If Melasma, Freckles, Lentigines, and Age Spots Are Not Treated After an Accurate Analysis

The pigmentary conditions we often loosely refer to as melasma or blemishes are actually very diverse, and they cannot simply be dismissed as a matter of increased pigment on the skin surface. These hyperpigmentation conditions may look different in terms of cause, depth of pigment, shape, and size, but in reality, it is very common for multiple pigmentary disorders to appear together on one face. That is why it is necessary to distinguish between them and create a treatment plan accordingly.

Pigmentation comes in many forms

Melasma is commonly seen in women in their 30s and 40s, and appears symmetrically on the cheekbones, forehead, and cheeks as broad, irregular dark-brown patches on the face. It develops through a combination of factors such as hormonal changes, ultraviolet exposure, genetic factors, and skin inflammation, and because pigment often penetrates deeply from the epidermis to the dermis, it tends to be difficult to treat. Freckles have a strong hereditary tendency and appear as multiple small, light-brown spots like grains of rice. They darken with sun exposure and lighten in winter, showing seasonal changes.

Lentigines appear as round brown or black spots. They are larger than freckles and are characterized by clear borders. Age spots occur due to skin aging and chronic ultraviolet exposure. They begin as flat brown spots, but over time they become darker and thicker, eventually protruding unevenly above the skin surface.

If pigmentation is treated incorrectly

If a dermatologist does not make a clear diagnosis and mistakes deep pigment such as melasma for simple blemishes and uses a strong laser, it can instead trigger an inflammatory reaction in the skin, stimulate pigment cells, and cause hyperpigmentation, in which the existing pigment becomes even darker. On the other hand, side effects such as hypopigmentation, where the pigment permanently disappears, may also occur. In particular, melasma related to hormones is very sensitive to strong stimulation and can become even more difficult to treat. In addition, treatments that are effective for superficial pigment such as freckles or lentigines may have no effect at all on deep pigment such as melasma or Ota nevus, resulting in wasted time and money.

Skin diagnosis comes first

To avoid these problems and achieve satisfactory results, an accurate skin diagnosis before treatment must come first. Dermatology clinics often diagnose the skin using precise diagnostic devices such as Mark-Vu. This device helps identify in detail the location and depth of melanin pigment that is difficult to confirm with the naked eye, as well as the degree of erythema, fine skin texture, and pore condition, through not only standard light but also imaging with four special light sources. Based on the diagnosis, treatment is carried out in various ways, and laser treatment is widely known.

The principle of laser treatment is to selectively destroy only melanin pigment, breaking it down into very small particles and then inducing the body's immune cells to absorb and eliminate them. Using various laser devices such as Clarity Pro and PicoPlus, the laser wavelength and irradiation time are precisely adjusted according to the depth and type of pigment to minimize skin irritation during treatment. Afterward, care such as medical skin care can be combined to help the skin recover and to promote regeneration while strengthening the damaged skin barrier.

Careful habits help maintain clear skin

Because pigmentation is difficult to treat once it appears and can easily recur, preventing it through careful daily care habits is more important than anything else. The key is sun protection. Ultraviolet rays are a major trigger for melanocytes, so you should be aware that UV rays can enter through windows even on cloudy days or indoors, and apply sunscreen every day of the year. It is important to apply it 30 minutes before going out and to reapply it from time to time during outdoor activities.

You also need to pay attention to skin moisture and regeneration. Along with adequate water intake, it is important to apply moisturizer thoroughly in daily life to keep the skin barrier strong. In addition, since skin cell regeneration is active between 10 p.m. and 2 a.m., getting enough sleep to allow the skin time to regenerate is also an essential care method for maintaining clear skin. Clear skin is partly something you are born with, but it can also be achieved through proper treatment and care, so if you are troubled by dull skin, I hope you will continue to receive care from a board-certified dermatologist and maintain helpful habits.