Melasma Laser at Kind Global Clinic Myeongdong is PicoCare 1064 nm picosecond low-fluence laser toning, layered with oral tranexamic acid, topical depigmentation and strict SPF 50+ photoprotection for chronic relapsing epidermal, dermal and mixed-type melasma in Fitzpatrick III to V skin — performed personally by co-directors Dr. Lee Wonjin or Dr. Lee Kangin.
Melasma is a chronic relapsing pigmentary disorder driven by hyperactive melanocytes that respond to ultraviolet light, visible light, heat and hormonal triggers. It presents as symmetric brown to grey-brown patches across the malar cheeks, forehead, upper lip and chin and predominates in women of Fitzpatrick III to V skin. Laser monotherapy is rarely sufficient because the pathology spans melanocyte signaling, vascular contribution and basement-membrane disruption — which is why Kind Global Myeongdong uses laser as one pillar within a multi-modal protocol rather than as a standalone treatment.
The laser pillar uses Wontech PicoCare picosecond Nd:YAG at 1064 nm in low-fluence toning mode (2 to 3 mJ/cm², 5 to 10 mm spot, 5 to 10 Hz repetition, 5 to 10 sessions every 2 weeks). The picosecond pulse duration (trillionth of a second) shatters dermal melanin photo-acoustically rather than relying on photo-thermal absorption alone, which produces less surrounding-tissue heating and a substantially lower rebound-melasma risk in Fitzpatrick III to V skin compared with older Q-switched nanosecond toning. Crucially, CO2 fractional and other ablative resurfacing modalities are contraindicated in melasma because the inflammation they trigger frequently worsens pigmentation.
For patients with stubborn dermal melasma that does not respond to toning plus topical alone, co-directors may add Density (Jeisys dual-mode RF microneedling delivering sequential monopolar then bipolar sub-pulses at 6.78 MHz, 400 W) to remodel the basement membrane and reduce melanocyte stimulation from disrupted dermal-epidermal junction. Adjunct pillars: oral tranexamic acid 250 mg twice daily, topical Cosmelan Peel or modified Kligman regimen, and strict SPF 50+ broad-spectrum sunscreen with iron oxide for visible light protection. Both co-directors personally manage every melasma plan — Fitzpatrick mapping, melasma type (epidermal vs dermal vs mixed), trigger history, oral contraceptive and pregnancy status, and baseline MASI score are charted at the consultation.