"I came in to get rid of melasma, so why are you telling me toning alone won't do it?"
"Aren't blemishes and melasma the same thing? Just take it all off in one go, please."
These are the kinds of things people who come in for pigmentation say all the time.
Hello, I'm Director Kwon Si-jin & Yoon Ju-hyun at DA Clinic Myeongdong ^^
We're getting ready to open our doors in Myeongdong soon, and since so many people have been asking about pigmentation treatment ahead of our opening, we wanted to put together this overview for your information first.
Let me start with the bottom line. Pigmentation isn't one single thing — each type is a different kind of 'stain', so working out which type it is matters before the device does.
Read this for just 3 minutes and you'll see the standards worth keeping in mind, wherever you have it done.
Pigmentation Isn't Just One Type
Melasma, blemishes, freckles, age spots, lentigines. We tend to lump them all together under the single word 'pigmentation', but they're really different kinds of stains.
A stain on your clothes needs a different washing method depending on whether it's coffee or oil, right? Pigment works the same way ㅎㅎ
Blemishes that sit shallowly in the epidermis fade relatively quickly, but melasma, which spans both the epidermis and the dermis in a complex way, is a concern of a different nature.
So even on the same face, even for the same 'thing that looks like melasma', working out what it actually is needs to come before deciding which device to use.
First, Melasma Is About 'Management', Not a 'Cure'
Many people come in expecting, "A few rounds of laser and the melasma will be gone."
But melasma is a chronic pigmentation tangled up with UV exposure, hormones, and constitution, so it's closer to the idea of fading it gradually in stages than removing it all at once.
The laser toning DA Clinic Myeongdong is bringing in uses a 1064nm Q-switched Nd:YAG, delivered evenly at a relatively low output, so it breaks melanin down slowly over several sessions rather than strongly all at once.
Usually the change becomes clearer when you build up 5–10 sessions at intervals of 2–4 weeks, and even after that, care such as UV protection determines the outcome. (Results may vary by individual)
Second, More Power Isn't Always Better
You think, since you're having it done anyway, it'd be nice to fire it hard once and get it out quickly.
But pigment lasers aren't a treatment where the effect improves in proportion to how much you crank up the power.
Too low and the pigment doesn't come out well, but too high and you can actually get more pigment — what we call post-inflammatory hyperpigmentation (PIH).
So what matters isn't unconditionally high intensity, but finely adjusting the output at each session to match the depth of the pigment and the thickness and sensitivity of the skin. This is exactly the point where the results diverge even when the same device is used.
Third, Toning and Pico Have Different Roles
People often ask whether toning is better or pico is better. But these two aren't about which is superior — they have different uses.
Toning, with its nanosecond (ns) pulse, is strong at gradually refining pigment, while the pico laser breaks pigment down into finer particles with an even shorter pulse of one trillionth of a second (picosecond, ps).
When the pulse is short, there's less thermal damage to surrounding tissue, so pico is often the better fit for dark or deep pigment and tattoos.
It's like grinding a stain down into fine grains like sand so the body can clean it up naturally — and in the end, the key is a design that first works out which pigment it is, then blends toning and pico appropriately.
Honestly, We Don't Recommend It for These Cases
A pigment laser isn't the answer for every stain.
In particular, if you try to remove lentigines (the age-spot family) with a strong laser when melasma was actually present alongside them, the pigment can end up rising even more.
So even when something looks like lentigines, you first have to work out whether melasma is mixed in, and in that case we think it's right to shift direction toward toning or melasma management rather than a strong treatment.
Those who are pregnant or breastfeeding, or taking photosensitizing medication, are also safer to postpone the treatment and consult first. Rather than reaching for the laser no matter what, knowing what your pigment actually is comes first.
Frequently Asked Questions
Q. Can melasma be completely removed with laser?
A. Melasma is less a pigment you remove completely in one go, and more one you manage gradually in stages. Since it's a chronic change tangled up with UV exposure, hormones, and constitution, we approach it by breaking melanin down slowly over several sessions with laser toning. Usually the change becomes clearer when you build up 5–10 sessions at intervals of 2–4 weeks, and the effect accumulates when you use a brightening agent along with UV protection. That said, it can rise again if you stop the care, so please understand it as a treatment that also involves ongoing maintenance. Do keep in mind that how much you notice differs from person to person.
Q. Between toning and pico, which is better?
A. Toning and pico aren't about better or worse — they're treatments with different roles. Toning, with its nanosecond pulse, is strong at gradually refining pigment, while the pico laser breaks pigment down into finer particles with an even shorter picosecond pulse, so it's often the better fit for dark or deep pigment and tattoos. So it's not about which is better, but about designing how to divide the two appropriately depending on what type your pigment is and how deep it sits. DA Clinic Myeongdong is equipped with both toning and pico, and we plan to choose and guide you to the suitable method after diagnosis.
Q. Can I go back to daily life right after a pigmentation treatment?
A. If the pigment laser is a treatment received at lowered output like toning, there's almost no downtime — even if there's slight redness right after the treatment, it usually settles within an hour or two and light makeup is possible too. That said, treatments that strongly remove blemishes or age spots go through a process where a scab forms for a few days and then falls off naturally. In either case, applying sunscreen thoroughly after the treatment, and for a few days postponing activities that apply a lot of heat such as saunas and jjimjilbangs, helps reduce pigmentation. Even if flaking occurs, please don't force it off and keep it well moisturized.
In Closing
If I sum up today's content in one line, it's this.
With pigmentation, it's the 'diagnosis that works out which pigment it is' and the 'appropriate output and staged management' that make the result — more than 'which device'.
This isn't an article recommending a treatment, but an informational article we've put together for your reference while preparing to open.
DA Clinic Myeongdong is set to open soon. We'll share news of our opening and treatment information first on our blog and Instagram ^^
Thank you for reading to the end. This was Director Kwon Si-jin & Yoon Ju-hyun at DA Clinic Myeongdong.
This column is an informational article intended to provide general medical information; the effects and side effects of treatments may vary by individual. DA Clinic Myeongdong is set to open soon. (Medical Service Act Art. 56)