Melasma: Causes, Treatment, and Management | Yonsei Star Dermatology Sinchon

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Pigment changes that spread darkly on both cheeks are a concern that even makeup can't hide well, making you linger in front of the mirror. The most common first question we hear in the consultation room is, "Is this melasma, or is it another type of blemish?" To put it simply, even if they look similar, the cause and depth differ, so the management approach will vary. Accurate differentiation is key.

Today, we will systematically explain why melasma occurs, what forms it takes, and how best to manage it.

Melasma is a pigmentary disorder where melanocytes in the skin produce excessive melanin pigment, leaving dark and dull traces on the surface. It doesn't arise from a single cause but rather from a combination of factors such as hormones, UV radiation, and genetic predisposition.

Hormonal changes, in particular, have a significant impact. Even individuals who normally maintain clear skin may suddenly develop pigmentation when hormonal changes occur. It is a common concern for pregnant women, with about 50-70% experiencing it. Even when taking birth control pills, melasma appears in about 1 in 4 women, showing the influence of hormones.

"Melasma" immediately brings "UV rays" to mind, indicating their well-known connection. UV radiation is a major factor that stimulates melanin formation in the skin. Starting with dull pigment changes, if the condition worsens, it can affect overall skin health, so it is important to practice daily UV protection.

Due to genetic predisposition, melasma can also appear in young people in their teens and twenties who have not experienced pregnancy. Since it is caused by various factors and requires time and effort to manage once established, it is best to pay attention in advance. UV management is also commonly important for those considering V-beam Facial Redness Treatment or Epidermal Pigment Removal.

Not all dull marks on the face are melasma. Many people confuse their pigmentary disorders, so we've compiled distinguishing points to help when looking in the mirror at home.

• Check if it appears symmetrically on both cheekbones and cheeks.
• If it's a wide, brownish lesion that looks like paint has spread, suspect melasma.
• If it's a distinct, spot-like shape the size of a grain of rice or a bean, it's closer to a blemish.
• Even if it only appears on one side, it may be hidden deep within the skin on the opposite side.

There are cases where people mistake a mark on only one side for a blemish, but in reality, it's highly likely that it has occurred on both sides, but one side is still hidden deep within the skin and not yet clearly visible on the surface. In such cases, it is difficult to distinguish with the naked eye alone. If you are confused between similar-looking pigment concerns, it is important to get an accurate diagnosis from a dermatologist and start appropriate management to prevent it from worsening.

If you have any questions, please feel free to leave them via Inquire about melasma and pigment management via chat consultation.

The basic principle of laser toning is to suppress the excessive production of melanin. However, there are precautions to take when undergoing the procedure. It is usually performed at 1-2 week intervals, but sometimes people stop midway if they feel some improvement in the beginning.

Many people are disappointed when the activity of melanocytes, which has decreased due to laser action, returns to its original state over time, making it feel like a recurrence. Therefore, we recommend continuing the procedure consistently, if possible, without delaying the treatment cycle for more than 3 weeks. Since there may be melasma hidden deep in the skin, it is recommended to receive toning care consistently for about 10 sessions.

Depending on the person, some may notice changes even without completing the recommended number of sessions, while in other cases, changes may gradually appear only after at least 5 sessions. There can be individual differences, so even if the number of sessions is adjusted according to the condition, it's good to remember that consistency is key to managing pigmentary disorders.

Recently, more people are seeking PicoWay Laser for pigment management. Even among PicoWay Lasers, there are different types depending on performance, and PicoWay is a superior version among them. It is known as equipment that can treat pigmentation at various depths with a wavelength 100 times faster than existing nano lasers, and relatively quick changes can be expected.

Even with the same laser treatment, the timing and extent of changes can vary depending on the performance of the device. It is good to check which equipment will be used before the procedure.

At Yonsei Star Dermatology Sinchon, we go beyond managing pigmentary disorders and also help improve keratin, performing G.D. Toning to enhance skin tone-up effects. Compared to traditional toning, it has less pain burden and allows for more comfortable management as changes can be expected with fewer sessions. Those considering Water-Luminous Injection or Customized Whitening Solution in addition to pigmentation can also determine the direction after diagnosis.

In this article, we've summarized why melasma occurs, how laser toning works for pigment management, and how to continue care to see changes.

As mentioned earlier, consistency is key, so diligently taking care of small details in daily life, both during and after treatment, is helpful.

• Do not forget UV protection before and after going out.
• Do not arbitrarily delay the recommended treatment cycle.
• Manage your lifestyle rhythm to prevent stress from accumulating.
• If you suspect pigment changes, get a diagnosis first rather than self-diagnosing.

Paying attention to these aspects in your daily life can help slow down the progression of melasma and maintain clear skin. Yonsei Star Dermatology Sinchon will continue to be with you to help you maintain healthy skin.

Chief Director Lee Sang-ju (MD, PhD, Yonsei University College of Medicine and Graduate School, completed dermatology residency at Severance Hospital, President of the Korean Dermatological Association) Chief Director Lee Sang-ju's Profile First published 2025-02-17 / Last reviewed 2026-06-16

This article provides general information, and pigmentary disorders vary in pattern and depth from person to person. For an accurate diagnosis and personalized management, please consult with medical staff.