Seongsu Dermatology Clinic: Laser Toning Treatment After Dermatologist Consultation for Refractory Melasma and Freckles

Refractory Melasma · Freckles

Hello, this is Seongsu Raon Dermatology Clinic :)

Many people worry when the overall color of their face looks dull and blemishes or spots do not fade easily. In particular, if whitening products or procedures do not last and the discoloration quickly becomes darker again, there is a high possibility that it is not simply melasma or freckles, but a “refractory pigment disorder.” Refractory melasma or freckles tend to spread deeper into the skin than ordinary pigmentation, so consistent diagnosis and precise treatment must go hand in hand.

Refractory Melasma · Freckles

What Are Refractory Melasma · Freckles?

Both melasma and freckles are pigment disorders caused by excessive melanin production, but when they are classified as refractory, their patterns and depths differ. Unlike ordinary freckles that exist only in the epidermis, refractory freckles have melanin settled down into the dermis, making the color darker and the borders less distinct. Melasma also is not limited to the epidermis; because pigment is deposited in the dermis as well, treatment is not easy!

In addition, refractory melasma is influenced by a combination of factors such as ultraviolet light, female hormones, vasodilation, inflammatory reactions, and stress. That is why it may not disappear completely after just one treatment, and it can become darker again depending on lifestyle habits or changes inside the body. Because the causes are diverse and the depths vary, it is necessary to carefully examine the skin condition and approach treatment in a customized way suited to it.

Refractory Melasma · Freckles

Why Is Treatment Difficult?

So why exactly is treating refractory pigmentation difficult? The reason is that the pigment exists simultaneously in multiple layers of the skin. If the pigment is only in the epidermis, it can improve to some extent with whitening care or peeling alone, but pigment that has spread to the dermis has limitations with a single whitening ingredient or one laser. In particular, if vasodilation or inflammation is present around the melanin pigment, it can easily recur even after treatment.

Also, because the skin is very sensitive to irritation, excessive laser intensity or frequent procedures can actually worsen pigmentation. This is due to side effects such as post-inflammatory hyperpigmentation caused by laser rebound! Therefore, refractory pigment treatment is not simply a process of “removing color”; it is important to take a complex approach that suppresses the reactivation of melanocytes while minimizing skin irritation. Stable results can be achieved only by identifying the distribution of pigment by skin layer and combining treatments suited to its depth :)

<Reasons treatment is difficult>

• Pigment depth varies / Vasodilation and inflammation around melanin

• Strong laser stimulation can lead to recurrence / risk of hyperpigmentation

• Stable improvement is possible only when individual skin condition is considered

Why Is Treatment Difficult?

2D MARK-VU

Before treatment, the current condition must be accurately identified first. In that sense, it is no exaggeration to say that diagnosis is more important than treatment. 2D MARK-VU is a high-resolution analysis device that can check even pigment that is not visible beneath the skin, precisely identifying the location and density of pigment as well as vascular condition. It also visualizes the depth of the pigment layer and the degree of inflammation, which are difficult to distinguish with the naked eye!

Through four light sources—ultraviolet, polarized light, cross-polarized light, and normal light—the skin can be observed from various angles. The ultraviolet mode reveals hidden pigment, polarized light analyzes sebum and pores, cross-polarized light shows vasodilation, and normal light analyzes the overall color and tone of the skin. Based on the diagnostic information obtained this way, unnecessary procedures can be reduced and the laser combination best suited to the skin condition can be determined. In the next slide, we will look at the laser devices actually used most often.

2D MARK-VU

Clarity2

First, Clarity2 is a dual-wavelength laser widely used in the treatment of pigment disorders. The 755nm Alexandrite wavelength acts on melanin in the epidermis to selectively remove blemishes, freckles, and age spots. Meanwhile, the 1,064nm Nd:YAG wavelength reaches deep into the dermis to reduce deep pigmentation such as refractory melasma, hyperpigmentation, and Ota nevus.

By using these two wavelengths together, pigment distributed across multiple skin layers can be treated at once. In addition, Clarity2 automatically detects skin temperature and adjusts the laser intensity, making it possible to selectively destroy pigment while minimizing damage to surrounding tissue. After treatment, the skin tone becomes more evenly bright, and improvements in skin texture can also be expected. With consistent care, you can be free from long-standing pigment concerns!

<Clarity2>

• Dual pigment laser / Simultaneous improvement of epidermal and dermal pigment

• 755nm Alexandrite: Selective removal of epidermal melanin

• 1,064nm Nd:YAG: Stabilization of dermal pigment and blood vessels

Clarity2

Helios 785

Second, Helios 785 is a pico-nano hybrid laser that finely addresses pigment located at various depths. The pico 785nm wavelength acts on pigment in the mid-dermis, and the nano 1,064nm and 532nm wavelengths improve pigment in the deeper layer and epidermis, respectively. Thanks to this, it can broadly respond even to refractory melasma and freckles with evenly distributed pigment.

In particular, the short-pulse energy of the pico laser finely breaks down pigment particles while causing almost no thermal damage to the surrounding skin. As a result, irritation is minimal, and the skin recovers much more stably after treatment. When procedures are performed at regular intervals, melanin within the skin gradually becomes more organized, and you may notice an improvement in overall complexion and a more even tone. You can expect a natural and gentle skin-improvement effect :)

<Helios 785>

• Uses three wavelengths with pico / nano

• Customized pigment treatment by depth

• Short pulse width / Minimizes damage to surrounding tissue

• Step-by-step treatment for refractory melasma / freckles

Helios 785

Customized Diagnosis According to Depth / Refractory Melasma, Freckles