"Is this a mole or melasma? I've got a brown spot with a sharp border."
"Does lentigo come off in a single laser session?"
These are things people who feel that clear brown spots have increased on their face or the backs of their hands often ask.
I'm Director Kwon Si-jin — we'll be seeing you in Myeongdong soon ^^
We're getting ready to open our doors in Myeongdong soon, and since so many people have been asking about lentigo ahead of our opening, we wanted to put together this overview for your information first.
I completely understand the frustration of not being able to tell whether it's a mole or melasma.
Assuming it's freckles and leaving it can backfire. With lentigo, confirming 'what it is' matters more than anything. Let me state clearly why identification comes first.
Lentigo Is a Benign Pigmented Patch With a Sharp Border
Let me first lay out what lentigo is.
Lentigo is a benign pigmented patch formed when melanin pigment gathers in one area, and it usually appears as a brown spot with a sharp border and uniform color.
Representative kinds are solar lentigo, which forms on areas long exposed to UV light, and senile lentigo, which increases with age (what's commonly called "age spots").
If melasma has a blurry border and a sense of spreading widely, lentigo often looks more like a distinct spot.
That's why, even for the same brown, melasma and lentigo call for different approaches.
Why 'Distinguishing' Comes Before Removal
With lentigo, what matters most is actually not the type of laser but 'confirming what it is first.'
Most lentigines are benign, but rarely, pigment that's irregular in shape, color, or border, or that keeps changing, may be a different lesion.
So for pigment that grows in size, is uneven in color, or has an irregular, spreading border, a diagnosis to distinguish what kind of lesion it is comes before removing it heedlessly.
Because even for brown spots that look similar on the surface, when the cause is different the approach changes completely.
This part is a matter of safety rather than cosmetics, so please be sure to take it into account.
The Laser Lightens the Pigment in Stages
For a benign lentigo confirmed after distinguishing it, the pigment can be gradually smoothed out with a laser.
When the laser finely breaks up the pigment, your body clears the particles out, and the color fades in the process.
Lentigo sitting toward the surface tends to respond relatively well, but for deep or thick cases it may need to be split over several sessions.
For a few days after the treatment, the color may look darker or fine scabs may form, and as they flake off, the color fades.(the degree of response varies by individual)
They Can Recur, and Pushing Too Hard Is a No
It's hard to see lentigo as finished just because you've tidied it up once.
As UV exposure accumulates, new lentigines can form in the same area or elsewhere.
So even after the laser, consistent sun protection is important.
Also, trying to do it strongly in one go to get rid of it quickly can trigger a reaction where the pigment deepens from irritation, or add a scarring burden, so splitting it into moderate-intensity sessions is often the safer path.
Records tell them apart better than the eye
Solar lentigines have a clear border, which makes them easy to confuse with freckles and moles.Yet these three differ in how they're handled and how they recur.
So checking before you start comes first.Since the eye alone often struggles to separate them, we use Eve-V's pigment mode to divide them by depth, and Photo Manager to keep records at the same angle under the same lighting.
There are two reasons for the records.One is to compare change, the other is to check whether the size or colour has shifted.If any lesion has changed shape or colour recently, please do mention it.Anything that has changed needs checking before removal.
In These Cases, Take a Closer Look First
Lentigo laser treatment isn't casually recommended in every situation.
As mentioned, pigment that changes in shape, color, or size, or has an irregular border, calls for a distinguishing diagnosis first.
If your skin is freshly sunburned, if you're taking photosensitizing medication, or if there's inflammation at the treatment area, it's safer to postpone and consult.
If you have a keloid-prone constitution or tend to develop hyperpigmentation, the intensity and interval need to be set more carefully, so it helps to share your skin's reactions in advance.
How the days after the treatment run
- The day itselftemporary redness or warmth is possible, generally settling within the day
- 2 to 3 daysfine flaking or a thin scab may form
- 1 to 2 weeksthe period where it comes away naturally and fades
The most common mistake here is picking at the flaking.Forcing it off makes a mark likely.
And missing sun protection in this period can bring pigment back to a site you worked hard to lighten.These few weeks sometimes shape the result more than the treatment did.
- Before the removal method, telling it apart comes first
- We start after it is confirmed benign
- They are faded and refined in stages
FAQ
Q. How are lentigo, age spots, and melasma different?
A. Lentigo refers to a benign pigmented patch with a sharp border and uniform color, and the senile lentigo that increases with age is commonly called age spots.In other words, age spots can be seen as a type of lentigo.Melasma, on the other hand, has a border that blurs and spreads, gives a sense of spreading widely, and tends to be trickier because hormones, heat, and UV light act on it in combination.If lentigo is distinct like a spot, you can picture melasma spreading like a mist, which makes it easier to grasp.Because the laser response and approach differ by type, distinguishing what kind of pigment it is comes before removal.
Q. Does lentigo come off in one laser session?
A. Benign lentigo sitting toward the surface tends to respond relatively well, but if the pigment is deep or thick, it may not be fully tidied up in one go and may need to be split over several sessions.The laser works by finely breaking up the pigment so your body clears it out, so the pace changes with depth.Also, applying overly strong energy in one go can deepen the pigment from irritation or add a scarring burden, so splitting it into moderate-intensity sessions is safer.The pace and degree of fading vary by individual.
Q. How do I keep them from coming back after treatment?
A. Lentigo is closely tied to accumulated UV exposure, so sun protection after treatment is the most important care.Applying sunscreen thoroughly and also blocking with a hat or parasol helps slow the pace at which new lentigines form.Don't force off the scabs at the treatment area; leaving them to fall away naturally reduces the scarring burden. That said, even with good UV management, new pigment can form due to constitution and aging, so it's easier on the mind to see this as an area closer to 'managing and maintaining' than 'remove once and done.'
Q. Can't it be cleared in one go?
A. Going in hard once may break the pigment, but the surrounding skin takes the stimulation too.That stimulation can come back as new pigment, so approaching it across sessions turns out faster.
Q. If it comes back, has it failed?
A. No. Pigment can be made anew by sun and time, so it's hard to see this as a one-and-done concept. It's closer to management.
Q. It looks darker after the treatment — is that all right?
A. There's a period where pigment rises to the surface and looks darker for a time. If it only ever darkens, though, the intensity or method may not have suited, so it's safer to have it checked where you had it done.
Q. If I have freckles too, are they treated together?
A. The depth and nature differ, so the approaches diverge.They're sometimes handled on the same day, but it's safer to set the intensity and method separately.Running both on one setting puts strain on one of them.
Q. Can it be done on the backs of the hands rather than the face?
A. Lesions on the hands and arms are sometimes treated.Recovery there is known to be slower than on the face, so allow a little more time for it.
Identify before removing
In the end it all gathers into this one sentence.
Lentigo is a pigment where 'distinguishing what it is first' matters more than how you remove it, and once it's confirmed benign, you gradually smooth and lighten it in stages.
This is my answer to the question you came in with.
If a distinct brown spot has been bothering you, it's good to start by confirming what kind of pigment it is rather than removing it. Please also keep in mind that the result and how well it holds vary by individual.
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 your time today.This was Director Kwon Si-jin at DA Clinic Myeongdong.
This column is an informational article meant to provide general medical information, and the effects and side effects of treatments may vary by individual. DA Clinic Myeongdong is set to open soon. (Medical Service Act Art. 56)