[Doctor's Column] Melasma Returns Even After Erasing: The Real Reason It Reappears After Laser Treatment

 

Have you ever had melasma completely removed with a laser, only for it to reappear in the same spot a few months later?

Many people blame themselves, asking, "Did I manage it wrong?" However, the return of melasma is not a failure of care. Melasma is originally a 'recurring disease' This is because of this.

Today, I will summarize why melasma reappears even after being removed, and what the most scientific method is to deal with it.

 

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▶ Why is it difficult to 'completely cure' melasma?

Melasma is not simply pigment deposition. A chronic condition in which melanocytes are overactivated no see.

・ Various factors, such as ultraviolet (UV) rays, hormonal changes (pregnancy, oral contraceptives), genetic predisposition, and chronic inflammation, act in combination.

Compared to normal skin, the skin in melasma areas is accompanied by angiogenesis (increased VEGF expression) and chronic inflammation, so even if pigment is removed, conditions remain for melanocytes to be reactivated.

・ In actual studies, at the 1-year mark after low-energy laser toning treatment Recurrence in 58.8% of patients This has been observed, and there are reports that the recurrence rate within 3 months reaches 64–81%.

In other words, freckles are 'Management' is a more realistic goal than 'complete cure' no see.

 

▶ What happens if you shoot the laser 'strongly'?

One of the most common misconceptions in melasma treatment is the idea that "shooting a strong laser makes it easier to remove."

・ High-fluence lasers are actually... on melasma areas Post-inflammatory hyperpigmentation (PIH) It can cause.

・ A 2022 systematic review (J Cosmet Dermatol) also warns that the use of aggressive lasers can actually cause melasma to darken due to an inflammatory response.

・ For this reason, the recent trend in melasma treatment is Instead of 'strongly all at once,' 'steadily with low energy, in combination with other treatments' It is shifting toward a management direction.

 

▶ What treatments are helpful for managing melasma?

According to a 2023 network meta-analysis (Ma et al., Photodiagnosis Photodyn Ther), compared to laser alone Laser + Topical Therapy Combination Therapy This was significantly effective. In addition, the combination of microneedle radiofrequency (MNRF) and topical agents showed superior results compared to picosecond laser alone.

The melasma-related treatments available at our Yeonsinnae branch are summarized as follows:

 

❙ Image: Produced by Maypure Doctor Column

 

・Pico Toning : It selectively breaks down melanin by irradiating with a low-energy picosecond laser. A 2023 systematic review (Feng et al.) concluded that the 1064nm picosecond laser is safe and effective for treating melasma. The pigmentation tends to lighten with each subsequent session, although the effectiveness varies from person to person.

・Mela This is a toning program specialized for melasma and pigmentation, and consistent care is key. We will provide guidance on the treatment intervals and sessions during the consultation.

・Quadsay (Melasma Mode) This is a Microneedle Radiofrequency (MNRF) device equipped with a dedicated mode for melasma. It delivers thermal energy to the dermis while minimizing epidermal damage and is performed at 4-week intervals. An option for simultaneous skin booster injection (Quad Fusion) is also available.

・IPL / Clarity This is a procedure for managing pigmentation and redness using broadband light or long-pulse lasers.

Director Sim Dong-gyu adjusts the combination and interval of treatments according to the condition of melasma and skin type, and tracks changes session by session based on chart records from visits.

 

▶ Do you have any lifestyle habits that worsen your melasma?

In managing melasma, daily habits are just as important as treatments.

・UV protection Blocking UVA/UVB alone is insufficient. Since visible light can also worsen melasma, the use of sunscreen containing iron oxide is recommended.

・Hormone management If you are using oral contraceptives or hormone replacement therapy, please be sure to inform us during your skin consultation.

・Minimize friction Excessive rubbing or the use of scrubs during facial cleansing can cause chronic inflammation and worsen melasma.

・Maintain moisture If the skin barrier weakens, it becomes sensitive to external stimuli, and pigmentation reactions may intensify.

 

▶ Melasma: Aim for 'Management' Rather Than 'Complete Cure'

Melasma is not a condition that disappears permanently with a single treatment. However, noticeable improvement and long-term stabilization are possible by combining scientifically based low-energy laser toning with MNRF and thorough UV protection. The effectiveness and recovery period may vary depending on individual skin conditions.

 

Skin concerns vary from person to person. After a consultation, we will guide you to the most suitable treatment based on your records.

 

Chief Director Sim Dong-gyu of Maypure Clinic Yeonsinnae Branch
· Graduated from Korea University College of Medicine
· Master of Medicine, Korea University School of Medicine
· Full member of the International Society of Aesthetic Plastic Surgery
· Regular member of the Korean Society for the Study of Obesity
· Regular member of the Korean Society of Aesthetic Plastic Surgery and Laser Medicine
· Allegan Juvederm Expert Member

 

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※ This post is intended to provide general information about the procedure, and the effects and recovery period may vary depending on individual skin conditions.

※ Please be sure to consult thoroughly with medical staff before the procedure. Swelling, bruising, and redness may temporarily occur after the procedure.

 

References

1. Feng J et al. (2023). Efficacy and safety of picosecond laser for the treatment of melasma: a systematic review and meta-analysis. J Cosmet Dermatol .

2. McKesey J et al. (2020). Melasma Treatment: An Evidence-Based Review. Am J Clin Dermatol , 21(2):173-225.

3. Management of Melasma: Laser and Other Therapies—Review Study. PMC , 2024.

4. Ma W et al. (2023). Efficacy and safety of laser-related therapy for melasma: A systematic review and network meta-analysis. Photodiagnosis Photodyn Ther .

5. Gokalp H et al. (2016). Long-term results in low-fluence 1064-nm Q-Switched Nd:YAG laser for melasma. J Cosmet Laser Ther , 18(3):157-161.

 

#Yeonsinnae Dermatology #Yeonsinnae Melasma Treatment #Melasma Laser #Yeonsinnae Pigmentation Management #Melasma Management

 

📍 Maypure Clinic Yeonsinnae Branch
3rd Floor, Metro Tower, Directly Connected to Yeonsinnae Station (856 Tongil-ro, Eunpyeong-gu, Seoul)
☎ 02-389-9980
Clinic Hours: Weekdays 10:30–20:30 / Saturdays 10:00–17:00 / Closed on Sundays and Public Holidays

 

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