Sometimes, you might suddenly notice faint brown smudges spreading across your face in the mirror. Melasma is a common pigmentary disorder characterized by excessive melanin deposition on both cheeks, forehead, and around the mouth. For those who first discover melasma, the most common question is, "Can I get rid of it with topical medication, or do I need laser treatment?" To answer directly, melasma is often reported as a condition that requires a consistent treatment plan because the pigment tends to settle deep within the skin.
Why is Melasma Common in Women in Their 30s and 40s?
Melasma is known to be caused by a complex interplay of hormonal changes, UV exposure, and genetic factors. It is particularly common among women in their 30s and 40s, with a prime example being melasma that develops during pregnancy. Approximately 50-70% of pregnant women experience concerns about melasma, and UV exposure can further stimulate melanin production, potentially darkening the spots.
During summer, like now, increased UV exposure makes melasma more noticeable. This is why many people look into melasma treatment lasers, ointments, medications, and whitening creams during this period. So, how can melasma be treated?
Are Topical Ointments and Whitening Creams Enough?
You may have tried ointments or whitening creams available at pharmacies. While they can be somewhat helpful, it often takes a long time to see changes. Melasma often involves pigment deposited deep in the dermal layer of the skin, so topical medications alone are reported to have limitations.
In addition to visible pigment, epidermal pigment such as blemishes, seborrheic keratoses, and freckles may also appear. Therefore, rather than insisting on a single method without an accurate diagnosis, it is essential to first assess the skin condition.
Why Melasma Treatment is Tricky
Which melasma treatment laser is best? The important thing here is to first consider the characteristics of melasma. Melasma often involves pigment spread deep within the skin layers and is not confined to one spot but distributed across the entire face.
It can also appear mixed with various other blemishes, making the treatment of widespread pigment issues on the face quite challenging and difficult.
It is reported that treating melasma with multiple low-energy laser sessions, rather than a single high-energy session, is safer and helps achieve more even improvement.
How Does PicoWay Laser Work on Pigment?
Treatment with multiple low-energy sessions is more beneficial than a single, high-energy laser session. The PicoWay Laser is a device that has recently gained attention; PicoWay is an ultra-short pulse pigment laser that operates in picosecond units.
It is designed to deliver high-energy in a short time, one trillionth of a second, rapidly breaking down pigment while minimizing thermal damage to skin tissue. For sensitive pigment like melasma, it is crucial to reduce skin irritation and finely shatter melanin. Therefore, melasma treatment lasers often require many sessions. Increasing the intensity excessively can destroy melanin itself, potentially causing hypopigmentation, so caution is needed.
In the clinic, we often see patients who desire strong output to remove melasma quickly. However, we always emphasize that for melasma, a slower approach is ultimately safer.
If you have any questions, inquire via chat consultation about melasma treatment
One Device for Various Pigment Issues
PicoWay can utilize multiple wavelengths with a single device, making it suitable for complex pigment issues such as melasma, blemishes, Nevus of Ota, and post-inflammatory hyperpigmentation. The ability to adjust the appropriate wavelength according to individual skin condition and melasma depth is also an advantage.
If you wish to manage skin tone evenly along with pigment treatment, combining it with a Customized Whitening Solution can also be considered.
| Category | Topical Whitening Agent | PicoWay Laser |
|---|---|---|
| Depth of Action | Primarily epidermal layer | Epidermal and dermal layers |
| Speed of Change | Relatively slow | Reported to be relatively fast |
| Scope of Application | Localized areas | Pigment across the entire face |
| Recommended Method | Standalone use | Multiple fractional treatments |
How Many Treatments Are Needed?
Melasma treatment lasers typically involve 10 or more treatments at intervals not exceeding 2 weeks. The number and interval of sessions are adjusted according to the individual's melasma condition. In the case of PicoWay, combining it with whitening or calming care to aid skin regeneration is reported to help achieve more even improvement. When skin calming is needed after the procedure, hydration and regeneration procedures like Water-Luminous Injection may also be considered.
Essential Post-Treatment Care
Melasma laser treatment should not be neglected once improvement is seen. Melasma is a skin problem that can easily recur due to small daily irritations such as UV exposure, stress, and hormones. Consistent care is needed even after the procedure; please pay attention to the following:
- Apply sufficient sunscreen before going out and reapply every 2-3 hours.
- Reduce direct sun exposure with hats or parasols.
- Avoid rubbing or irritating massages on the skin.
- Maintain hormonal balance with sufficient sleep and stress management.
- Discuss and follow treatment intervals and home care methods with your medical team.
For some, melasma can be more than just a cosmetic issue, affecting self-confidence. As it is a sensitive pigment problem, it is crucial to consult with a dermatologist experienced in melasma treatment and establish a melasma treatment laser plan tailored to your skin condition.
Start your melasma treatment consistently, gently, and tailored to your skin. As your skin brightens, your expression and mood can also become much brighter.
Chief Director Lee Sang-joo (MD, PhD, Yonsei University College of Medicine and Graduate School; Resident in Dermatology, Severance Hospital; President of the Korean Dermatological Association) Chief Director Lee Sang-joo's Profile First published 2025-07-11 / Last reviewed 2026-06-16
The results of melasma treatment may vary depending on individual skin conditions, and an accurate diagnosis and treatment plan should be determined through consultation with medical staff.