The Difference Between Melasma and Lentigo, and the Criteria for Choosing PicoWay and RePott Lasers

Many people tend to broadly categorize dark facial pigmentation as melasma or blemishes.

However, melasma and lentigo are distinct pigmentary disorders, differing in their causes, location within the skin layers, and treatment methods. Choosing a laser that isn't suitable for the type of pigmentation can worsen symptoms or increase the risk of recurrence, so the first step before treatment is to identify the type of pigmentation you have.

Melasma is a pigmentary disorder characterized by brown or grayish patches, significantly influenced by hormonal changes. Pregnancy, oral contraceptives, and hormone therapy are primary contributing factors, with sun exposure, stress, and genetic factors also playing a role. Melanin pigment often penetrates deep into the dermal layer, and it appears as a complex interplay of vascular dilation, hormones, and UV radiation.

Its characteristic appearance includes:

• Symmetrical distribution on both sides of the face
• Blurry, widely spreading patches
• Spreading across the entire face, including cheekbones, cheeks, forehead, and jawline
• Frequent recurrence

Lentigo is a pigmentary disorder caused by sun exposure and aging. It typically presents as distinct, round spots, approximately 1 cm in diameter, sometimes appearing as coin-sized patches of 2 cm or more. Unlike melasma, lentigo often appears on only one side and can occur not only on the face but also on sun-exposed areas like the back of the hands and shins. Melanin pigment and melanocytes proliferate primarily in the epidermal basal layer. Even with conventional removal methods, there is a possibility of recurrence as the epidermis regenerates. More information on melasma can be found under Melasma·Blemishes·Hyperpigmentation, and on lentigo under Lentigo·Nevus·Spots.

Melasma is a complex disorder where pigment is deeply deposited in the dermis, often accompanied by vascular dilation. Therefore, strong thermal stimulation can activate melanocytes, potentially leading to darker pigmentation or recurrence.

PicoWay Laser delivers energy in picosecond units, shorter than traditional nanosecond methods, finely fragmenting pigment particles. It works by minimizing thermal damage to surrounding healthy skin and aiding recovery, thus offering a less burdensome approach for melasma, which is sensitive to irritation. Pico toning, which involves repeated low-energy irradiation, is used to treat lesions without forming scabs. Information on pigment toning treatments can be found under Pico·Dual·Gold-Diamond Toning.

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RePott Laser is a device that has recently gained attention for lentigo treatment. It is characterized by precisely delivering energy only to the lesion while minimizing damage to healthy skin. It uniformly treats the depth where the pigment is located, regardless of the amount of pigment in the lesion, and induces a wound healing response.

The operation of the RePott Laser can be summarized as follows:

• Melanin pigment selectively absorbs energy, converting it into heat, and breaking down the pigment.
• Vascular supercooling technology protects capillaries and mitigates the risk of post-inflammatory hyperpigmentation.
• Technology that automatically adjusts energy according to pigment density is applied.
• Relatively uniform energy delivery from the basal layer to the dermal layer.
• After treatment, pigment is cleared along with scabs during a 2-3 week regeneration process.

Both melasma and lentigo are difficult to completely disappear naturally. Melasma often involves pigment in the dermis, so simple pigment removal alone may not yield satisfactory results. Lentigo also tends to darken over time due to the proliferation of melanocytes in the basal layer. In clinical practice, it is common to see a mix of melasma and lentigo on the same face, making it challenging to approach with a single device. Since pigmentation can easily worsen with continuous UV exposure or repeated irritation, consistent sun protection must be combined with laser treatment. Epidermal Pigment Removal for blemishes, lentigo, and freckles may also be considered depending on the condition.

Even if they look similar, melasma and lentigo have different causes and locations, requiring different equipment and methods. PicoWay Laser is used for melasma to approach dermal pigment with less burden, while RePott Laser is used for lentigo to precisely treat basal layer pigment. Even for the same pigmentary disorder, the response and number of sessions required can vary depending on the depth of the lesion and individual skin condition. Therefore, it is safer to confirm the type of pigmentation through a consultation rather than self-diagnosing and choosing equipment.

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Lee Sang-Joo · Board-Certified Dermatologist

This article was reviewed by Lee Sang-Joo, the chief director of Yonsei Star Dermatology Sinchon. He has extensive experience in treating pigmentary disorders and scars, and in 2026, he serves as the president of the Korean Dermatological Association and an adjunct professor at Yonsei University College of Medicine, Department of Dermatology. More details on his background can be found in Dr. Lee Sang-Joo's Profile.

First published 2026-06-22 / Last reviewed 2026-07-23

Treatment methods and outcomes may vary depending on symptoms and individual skin conditions, so it is recommended to plan after a consultation with a board-certified dermatologist.