Melasma Treatment in Seoul
Type-specific diagnosis and customized laser therapy
Type-specific diagnosis and customized laser therapy
Melasma is brown to gray-brown pigmentation appearing on the cheeks, forehead, and nose bridge, most common in women over 30. While UV exposure is the primary cause, hormonal changes (pregnancy, oral contraceptives, menopause), genetic predisposition, and cosmetic irritation all contribute. Melanin is distributed broadly between the epidermis and dermis, making melasma a chronic pigmentation disorder that requires precise type classification and long-term management—not just simple spot treatment.
Epidermal melasma occurs when melanin accumulates only in the skin's outermost layer. On Wood's lamp examination, it appears darker. This type responds best to laser treatment, and significant improvement is achievable with PicoPlus or low-energy laser toning.
Dermal melasma involves melanin deposition in the deeper dermis layer. On Wood's lamp, there is minimal color change, making diagnosis difficult. Because pigment resides deeper, this type is more challenging to treat than epidermal melasma and requires Q-Switch Nd:YAG laser toning combined with medication. Low-energy toning alone often yields minimal results, emphasizing the importance of expert diagnosis.
Mixed melasma is the most common type, with melanin distributed throughout both epidermis and dermis. Since it exhibits characteristics of both types, combined therapy—starting with PicoPlus to address epidermal pigment, then Q-Switch toning to gradually improve dermal pigment—is most effective.
Melasma doesn't disappear after a single treatment because of recurrence mechanisms. Since melasma stems from repeated stimuli—UV exposure, hormonal fluctuations, and genetic predisposition—the skin continues producing melanin even after laser removal. Preventing recurrence requires regular maintenance treatments every 4-8 weeks, rigorous sun protection, and concurrent oral tranexamic acid therapy. Overly aggressive laser energy can actually darken pigment or trigger depigmented patches, making gentle, consistent treatment the key to safety and success.
Epidermal melasma: PicoPlus laser (picosecond-level ultra-fine pulses) rapidly breaks down epidermal melanin. Visible improvement possible within 2-3 months.
Dermal melasma: Q-Switch Nd:YAG laser toning (1064nm, low-energy repeated stimulation) gradually expels melanin from deep dermal layers. Requires 6+ months of consistent management. Oral tranexamic acid recommended.
Mixed melasma: Initial PicoPlus to remove epidermal pigment, followed by Q-Switch toning for dermal pigment management. Combined approach is most effective.
Key principle: "Strong once" with aggressive energy can worsen pigmentation. "Gentle repetition" with appropriate energy reduces melasma recurrence and ensures safe results.
Prolonged UV exposure triggers excess melanin production and melasma formation. UV radiation is the most significant melasma trigger.
Oral contraceptive use, pregnancy, and menopause can increase melanin production and worsen melasma. Female hormones stimulate melanocytes.
Melasma is genetically influenced. If parents have melasma, children are at higher risk. It's more common in people with darker skin tones.
Wood's lamp and magnified skin imaging accurately identify melasma depth (epidermal vs dermal vs mixed). Since deeper dermal pigment requires different management than surface toning, precise diagnosis directly determines treatment outcomes.
Epidermal melasma receives PicoPlus for rapid improvement; dermal melasma receives Q-Switch Nd:YAG toning for gradual improvement; mixed type receives combined laser therapy. Oral medication (tranexamic acid) is added based on melasma activity level.
Melasma management requires regular treatments every 4-8 weeks plus comprehensive care: rigorous sun protection, brightening topicals, and when needed, oral medication. We provide a customized maintenance plan for lasting recurrence prevention.
Melasma is a chronic pigmentation disorder from hormonal changes, UV exposure, and genetics, appearing symmetrically on cheeks, forehead, and nose. Age spots are simple pigment spots appearing randomly on sun-exposed areas. Melasma involves different dermal depths and is classified as epidermal, dermal, or mixed, each requiring different treatment approaches.
Depending on melasma type and depth, typically 5-10 sessions spaced 4-8 weeks apart. Epidermal melasma may improve in 2-3 months, while dermal melasma may require 6+ months of consistent treatment. ABLE Dermatology personalizes the schedule based on individual response and pigment depth.
Sun protection is critical—use SPF 50+ sunscreen daily and avoid direct sun exposure. For 2 weeks post-treatment, avoid saunas and intense exercise. Consistent use of prescribed brightening creams and oral tranexamic acid significantly reduces recurrence.
Be able to choose, not be pushed.
We present transparent options — never pressure
This page constitutes medical advertising in accordance with Article 56 of the Korean Medical Service Act, and treatment results may vary by individual.
