Pigmentation & Melasma
Brown patches on the face are not one condition. Sun spots, freckles, melasma, and darkening after inflammation look similar but respond very differently to heat and light. Melasma in particular can darken after aggressive laser or light treatment. A clinic that names the type of pigment before proposing anything is showing the diagnostic care this concern demands.
Common causes
- Cumulative sun exposure, which produces sun spots and deepens existing patches
- Hormonal influences, such as pregnancy or hormonal medication, that are linked with melasma
- Inflammation from acne, irritation, or previous procedures that leaves darker marks
- Genetic tendency and skin tone, since deeper tones darken more readily after injury
- Heat exposure and some photosensitizing products or medications
How doctors usually approach it
- Identify the pigment type
- A doctor examines the patches, often with magnified or polarized imaging, to separate melasma from sun spots and post-inflammatory marks.
- Start with protection and topical care
- Strict sun protection and prescribed topical agents form the base of most plans, because pigment tends to return without them.
- Choose gentle energy or peels with care
- Low-energy lasers, light-based treatments, or peels may be used, but settings should be conservative for melasma.
- Plan for maintenance and relapse
- Melasma often fluctuates, so a reasonable plan describes how recurrence will be managed rather than promising a final result.
Treatments often discussed
What a good consultation for pigmentation looks like
A good consultation begins with questions: when the patches appeared, whether pregnancy, hormonal medication, or sun exposure played a role, and how your skin has reacted to past treatments. The doctor should look closely, ideally with imaging, and tell you what type of pigment they think it is. If a proposal arrives before any diagnosis, the order is wrong.
Listen for how the doctor treats melasma specifically. A cautious approach uses lower energy, longer intervals, and often topical or oral medication, and it openly says that relapse is common. A clinic that promises to clear patches quickly with strong lasers should prompt questions, because over-treatment can darken melasma and sometimes causes lighter patches. Ask what happens if your skin reacts badly.
Finally, ask what the plan will cost you in time and sun avoidance. Honest advice includes the need for daily sunscreen and sometimes a pause in treatment during summer. Compare how different clinics describe the same patches. If one calls it melasma and another calls it sun damage, ask each to explain their reasoning, and consider whether a second opinion from a dermatology specialist is worth seeking.
Pigmentation & Melasma: common questions
How can I tell whether my patches are melasma?
Melasma usually appears as symmetrical, blotchy patches on the cheeks, forehead, or upper lip. Only an examination can separate it from sun spots or marks left by inflammation.
Will laser treatment make melasma worse?
It can if settings are too strong. Gentle protocols are often used, and some doctors prefer topical or oral approaches first. Ask how the clinic adapts treatment for melasma.
Can pigmentation be removed completely?
Often it can be lightened, but complete and lasting clearance is not predictable, especially for melasma. Maintenance and sun protection continue to matter.
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- Sinsa, Gangnam
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- 10:00 - 21:00 (late clinic)
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