Non-Surgical · Melasma

Pico Laser for Melasma

A condition to control, planned with relapse in mind

Gangnam, Seoul | Board-certified plastic surgeon, Dr. Jonghwan Choi
KHIDI-registered for international patients · Apgujeong Rewind

Melasma Melasma Melasma Melasma Melasma Melasma 
Define

Melasma and pico toning

Does pico laser work for melasma? What it can and cannot do

The short answer

Pico laser toning can lighten melasma, and Rewind in Gangnam, Seoul uses the Pico K for that purpose. It does not end the condition. Melasma is chronic and tends to recur, particularly with sun exposure and hormonal change, so a course is planned as a lightening phase followed by maintenance, with the number of visits set by the doctor after examining your skin.

The research figures on this page come from studies of low-fluence Q-switched lasers, the older toning technology that the picosecond protocol grew out of. They were not carried out at Rewind and do not predict an individual result.

Melasma is the brownish-grey patching that settles symmetrically over the cheeks, forehead, upper lip or jawline. It arises from a mix of sunlight, hormones and skin primed to overproduce pigment, so it often appears or deepens with pregnancy, hormonal contraception or a summer spent outdoors. Treating it with a laser means calming that overproduction without provoking more of it.

That last point shapes everything below. Heat and inflammation can make melasma darker, so the laser approach used for it is gentle, repeated and conservative. A pico toning plan for melasma moves more slowly and cautiously than one for freckles, and the maintenance conversation starts at the first appointment.

Dr. Jonghwan Choi assessing a patient's skin at the consultation desk
Fig. 01 — Melasma is confirmed and mapped at the desk, and mixed pigment changes the plan
Pattern

Where it shows

Melasma patterns mapped when a pico toning plan is drawn up

Where melasma sits, and what sits alongside it, decides how the passes are distributed and how cautiously the course begins.

pattern 01
Cheekbone patches
The most familiar pattern: broad, mirror-image patches over both cheeks that deepen after time in the sun.
pattern 02
Forehead and temples
Wider and sometimes fainter patches across the brow, easily mistaken for an uneven tan.
pattern 03
Upper lip
A shadow above the lip that is frequently hormonal and reacts readily to heat and friction.
pattern 04
Mixed with other pigment
Melasma overlaid with freckles or sun spots. Each element responds differently, so the plan is built around the melasma.

Not every brown patch is melasma. Raised spots, marks that have changed in shape or colour and pigment that bleeds are examined as lesions and are not toned; the mole removal page explains that route.

Data

What the studies show

What published melasma research says about low-energy laser toning

Four studies from the reference list below frame realistic expectations. All used low-fluence Q-switched lasers; picosecond toning follows their protocol, and the same caution carries over.

01Improve

Measurable lightening in the short term

Among 34 melasma patients given a low-fluence 1064-nm laser for a median of eight sessions two weeks apart, the average severity score fell from 6.7 to 3.2, and 20 of the 34 rated their melasma at least half improved when treatment ended.

02Relapse

Recurrence was common a year on

In that same group, melasma had recurred in 20 patients one year after the final session, and the average score had climbed back from 3.2 to 5.8. The authors judged long-term recurrence to be high. That finding is why Rewind describes melasma treatment as management.

03Combine

A second modality sped lightening but did not stop relapse

A split-face trial in 20 women with mixed-type melasma gave five weekly low-fluence sessions to the whole face and added intense pulsed light to one side. Lightness improved by 55 percent on the combined side and 37 percent on the laser-only side, and recurrence still appeared on both.

04Mechanism

Less pigment made, the same number of pigment cells

Biopsies from eight Korean women whose melasma improved after a series of low-fluence treatments showed fewer melanosomes and lower levels of pigment-making proteins, while melanocyte numbers were unchanged. The authors warned that repeated low thermal energy may harm those cells and leave lasting pale spots.

Energy-device session in a treatment room at Rewind Plastic Surgery
Fig. 02 — Settings for melasma start conservative and move only as the skin allows
Rewind

Approach

How Rewind plans pico toning for melasma

Each of these three decisions follows directly from the relapse and mottling findings above.

01Confirm

Melasma is confirmed first

Melasma, sun spots and marks left by inflammation can share one cheek. Dr. Jonghwan Choi, a board-certified plastic surgeon, works out which is which, because energy that suits a freckle can aggravate melasma lying next to it.

02Pace

Gentle settings and generous spacing

Scattered pale spots are the recognised complication of repeated low-energy toning in melasma. The plan favours conservative energy, gives the skin time between visits, and slows further at the first sign of uneven lightening.

03Maintain

Maintenance is discussed from day one

Given the relapse data, the consultation covers what happens after the lightening phase: daily sun protection, what to watch for, and when a top-up visit might be worth considering.

Dr. Jonghwan Choi discussing a treatment plan with a patient at Rewind Plastic Surgery
Fig. 03 — The relapse conversation takes place at the first consultation
Room

Melasma visit

A melasma toning visit at the Gangnam clinic

Private room on the treatment floor at Rewind Plastic Surgery

Fig. 04 — A private room for toning on the fourth and fifth floors

Private waiting room at Rewind Plastic Surgery, Apgujeong

Fig. 05 — Waiting room on the treatment floor

Each melasma visit starts by comparing the patches with the previous record under the same clinic lighting, so that slow change is not missed. Makeup is removed, eye protection goes on, and low-energy passes are made across the affected zones on the Pico K. Most patients feel light, rapid tapping and some warmth, and the skin is usually pink afterwards.

Pico K, 300-picosecond pulse at 2.9 W
Low-energy passes over melasma zones
Progress compared visit to visit
Eye protection throughout
Plan slowed at signs of pale mottling
Sun protection reviewed every visit

The clinic occupies the fourth and fifth floors of the Richro Building in Gangnam, Seoul, and sees patients by appointment on Monday, Tuesday, Wednesday and Friday from 10:00 to 19:00 and on Saturday from 10:00 to 16:00. Numbing arrangements and visit length are decided in the room and are not listed on this page.

Rates

Pricing

Pico toning rates for a melasma course

Melasma is treated with standard toning sessions, so the first line below is the one a melasma plan is built from. The fractional line is included for completeness; it is aimed at texture and scarring.

Pico toning, single sessionThe session a melasma course is made of
₩150,000
Pico fraxel, single sessionFractional mode, used for texture complaints
₩300,000

A melasma course total is the session rate multiplied by the visits agreed after examination, plus VAT. Because relapse is common, ask at consultation how occasional maintenance visits would be charged, so the longer-term cost is visible from the start.

Both rates are list prices with VAT added at payment, and both include numbing preparation.

Fit

Suitability

Who pico toning for melasma suits, and who should wait

Usually a reasonable plan

  • Melasma confirmed at examination, in someone prepared to manage it long term
  • Patients already using daily sunscreen and willing to add hats and shade in summer
  • People able to attend a series of visits, or to continue with a clinician at home
  • Melasma that has not settled with sun protection and topical care alone

Reasons the doctor may ask you to wait

  • Pregnancy or the months after giving birth, when melasma is often still changing; timing is discussed first
  • A recent tan, sunburn, or an outdoor holiday planned straight after treatment
  • Pale mottled spots from earlier toning with a previous provider
  • An expectation that one visit, or one course, will end melasma
  • Active infection or irritation over the patches
After

Between visits

Keeping melasma quiet between pico toning visits

The four points on Rewind's laser aftercare sheet matter more for melasma than for most pigment, because heat and ultraviolet light are among its triggers.

Straight away
Redness can show
Short-lived redness after the laser is expected, according to the clinic's sheet. Resist scrubbing it away.
Same day
Stay cool
Sauna, jjimjilbang and sweaty workouts are avoided. For melasma, heat is a trigger as well as an irritant.
Next days
No rubbing
Massage and strong stimulation of the treated area are ruled out while it settles.
Every day
Sunscreen outdoors
Sunscreen whenever you go outside, with shade where you can find it. The long-term relapse reported in the studies is why this step is not optional.

Reactions worth naming are redness, mild swelling, temporary darkening of melasma after irritation, and mottled pale spots after repeated sessions, which case reports describe as scattered white marks inside the melasma patch. A new pale area, a patch that grows darker, or discomfort lasting beyond the day should be reported to the clinic before the next visit.

Doctor

Professional

At Rewind, one board-certified plastic surgeon carries every case — from the first consultation to the final follow-up. Because a face is a story, and a story deserves a single author.

Dr. Jonghwan Choi, board-certified plastic surgeonRewind,
Dr. Jonghwan Choi presenting at an academic session
Fig. 06 — Academic presentation, thread-lifting session

Rewind's Doctor

Dr. Jonghwan Choi Medical Director

One surgeon, from the first
consultation to the last follow-up.

A board-certified plastic surgeon devoted to anti-aging lifting — with the precision and restraint built through years of craniofacial practice.

Board-certified plastic surgeon (Plastic Surgery)
10 peer-reviewed publications
Medical Director, Rewind Plastic Surgery
Korean Society of Plastic & Reconstructive Surgeons
Former chief director, Apgujeong Y&T Plastic Surgery
Korean Society for Aesthetic Plastic Surgery
J Craniofac Surg · JKMS · Arch Craniofac Surg
Korean Cleft Palate-Craniofacial Association
Voices

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Ask

Questions

Melasma and pico laser: patient questions

Does pico laser work for melasma?
It can lighten it. Low-energy laser toning has reduced melasma severity scores in published studies, and picosecond toning uses the same gentle, repeated approach. It does not remove the tendency to melasma, so the realistic goal is visible lightening followed by control with sun protection and occasional maintenance.
How many pico toning sessions does melasma usually need?
Melasma generally needs a longer series than freckles, and Rewind fixes the figure only after examination. In published research on low-fluence toning for melasma, one trial ran five weekly treatments and another ran between six and ten at fortnightly intervals. Plan also for occasional maintenance, because melasma commonly returns.
Can melasma come back after pico laser?
Yes, and it frequently does. In one study melasma had recurred in 20 of 34 patients one year after low-fluence treatment finished, and a split-face trial reported recurrence on both sides of the face. Sun exposure, heat and hormonal change can all bring it back.
Why is melasma treated so gently with a laser?
Inflammation can darken it. Energy strong enough to clear a freckle can leave melasma skin darker than before. Toning uses low energy over repeated visits to reduce pigment production gradually, and settings stay conservative, especially on skin that has reacted to treatment in the past.
What are pale spots after toning, and could they happen to me?
They are scattered white marks that can appear inside a melasma patch after repeated low-fluence sessions, described in case reports cited on this page. Biopsies showed fewer melanosomes while pigment cells remained. That risk is the reason visits are spaced and the plan is paused at the first sign.
Will hormonal melasma respond in the same way?
Melasma linked to pregnancy or hormonal contraception can be lightened with toning, but it tends to persist while the hormonal trigger remains. The doctor discusses timing with you, because treating during an active hormonal phase may give a shorter-lived result.
What does a maintenance visit for melasma involve?
It is a toning session at the same conservative settings, considered after the lightening phase when the melasma begins to return or ahead of a season of heavier sun. Whether and when to book one is decided at review; there is no fixed calendar.
What should I do if my melasma darkens after a session?
Contact the clinic, and keep the area out of the sun and away from heat. Temporary darkening can follow irritation in melasma-prone skin. The doctor reviews the reaction, and the next visit is usually postponed or adjusted until the skin has settled.
Booking

Reservation

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Scientific evidence

Melasma and low-fluence laser toning: the published record

Read together, these five papers show both sides of laser treatment for melasma: measurable lightening, frequent recurrence after a year, a biopsy study of what changes in the treated skin, and two reports on the pale mottling that repeated sessions can cause. Every one of them examined Q-switched lasers at low fluence, the method picosecond toning adapts. None was conducted at Rewind Plastic Surgery, and none describes what your own melasma will do.