solar lentigines
These are pigmented spots with well-defined borders that occur due to the effects of ultraviolet rays. We will consider full face laser treatment and partial laser treatment depending on the spread and density.
RUBY FRACTIONAL LASER
Ruby Fractional
Q-Switched Ruby Laser
pigmented spots are caused in part by the fact that melanin becomes difficult to excrete due to metabolic decline caused by photoaging. By combining pigmented spot treatment with care that regulates skin metabolism, we work together to create skin that is less likely to get pigmented spots again. At our clinic in Motomachi, Kobe, we focus on ruby fractional toning, and select treatment methods from physician treatment and spot laser treatment.
OUR APPROACH
Rather than "same laser treatment because it's a pigmented spot",Assemble treatments according to type and distribution.
Contents of this page
CONCERNS
Ruby Fractional
Ruby Fractional
Concerns to consider
Fine spots have increased on my cheeks.
Dullness and uneven skin tone are a concern.
I would like to treat widespread freckles.
I want to partially treat dark spots
I would like an assessment for ADM or a pigmented birthmark.
I don't know the difference between melasma and normal age spots
It is important to continue using a method that does not apply too much laser treatment.
The cheeks may have a mixture of solar lentigines, freckles, melasma, and post-inflammatory pigmentation. Too strong laser treatment may worsen melasma and post-inflammatory pigmentation, so the laser output is gradually adjusted while checking the skin reaction. We aim to improve dullness and age spots on the entire face while minimizing downtime.
PIGMENT TYPES
Type of pigmented spot
Type of pigmented spot
Reasons to tell
Even though they look the same brown, the treatment strategy will vary depending on the origin and depth of the pigment.
Freckles
A condition in which small pigment spots are scattered on the left and right cheeks and around the nose. Fractional treatment, which distributes laser treatment to the entire face, may be considered.
ADM / Birthmark
If there is pigment in the dermis or a birthmark with a bluish tint, a physician-administered treatment or spot laser treatment may be performed multiple times.
Melasma/post-inflammatory pigmentation
It may become darker due to irritation, so redness and inflammation must be assessed carefully. Topical medication or another treatment may be recommended first.
Please do not self-diagnose the diagnosis; please also inform us of your medical history, sunburn, friction, and any cosmetics or medicines you are using at the time of your consultation.
694nm RUBY LASER
What is Ruby Fractional?
Q-switched ruby laser is a laser that selectively targets melanin pigment using a wavelength of 694nm. Our clinic uses the medical device "NanoStar R" approved by the Ministry of Health, Labor and Welfare.
With fractional laser treatment, the laser is delivered to the skin in small dots. Treatment may involve low-fluence full-face delivery or higher-fluence physician-administered treatment to selected lesions, depending on pigment type and skin response.
In addition to treating the irradiated area, UV protection, moisturizing, and avoiding friction are also part of the treatment. Combining topical/skin care and other device treatments as necessary.
WHY RUBY FRACTIONAL
Ruby for pigmented spots
Ruby for pigmented spots
Three reasons to choose
01
Balance between reactivity to melanin and depth of reach
Ruby has a wavelength of 694nm, which makes it strongly absorbed by melanin and less strongly absorbed by oxyhemoglobin, which is a component of redness. It is used to treat age spots, freckles, and discoloration because the wavelength can address epidermal pigment and selected pigment near the basement membrane or superficial dermis.
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Comparison of laser absorption curves: the target chromophore differs by wavelength. The horizontal-axis tick marks are 400, 500, 600, 700, 800, 900, 1000, and 1100 nm; the vertical axis runs from low to high absorption. Curves are labeled melanin, water, and oxyhemoglobin; device markers include 532 nm frequency-doubled YAG, 595 nm dye laser, 694 nm ruby, 755 nm alexandrite, 800 nm diode, and 1064 nm YAG. 532 nm reacts with melanin and readily with redness/oxyhemoglobin, so it is used for superficial pigmented spots and freckles. 694 nm reacts strongly with melanin and relatively little with redness, making brown pigment easier to target. 1064 nm reaches more deeply but has somewhat weaker melanin reactivity and is used for dermal heating and skin-quality treatment. The conclusion identifies 694 nm ruby as a wavelength that strongly targets melanin, reacts less with redness, and can reach the superficial dermis. The curves are illustrative general tendencies.
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Illustration of penetration depth: longer wavelengths reach more deeply. The three columns are 532 nm (green), 694 nm (ruby), and 1064 nm (YAG), shown across the epidermis, basement membrane, superficial dermis, and deep dermis. Ruby 694 nm targets not only epidermal melanin, a main cause of pigmented spots, but also melanin immediately below the basement membrane and in the superficial dermis. The image concludes that 694 nm reaches from the epidermis to the superficial dermis in a balanced way.
02
Fractional delivery distributes energy to limit inflammation and gradually improve pigmentation
Spot laser treatment, which concentrates intense heat on one point, is necessary depending on the lesion, but it can also cause severe inflammation and post-inflammatory hyperpigmentation (PIH). Ruby Fractional treatment, which is performed on the entire face, aims to improve the pigmentation of the entire face by dividing the laser treatment into small points, leaving normal skin and reducing downtime.
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Risk sequence with strong spot irradiation: concentrated high heat at one point → strong inflammation → post-inflammatory hyperpigmentation (PIH) becomes more likely. Even when the original pigmented spot clears, residual darkening may remain.
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Why darkening can persist in adult skin. Photoaging and chronic inflammation reduce barrier function and pigment clearance; aging and persistent inflammation make melanocytes more reactive. Inflammation or irritation can increase melanin production. Reduced barrier function and slower turnover allow melanin to deposit not only in the epidermis but also in the superficial dermis; accumulated UV damage and chronic inflammation make dermal pigment harder to clear. Treatment comparison: high-output spot irradiation can produce a large reaction in one session, increasing inflammation and PIH risk and potentially worsening melasma or existing pigmentation. Ruby Fractional disperses inflammation, may reduce PIH risk, allows settings to be adjusted to the skin response, and is easier to plan when melasma or pigmentation coexists. The clinic therefore prioritizes gradually reducing pigment while controlling inflammation, with the aim of lowering post-treatment darkening risk rather than removing pigment aggressively in one session.
03
Repeat the number of times to create a skin environment where pigmented spots are difficult to return to.
At our clinic, we do not apply strong laser treatment from the beginning, but adjust the output while observing the skin reaction, using 5 treatments as a guideline once every 2 to 3 weeks. By repeatedly applying heat to the superficial layer of the dermis, you can expect a skin rejuvenation effect.
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Three reasons for fractional treatment: 1) disperse inflammation to make PIH less likely; 2) build the delivered heat dose safely over repeated sessions; 3) use repeated thermal stimulation for a skin-remodeling effect. The left diagram shows small irradiated zones of microthermal injury separated by non-irradiated normal skin across the epidermis, basement membrane, superficial dermis, and deep dermis; this lowers the overall inflammatory peak and supports faster recovery. The center graph shows treatment sessions 1 through 5, with the dose adjusted to each response rather than using excessive energy in a single session, gradually reducing pigment. The right diagram explains that repeated heat may promote turnover and collagen production and may improve dullness and uneven tone.
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): A four-part plan combines regular laser treatment + retinol guidance/topical treatment + optimized brightening and moisturizing care + UV protection. Laser treatment gradually targets pigment; retinol supports turnover and pigment clearance; brightening and moisturizing care reduces inflammation and supports the barrier; UV care is essential to reduce recurrence or worsening. Benefits of regular follow-up: settings and intervals can be adjusted to the skin condition while reducing PIH risk; retinol amount and frequency can be guided; redness or peeling can be addressed early; and worsening of melasma or pigmentation may be less likely. The goal is not only removal but also a skin environment in which pigmented spots are less likely to return.
TREATMENT OPTIONS
Ruby laser
Ruby laser
Three laser treatment methods
Choose according to your purpose, laser treatment range, and ease of downtime.
Fractional Toning
Minor pigmented spots, freckles, overall color unevenness
A low-power dot laser treatment is applied to the entire face, gradually adjusting the treatment while avoiding strong reactions. A series of treatments is typically recommended rather than a single session.
- Guideline
- Every 2–3 weeks / approximately 5 sessions per course
- Main reactions
- Redness, warmth, dryness, and fine crusting
Physician-administered treatment
Dark pigmented spots, ADM, birthmarks, etc.
The doctor will check the condition of the pigment and administer high-power fractional laser treatment. The number and interval required will vary depending on the lesion and response.
- Guideline
- Determine the number and interval of laser treatment by examination
- Main reactions
- Redness, swelling, dotted color changes, etc.
Spot laser treatment
Dark pigmented spots/birthmarks with clear boundaries
Intensive laser treatment to localized lesions. After laser treatment, scabs and post-inflammatory hyperpigmentation may occur and require protection and follow-up.
- Guideline
- Determined after examination of each lesion
- Main reactions
- Pain, redness, scabs, pigmentation, etc.
| Laser treatment method | Main purpose | How to proceed with treatment | Downtime |
|---|---|---|---|
| Toning | Uneven color on the whole face | Multiple times at low power | Usually mild |
| Physician-administered treatment | Deep/dark pigment | Adjusted for each consultation | Depends on the reaction |
| Spot | Localized pigmented spots | Intensive laser treatment to the lesion | Crusting; protective care may be required |
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Melasma and discrete pigmented spots develop differently and can coexist on the cheeks, so treatment is selected after assessing the skin. Melasma is associated with chronic inflammation leading to pigmentation and can be influenced by friction, hormones, and UV exposure. Discrete spots such as solar lentigines are associated with photoaging and reduced pigment clearance after years of UV damage. The arrowed comparison converges on the cheeks, where both conditions commonly coexist; because appearance alone may not distinguish them, careful diagnosis is required.
CUSTOMIZED PLAN
Melasma and redness
Melasma and redness
When mixed
The pale tone of the cheeks can be caused not only by age spots, but also by melasma, chronic inflammation, and vascular redness. Areas that may be aggravated by the stimulation of laser treatment require adjustments such as reducing the output, increasing the interval, or avoiding laser treatment.
Assess pigmentation and redness separately
Check boundaries, left-right differences, redness, friction, hormones, treatment history, etc.
Adjust the skin condition first
If inflammation is noticeable, consider using topical/skin care products such as Mesona J or Advatex.
Look at reactions and re-evaluate
Do not repeat the same output, check and adjust for redness, dryness, and color tone changes each time.
OUR FEATURES
Our clinic cherishes
Our clinic cherishes
What you are doing
01
Address photoaging
Spots are a condition in which melanin pigments are difficult to excrete and accumulate due to decreased metabolism of the epidermis due to photoaging. Treatment that takes photoaging into consideration can help prevent the recurrence of dullness and age spots.
02
Support skin remodeling
Ruby Fractional applies heat to the superficial layer of the dermis and stimulates collagen production, which can also be expected to improve pores and sagging skin.
03
Plan for long-term skin health
At our clinic, we place importance on creating a skin environment where pigmented spots do not return easily. Through maintenance, we aim to maintain your skin in good condition for one, two, and five years.
CASES & COLUMNS
Ruby Fractional
Ruby Fractional
Case/Related Columns
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Ruby Fractional clinical case. Panels are Before → After in two views. Treatment: five Ruby Fractional toning sessions plus home use of hydroquinone and Skin Brightening Serum 0.25. Pigmented spots and dullness improved and skin texture changed. The image notes that combining laser treatment with high-concentration retinol and hydroquinone at home contributed to the observed change.
CASE 01
(Japanese page)
pigmented spots/dullness + topical treatment
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Combination laser clinical case. Panels are Before → After in two views. Course after five ruby treatments and two ADVATx laser sessions. Melasma and discrete pigmented spots coexisted, so ruby treatment began at lower output to avoid worsening melasma, with ADVATx added. Darker spots and overall uneven tone improved.
CASE 02
(Japanese page)
Melasma/pigmented spot + Advatex
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Ruby Fractional clinical case. Panels are Before → After in two views. Treatment: five Ruby Fractional toning sessions plus home use of hydroquinone and Skin Brightening Serum 0.25. Uneven tone and dullness improved, fine pigmented spots became lighter, and fine lines and firmness also improved.
CASE 03
(Japanese page)
Uneven color/dullness + topical treatment
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Ruby Fractional clinical case. Panels are Before → After in two views after five Ruby Fractional toning sessions. Because melasma was suspected, the full area was treated at low output; improvement occurred without worsening. No other treatment was used. The image also describes improved firmness, lifting, and fine lines after thermal treatment.
CASE 04
(Japanese page)
Low power laser treatment considering melasma
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): The retained source image is a hyaluronic-acid case creative labeled “A refreshed appearance with hyaluronic acid.” Its comparison order is “2 years before” → “After.” No ruby-laser course, fee, or risk statement is printed in this image.
CASE 05
(Japanese page)
pigmented spots/yellowing on cheeks
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Ruby Fractional clinical case. Panels are Before → After in two views. ADM extended from the cheeks to the forehead. Treatment: five Ruby Fractional toning sessions plus Skin Brightening Serum 1.0 and Miramin at home. ADM became lighter and overall skin tone improved. The image cautions that ADM is difficult to diagnose and requires proper examination and appropriate treatment.
CASE 06
(Japanese page)
ADM + topical treatment
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): ADVATx case 5. Sequence: Before → after two ADVATx sessions → after three Ruby Fractional sessions. Ruby Fractional and ADVATx were alternated to address sebum-related shine and overall dullness. The image reports brighter overall tone and reduced shine.
CASE 07
(Japanese page)
Sebum, shine, dullness
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Toning-treatment clinical case. Before: numerous pigmented spots of different sizes and colors, with laxity related to photoaging. After: fewer prominent spots and improved firmness around the eyes and cheeks. Treatment: 15 ruby laser toning sessions plus ZO Skin Health products containing high-concentration vitamin A and hydroquinone.
CASE 08
(Japanese page)
1 and a half years of maintenance progress
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Toning-treatment case 3. Before: many light freckles were noticeable against naturally fair skin. After: clearer, brighter-looking skin; removal of outer facial spots also created a slimmer facial impression. Treatment: five ruby laser toning sessions plus ZO Skin Health products containing high-concentration vitamin A and hydroquinone.
CASE 09
(Japanese page)
Skin dotted with pale spots
Direct English rendering of the Japanese text in the retained source image, in visual reading order (top to bottom and left to right within each row; Before/After panels and arrows remain in the image): Toning-treatment case 1. Before: freckle-like spots and dullness across a relatively broad cheek area. After: lighter spots and dullness, brighter-looking skin from within, improved firmness, and greater radiance on the forehead and cheeks. Treatment: five ruby laser toning sessions plus ZO Skin Health products containing high-concentration vitamin A and hydroquinone.
CASE 10
(Japanese page)
Skin with many spots/freckles
Main side effects/risks: pain, redness, swelling, itching, dryness, scabs, post-inflammatory pigmentation, depigmentation, burns, scarring, recurrence, etc. Changes in cases also include the effects of concomitant topical treatment and skin care.
PRICE
Ruby Fractional fees
Confirm the laser treatment method and area during the examination. The displayed price includes tax.
Fractional Toning
Full face 1 time¥16,500
1st course 5 times¥66,000
5 times after 2nd course¥55,000
Physician-administered treatment 1 time¥27,500
Spot laser treatment
up to 1cm x 1cm¥6,600
1cm x 1cm or more, every 1cm²¥4,400
Examination fees, anesthesia, protective materials, topical medications, cosmetics, etc. may be required separately. There are some types of birthmarks and spots that are covered by insurance, so we will inform you about them at the time of your consultation.
TREATMENT FLOW
From consultation to post-treatment
Face washing/Photography
Remove make-up and check pigmented spot color, border, depth, distribution, redness, and sunburn and treatment history. Take progress records if necessary.
Examination
Choose the method that suits your purpose and downtime from toning, physician-administered treatment, and spot laser treatment.
Laser treatment/cooling
Laser energy is delivered while the skin response is monitored. Special eye protection will be provided during laser treatment. Cooling and protective materials are used depending on the laser treatment method.
Aftercare/Re-evaluation
Please take measures against UV rays and moisturize. At subsequent sessions, we adjust the output and interval based on the reaction.
DOWNTIME & RISKS
Downtime and risks
Immediately after treatment
Redness and warmth usually improve within several hours.
A few days to a few weeks
Protective tape may be required for spot laser treatment.
Rare complications
Swelling, itching, dryness, stinging, rash
Precautions after treatment
Avoid extreme sunburn, avoid rubbing and forcefully peeling off scabs, and continue moisturizing and use appropriate sun protection.
FAQ
Ruby Fractional
Ruby Fractional
Frequently Asked Questions
Can Ruby Fractional remove pigmented spots in one session?
Full-face fractional toning is a treatment that uses low-power laser treatment to the entire skin, applying it multiple times to smooth out uneven skin tone. For dark spots, spot laser treatment or physician-administered treatment are candidates, so the type and laser treatment method will be determined through a medical examination.
Can I receive treatment even if I have melasma?
The area where melasma is suspected should be carefully determined, taking into account the possibility that irritation may worsen the color tone. If redness or inflammation is associated, we may first consider adjusting the output and interval, using topical medication or appropriate skincare, and other treatments.
Can I apply makeup immediately after the treatment?
With low-output fractional toning, you may be able to apply makeup after the treatment if there are no problems with your skin condition. Spot laser treatment requires consideration of protective tape and scabs. Follow the instructions on the day of your treatment.
What is the difference between spot laser treatment and fractional toning?
Spot laser treatment mainly targets localized dark pigments, and post-laser treatment scabs and post-inflammatory hyperpigmentation may occur. In fractional toning, low-power laser treatment is applied to the entire face in small dots to gradually improve fine spots and uneven skin tone over multiple sessions.
Are there times when I cannot receive treatment?
If you have severe sunburn, inflammation or infection at the laser treatment site, or are taking photosensitizing medication, consider postponing treatment or considering alternative treatment. If you are pregnant, breastfeeding, or are currently receiving medical treatment, please let us know at the time of reservation or consultation.
Can it happen again?
Even after treatment, new spots or uneven coloring may appear due to UV rays, friction, aging, etc. Daily sun protection, moisturizing, and avoiding friction remain important; maintenance options can be discussed according to your skin condition.
COUNSELING
From the type of pigmented spot
From the type of pigmented spot
Organize together
If you are not sure whether full face or spot treatment is better, or if you are worried about melasma being mixed in, please contact us. We will ask about the desired changes and possible downtime, and then decide on suitability, including choosing not to rush the laser treatment.
