For melasma, many people think of laser toning. Even among the people with melasma viewing this video, I bet many of you are currently getting laser toning. Has it been effective? Hello, I am Dermatologist Dr. Ogana. Today, we'll talk about melasma.

Director, do you have melasma? I think I do. You don't have it. Although melasma is a common condition, not just anyone has it. I also don't have melasma.

As I've played a lot of golf, I'm starting to get sunspots. I've gotten sunspots from UV ray exposure. We need to differentiate the types of hyperpigmentation. For pigment that forms at a young age with dark spots and clear borders

and sprinkled across the nose like sesame seeds, we call these "freckles." Freckles are relatively easier to treat. And there are round spots after you age, not age spots, which are dark spots, but lighter spots with faded borders are called "sunspots."

They are pigment lesions from UV ray exposure. And for today's topic of "melasma," it's irregular. It appears on both sides, mostly affects females, and appears with age in your 30s-40s.

It appears evenly on both sides, but the shape is irregular, so I can easily tell if it zigzags or spreads like a leaf it is probably melasma. Treating melasma is difficult. The key to treating melasma:

don't even try if you're only going to treat it half-heartedly. There are three factors to melasma: first is genetics, second is UV rays, third is female hormones. So

when parents have melasma, their children will likely also have melasma. If you have melasma in your genes and have sun exposure, your chances of getting melasma are high. And during your 20s, 30s, and 40s when you produce a lot of female hormones,

melasma can worsen. It is said to get better after menopause. Melasma can also worsen after childbirth so it is related to female hormones. To treat melasma, common methods include lasers, topical medication, and oral medication.

I personally dislike topical medication. Not only are the effect subpar, it can also cause darker pigmentation from irritation. So I don't prefer topical creams. So then lasers and oral medications remain. For oral medication, there is Doransamin

which is tranexamic acid. In Chinese, they call it "brightening acid." It's called tranexamic acid and it stops small bleeding so it's used for hemostasis. When taken in small doses,

it is effective against melasma. If you have melasma and want to treat it, I strongly recommend oral medication first. Of course, you must talk with a medical professional first. You must confirm if you have melasma and if it will respond to oral medication.

Melasma usually isn't present just by itself but is present with pigmentation, sunspots, and other lesions that must be addressed. In these cases, it won't fade with just oral medication. Next is lasers. For melasma, many people think of laser toning.

Even among the people with melasma viewing this video, I bet many of you are currently getting laser toning. Has it been effective? Back when I was a resident, I treated many melasma patients with laser toning, but truthfully, it was completely ineffective.

So now I don't perform laser toning. You must understand the ailment. We don't just fade the pigment that is present for melasma. Melasma is like a weed that keeps making pigment. How do you handle weeds? You must cut the top and pull out the root.

But if you hastily pull it out, a larger weed will appear. Melasma is the same. So in order to treat melasma, we must calmly target the weeds. We should calmly address them.

and replace the soil. What I mean by that is, for melasma, when you evaluate the tissue, the collagen and elastin in the dermis– –which we call the connective tissue– the tissue is often soft and mushy.

This is caused by genetics and UV exposure and is destroyed or denatured. So the key to treating melasma, though fading the visible pigment is also important, is to prevent the formation of more pigment, or to fix what is defective.

So while laser toning may fade the pigment, it makes the defect worse, sometimes worsening melasma. So when I treat melasma, I combine X Laser and Y Laser. This is a secret.

Though treatment is important, for melasma, getting an accurate diagnosis and suitable treatment is vital. Among topical, oral, and laser options, skip topicals. Oral medication is okay but talk to a medical professional beforehand.

And for lasers, skip laser toning. This is today's conclusion. Should I tell you (the secret)? Please tell us. I'll tell you. For me, I try to target melasma,

or, I perform treatments to strengthen the deep skin layers. So I start with soundwave treatments and also use extracorporeal shock wave therapy and also use picolaser and use the XXX mode to treat patients but as this is a trade secret,

I will only tell patients who come in for treatment. UV imaging below the skin is important for melasma patients. As you can see, there is obviously melasma around the eye area. The lesions like sunspots around it can be easily treated with lasers.

On the other hand, there's this band. For this area that is especially damaged, as there is still degeneration, reverting the structure is very important. So if we check the actual image... Although it got much better,

we can still see the degraded band. If we use laser toning here, it can actually get darker so using a treatment to revert and regenerate the tissue or a rejuvenating treatment is key to treating melasma. This person also had widespread melasma. She came to our clinic for widespread melasma.

She received strong laser treatments at other clinics so there are some spots that are faded. We mainly used treatments to rejuvenate the tissue. So if we see the actual pictures... You can see it has improved greatly but there is still pigment on the side.

Slowing down the rate of pigment formation and slowly and safely removing the existing pigment is the key treatment point. So for melasma treatment, grooming the sleeping tiger without waking it up is the key to treatment.

I've gone over melasma up to this point. For melasma, even our doctors can't tell patients how many sessions will be required. In my case, for redness, acne, sensitivity, etc. I treat them 15 times. Patients see satisfying results after 15 sessions.

If not, I treat them until they're satisfied and if it doesn't work, I give them a refund. I confidently tell this to patients I treat. But melasma treatments typically are long-term. It can especially take longer depending on skin type So we consider the patient's financial abilities,

ability to come to our clinic, etc. when making their plan. So we create an ideal plan before treating them. So if you have melasma, while you may think it's too late, this is the earliest time to take action. Don't just give up

and please try to get treated. This has been Dermatologist Dr. Ogana and I am the director of Oganacell Dermatology at Cheongdam. Thank you!

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