Society of Aesthetic Plastic Surgery · Regular member of the Korean Society of Dermatological Aesthetics · Restylane Aesthetic Thought Leader · Classys (Shrink) Advisor, Instructor 📌 Skin Booster Maypure Whitening Freckle Specialist 'Meladuce' Details [Click] 📌 Maypure Pico Toning Details [Click]