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Column March 5, 2026

Melasma and Hyperpigmentation — Clear Skin Through Internal (Herbal) and External (Pharmacopuncture) Care

Hyo-seop Kim
Hyo-seop Kim
Chief Director

Why does melasma develop?

Melasma is a brown pigmentation that appears symmetrically on the cheeks, forehead, and above the nose. UV exposure is the most important external trigger, while hormonal changes (pregnancy, oral contraceptives, menopause), genetic predisposition, and stress all contribute. UV light stimulates melanocytes to produce more melanin, while estrogen and progesterone activate tyrosinase, the key enzyme in melanin synthesis.

Liver qi stagnation and its link to melasma

In Korean medicine, melasma is called liver spots for a reason. The liver governs the smooth flow of qi and the storage of blood. When stress causes liver qi to stagnate, qi and blood circulation become blocked, and dull pigmentation deposits on the face. Many patients notice that melasma darkens during stressful periods. In addition, when kidney deficiency leads to a lack of water, fire rises and the skin becomes dry, worsening pigmentation.

Internal treatment — Gami-soyo-san plus whitening herbs

Gami-soyo-san resolves liver stagnation and restores qi and blood circulation, which in turn promotes the metabolism and excretion of melanin accumulated in the skin. We add herbs specialized for brightening:

  • Baekji (Angelica dahurica): Improves qi and blood circulation in facial skin and has a brightening effect
  • Baekbokryeong (Poria cocos): Removes dampness and turbidity from the body, clarifying the skin
  • Sangbaekpi (Morus alba root bark): Cools lung heat and improves skin clarity

External treatment — whitening pharmacopuncture and skin care

Pharmacopuncture is a treatment that injects herbal extracts directly into the affected areas of melasma. Pharmacopuncture made from danggui (Angelica), hwanggi (Astragalus), and licorice extracts improves blood flow in the skin and accelerates the elimination of melanin. Combining this with facial cosmetic acupuncture doubles the effect.

Sun protection is essential

No matter what treatment you choose, melasma will recur without UV protection. Apply SPF50+ PA++++ sunscreen every day and reapply every 2–3 hours. A vitamin C serum is an effective adjunct that suppresses melanin synthesis.

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Hyo-seop Kim

Hyo-seop Kim Chief Director

Hello, I am Director Hyo-seop Kim, Chief Director of Geummaek Korean Medical Clinic. I look beyond visible symptoms to find the root causes. Through over 15 years of clinical experience and research, I provide the most helpful treatment for each individual patient. Please feel free to share your concerns. Together, we will find the answers.

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