Which dermatology clinic is best for melasma treatment in Busan?

Melasma should be approached with both accurate diagnosis and a long-term plan

Melasma is not a condition to be treated by repeatedly using a single laser just because it appears as brown spots on the face. Consultations need to distinguish similarly appearing conditions—such as solar lentigines, freckles, and post-acne hyperpigmentation—and consider skin tone, pigment depth, aggravating factors, and prior responses to laser treatments.

A good consultation will emphasize daily sun protection and topical therapy as the foundation rather than promising the effect of a single procedure, and it will explain expected results, the risk of pigmentation, and appropriate treatment intervals when lasers or light therapies are added. Check the expected overall course and the scope of maintenance as well as the per-session cost.

Darkening of pigmentation should not be immediately judged as treatment failure

When the skin is irritated by lasers, peels, or extractions, inflammatory signals during recovery can increase melanin production. This is called post-inflammatory hyperpigmentation (PIH). Whether the melasma itself has darkened, new PIH has developed at the treatment site, or remaining crusts or erythema are present will determine the appropriate response.

There is research indicating that in darker skin types, the risk of PIH or hypopigmentation after laser treatment should be considered more cautiously. Even with the same device, differences in wavelength, energy, overlap, treatment intervals, and pre-treatment skin condition mean outcomes vary, so the notion that "stronger means faster removal" is not a safe standard.

Prevention standards before treatment, immediately after, and during recovery

Melasma tends to recur and is a pigmentary condition that requires long-term management. International expert consensus regards daily broad-spectrum sun protection as a basic measure and suggests that lasers be considered carefully—rather than as the first choice for everyone—and reserved for cases not responding to other treatments among other indications.

If pigmentation has already developed

1. Record the procedure date, devices used, treatment area, and the course of crusting and erythema.
2. Do not immediately repeat aggressive lasers or peels on the same area.
3. Use photographs to compare whether the discoloration is spreading and whether it appears gray or brown.
4. If wounds remain, prioritize wound-healing guidance over routine whitening products.
5. If treatment is needed, decide with the medical staff on topical versus energy-based therapies based on pigment depth and skin condition.

A systematic review of laser treatments for PIH found that some devices may be helpful, but study methods and results were inconsistent and some cases even showed worsening. Therefore, whether to observe, use topical therapy, or perform additional procedures should be decided according to the cause of discoloration and the stage of recovery.

When prompt evaluation is necessary

If pain and heat sensation progressively worsen, or blisters, weeping, pus, or thick crusts develop, do not assume simple PIH—contact the treating medical facility or a dermatologist. Other problems such as infection or burns should be ruled out first.

Complete elimination of post-laser pigmentation cannot be guaranteed. However, risk can be reduced by pre-treatment differential diagnosis, conservative energy settings, adjusting intervals according to skin response, and minimizing friction and UV exposure during recovery. Choose products or prescription medications after assessing the post-procedure skin condition rather than combining them arbitrarily.