What causes melasma?

Melasma is a chronic skin condition that causes symmetrical brown or gray-brown patches, most often on the cheeks, forehead, nose and upper lip. It happens when pigment cells become overactive and produce too much melanin. It is far more common in women and in medium skin tones, including many East Asian, South Asian, Middle Eastern and Latin American people. The main triggers are:

Sun and visible light: UV and visible sunlight darken patches, even through windows
Hormones: pregnancy, the contraceptive pill and hormone therapy
Heat: saunas, hot yoga and heat-based treatments can make it worse
Genetics: it often runs in families

How melasma is assessed

At Dernia Clinic Myeongdong, your doctor examines the pattern and depth of pigment, often with a skin analysis camera. Melasma may sit in the upper skin (epidermal), deeper (dermal) or both (mixed), and deeper pigment responds more slowly. Your doctor also asks about hormones, medicines, sun habits and past treatments, since these shape the plan. It is also important to rule out look-alikes such as sun spots, freckles and Hori's nevus, a deeper pigment condition common in East Asian skin that needs a different laser approach. Our guide to melasma vs freckles vs sun spots explains the differences.

Treatment options for melasma

Melasma is managed, not cured. The goal is to lighten patches gradually while keeping pigment cells calm, because aggressive treatment can trigger rebound darkening.

Pico Toning

Pico toning uses a picosecond laser at low energy to break pigment into tiny particles that the body clears. Because the pulses are extremely short, it delivers less heat than older lasers. Your doctor often chooses it as the main laser for melasma, as a series of 5–10 sessions spaced to suit your skin. Many people notice gradual brightening after three to five sessions.

Laser Toning

Laser toning passes a low-fluence Nd:YAG laser evenly over the face. It has been used to manage melasma in Korea for many years. Your doctor chooses it as a gentle, lower-cost option or for maintenance, also as a series. Like pico toning, it is kept at low energy to avoid irritating pigment cells.

Comparing your options

Treatment	Best when	Downtime	From price
Pico Toning	Main laser for most melasma	None to mild redness	₩69,000 (1 session, full face)
Laser Toning	Gentle, lower-cost option or upkeep	None	₩49,000 (1 session, full face)

Prices are in Korean won (KRW), exclude 10% VAT, and are confirmed at your consultation. You can compare every treatment on our price list.

Combination plans and medical skincare

The best results usually come from combining gentle toning with daily skincare. Your doctor may discuss prescription options such as lightening creams, or oral tranexamic acid, which is not suitable for everyone, for example people with a history of blood clots. Soothing treatments such as LDM help calm the skin after laser. Read our melasma treatment options in Korea guide and pico vs laser toning.

What we avoid

Strong heat-based treatments, high-energy lasers and IPL can inflame pigment cells and make melasma darker. Over-treating with toning can also cause white spots, known as mottled hypopigmentation. That is why sessions are spaced out and energy is kept low, and why your doctor may pause treatment if your skin reacts.

At-home care and prevention

Wear broad-spectrum SPF 50 every day; a tinted sunscreen with iron oxides also blocks visible light.
Reapply every two to three hours outdoors and wear a wide-brimmed hat.
Avoid saunas, steam rooms and very hot water on the face.
Use gentle skincare and skip harsh scrubs and peels that irritate.

Planning treatment during a trip to Seoul

Pico and laser toning have little or no downtime, so you can sightsee the same day. A short trip allows only one or two sessions, which is a start rather than a full course. Even after a single session, protect your skin strictly for the rest of your trip. Your doctor can set up a plan to continue at home; see how many pico toning sessions you need. Book a consultation to have your pigment assessed.

When to see a doctor

A single dark patch that is growing, uneven in color or raised is not typical melasma and should be examined. Melasma that starts in pregnancy often fades afterward. Laser treatment and some prescription creams are usually postponed until after pregnancy and breastfeeding, so tell your doctor if you are pregnant, nursing or taking hormonal medication.

Can melasma be cured?

No. Melasma is a chronic condition, but it can be lightened and kept under control. Most people need ongoing sun protection and occasional maintenance sessions.

How many toning sessions will I need?

Most people need a series of 5–10 sessions, followed by maintenance. See how often you should do pico toning for typical intervals.

Is pico toning better than laser toning for melasma?

Both can work. Pico toning delivers less heat per pulse and may clear pigment with fewer sessions for some people, while laser toning is a gentle, lower-cost option. Your doctor chooses based on your skin.

Will melasma come back after treatment?

It can, especially after sun exposure, heat or hormonal changes. Daily sunscreen and gentle skincare are the most important ways to keep it controlled.

What should I avoid after pico toning?

Avoid sun, saunas, harsh exfoliants and scrubbing for a few days. Read what to avoid after pico toning for a full list.

Related treatments

Pico toning — low-energy picosecond laser
Laser toning — gentle Nd:YAG toning
LDM Water Drop — soothing after laser

Prices and results

Pico toning price — cost per session and course
Pico toning results — how pigment fades over a series
Laser toning results — what to expect

Guides

Melasma treatment options in Korea — a fuller overview
Pigmentation types explained — melasma vs freckles vs sun spots
Sun protection after toning — keeping results

Related concerns

Sun spots and age spots — defined spots from UV damage
Uneven skin tone — mixed pigment and redness

Dernia Clinic Myeongdong

Melasma Treatment in Seoul