Frequently Asked Questions About Dark Spots, Freckles, Melasma, and ADM

The main cause of age spots is ultraviolet (UV) radiation. Aging, hormonal changes, stress, lack of sleep, skin inflammation, and excessive irritation can also contribute to hyperpigmentation. Since the causes and types of age spots vary from person to person, it’s important not to make assumptions based solely on appearance but to have them examined by a doctor.

The main differences between age spots and freckles lie in their causes, size, and appearance. Common age spots (senile lentigines) are primarily caused by exposure to ultraviolet rays and appear as relatively well-defined, circular spots on the face and the backs of the hands. Freckles are strongly influenced by genetic factors and are characterized by small spots, about 2 to 3 mm in size, that are concentrated on the nose and cheeks.

The main ways to distinguish between common age spots and melasma are their outlines and how they appear. While common age spots have relatively distinct borders, melasma tends to have blurred borders and appears symmetrically on both sides of the face, such as on the cheeks and under the eyes. However, since age spots and melasma can sometimes coexist, it is important not to choose a treatment based on your own judgment but to consult a doctor.

Multiple types of pigmented lesions—such as age spots, freckles, melasma, and ADM—can coexist on the same face. Since the appropriate treatment varies depending on the type, and the condition may worsen if the order of treatment is incorrect, at YAYOI CLINIC, we carefully assess your skin condition before determining the optimal sequence and combination of treatments.

At YAYOI CLINIC, we offer a range of treatments—including laser, IPL (intense pulsed light), RF (radiofrequency), and oral medications—and select the most appropriate option based on the type of dark spot and the condition of your skin. We also incorporate customized treatment plans that combine topical medications and at-home care as needed, proposing a treatment approach that takes into account not only prominent dark spots but also the overall condition of your skin.

High-power laser treatments for dark spots may not be suitable for melasma in some cases, as the intense stimulation could cause the condition to worsen. At YAYOI CLINIC, we assess whether dark spots and melasma coexist and, if necessary, select treatments such as the TriBeam Premium—which is designed with melasma in mind—and determine the optimal treatment sequence.

The level of discomfort experienced during dark spot treatment varies depending on the treatment method, the area being treated, and the condition of your skin. At YAYOI CLINIC, we use anesthetic creams and other measures as appropriate for each treatment to address any concerns you may have about pain. If you are sensitive to pain or have experienced discomfort during previous procedures, please let us know during your consultation.

After pigmentation treatment, it is important to continue protecting your skin from UV rays and keeping it moisturized, and to avoid rubbing the treated area vigorously. At YAYOI CLINIC, we provide guidance on pre- and post-treatment care to help prevent scarring and the recurrence of pigmentation. If a scab forms as a result of the treatment, do not peel it off forcefully; instead, protect it as instructed.

Melasma and ADM are different types of pigmented lesions, and they differ in appearance and the depth of the melanin. Melasma has blurred edges and often spreads symmetrically across the cheeks, whereas ADM is characterized by melanin located deep within the dermis, giving it a bluish-gray appearance. Melasma and ADM can sometimes coexist, and since it is difficult to distinguish between them based on appearance alone, a medical examination by a doctor is necessary.

At YAYOI CLINIC in Hiroshima, the downtime for laser treatment of age spots and freckles varies depending on the equipment used. With the Q-switched ruby laser, scabs may form after the procedure, and you may need to apply ointment and protect the area for about one week. On the other hand, with laser toning, you may be able to apply makeup the same day if there is no redness. It is important to choose a treatment based on your skin condition and the amount of time you can set aside for recovery.