solar lentigines
These are relatively well-defined pigmented spots associated with cumulative ultraviolet exposure. The treatment area and settings determine whether full-face or spot treatment is appropriate.
PIGMENTATION TREATMENT
Spots and dullness treatment
Customized Skin Treatment
Dullness or uneven tone may reflect overlapping solar lentigines, freckles, melasma, post-inflammatory hyperpigmentation and redness. At our clinic in Motomachi, Kobe, we assess color, depth, distribution and skin response, then plan a suitable combination of laser treatment, transdermal delivery and topical or oral medication.
OUR APPROACH
Even if it looks the same "brown",Treatment is not one-size-fits-all.
Contents of this page
CONCERNSSuch pigmented spots and dullness
Such pigmented spots and dullness
don't you care
You can contact us from the stage of "I want to treat these spots, but I don't know what to choose".
The number of fine spots on my cheeks is increasing
My complexion looks dull or uneven
I want to treat widespread freckles
I want targeted treatment for defined dark spots
There is diffuse pigmentation across both cheeks
Pigmented spots and redness appear together
I am worried pigmentation may darken after treatment
I also want to consult about topical medication and home care
It is important to identify the type of treatment before choosing a strong treatment based on your own judgment.
When melasma and inflammation coexist, excessive irritation can worsen pigmentation. During consultation, we assess the current condition and sequence targeted treatment and skin-conditioning care.
PIGMENT TYPESpigmented spots/dullness
pigmented spots/dullness
Identify Types
Similar-looking pigmentation may require a different approach depending on pigment depth and whether inflammation is present.
freckles
Freckles often appear as fine pigmented spots across the nose and cheeks. A carefully selected full-face treatment may be considered.
melasma
It often appears as diffuse, symmetrical pigmentation on the cheeks and may fluctuate with irritation or inflammation. Treatment is planned with stabilization as the first priority.
ADM / deeper dermal pigmentation
These lesions may appear blue-gray because pigment lies deeper in the dermis. A course of physician-administered treatment may be required.
post-inflammatory hyperpigmentation
Pigmentation may remain after acne, friction, burns or other inflammation. Avoiding further irritation is important; topical medication and observation over time may be considered.
Please do not try to diagnose the type of pigmentation from appearance alone, During consultation, tell us about previous treatment, recent sunburn, friction, cosmetics and medications.
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.
DIAGNOSIS FIRSTPrior to the name of the treatment,
Prior to the name of the treatment,
Organize the condition of your skin
At our clinic, we do not select a device in advance. We first assess borders, asymmetry, color depth, redness, dryness and previous treatment responses. We also consider your preferred degree of change and acceptable downtime.
Dark dots or overall color variation?
We assess targeted and full-face treatment as distinct options.
Is there a mixture of melasma and redness?
Stabilizing inflammation or irritation may take priority.
See and adjust every reaction
Settings are reassessed according to redness, dryness and changes in tone.
TREATMENT OPTIONSFor the treatment of pigmented spots and dullness
For the treatment of pigmented spots and dullness
Choices
Treatment may involve more than one method, selected for distinct goals.
01 / PIGMENT LASER
fractional ruby laser treatment
The 694 nm ruby laser delivers energy in a fractional pattern of fine microbeams. We will consider low-power full face irradiation for fine spots, freckles, and color variations on the full face, and physician-administered spot treatment for dark spots and ADMs.
- Potential indications
- Solar lentigines, freckles, dullness and ADM
- Treatment approach
- A course of full-face treatment; localized lesions are assessed individually
02 / REDNESS & INFLAMMATION
ADVATx
ADVATx may be considered when pigmentation coexists with redness, visible vessels, sebum or chronic inflammation. When redness accompanies melasma, addressing inflammation and the skin condition first may be appropriate.
- Potential indications
- melasma with redness, pigmentation, sebum, acne
- Treatment approach
- Multiple times while checking for changes in redness and tone
03 / MELASMA
POTENZA Melasma Treatment
POTENZA may be considered when melasma is the primary concern and a staged, skin-responsive approach is appropriate. It may be combined with peeling or topical and oral medication, with treatment staged to minimize irritation.
- Potential indications
- Diffuse, symmetrical melasma on both cheeks
- Treatment approach
- Selection of tip and depth depending on skin condition and treatment history
04 / SKIN CONDITIONING
Mesona J · Topical · Skincare
When dryness or irritation is pronounced, stabilizing the skin comes first. Options include Mesona J transdermal delivery, topical or oral medication, gentle cleansing, moisturizing and sun protection.
- Potential indications
- Melasma with dryness or irritation; ongoing maintenance
- Treatment approach
- Before or after device-based treatment, or as ongoing maintenance
| Status | Potential options | Treatment role | downtime |
|---|---|---|---|
| Fine spots/dullness | fractional ruby laser treatment | A course of low-fluence full-face treatment | Usually limited |
| Dark localized pigmented spots | Physician-administered spot treatment | Target defined lesions | Crusting; protective dressing may be required |
| melasma | Topical/oral medication/POTENZA/Mesona J | Stabilize the skin and reduce irritation | Depends on treatment |
| Reddish tones | ADVATx | Address vascular redness and inflammation | Usually limited |
OUR FEATURESWith the treatment of spots and dullness at our clinic
With the treatment of spots and dullness at our clinic
What we care about
01
Examination to identify the type of pigmented spot
We assess borders, pigment depth, redness, skin texture and treatment history as well as color. If a procedure is not appropriate, we recommend another option without rushing into laser treatment.
02
Separate treatment to remove and treatment to trim
Treatment for dark spots and treatment for dullness, redness, and dryness throughout the face have different roles. We separate these goals and plan them in a suitable order.
03
Long-term management, including post-treatment
Sun protection, moisturizing and avoiding friction are also part of treatment. We review each response and adjust settings, intervals and home care.
CASES & COLUMNSFor the treatment of pigmented spots and dullness
For the treatment of pigmented spots and dullness
Clinical cases and related articles
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 articleSpots, 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 articlemelasma/spots + redness 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. 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 articleColor variation/dullness + topical medication
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 04
Japanese articleCheek pigmentation and sallowness
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 05
Japanese articleSebum, texture, dullness
Major side effects/risks: pain, redness, swelling, itching, dryness, scabs, post-inflammatory pigmentation, loss of pigmentation, burns, scarring, recurrence, etc. The change in the case also includes the effect of the combination of topical medication and skin care. Effects and progress can vary from person to person.
PRICE
pigmented spot/dullness treatment fee
These are representative fees for fractional ruby laser treatment. Prices shown include tax.
Ruby Fractional / full face
Once16,500 yen
First five-session courseFrom 66,000 yen
Subsequent five-session course55,000 yen
Physician-administered treatment, one session27,500 yen
Ruby Laser Spotting
Up to 1cm x 1cm6,600 yen
1cm x 1cm or more/per 1cm ²4,400 yen
Examination fees, anesthesia, protective materials, topical medications, cosmetics, etc. may be required separately. See the current price list for ADVATx, POTENZA, Mesona J and prescription medication fees.
TREATMENT FLOW
From consultation to post-treatment
Confirmation of facial cleansing and skin condition
Remove makeup, check color, boundaries, distribution, redness, dryness, sunburn, and treatment history.
Consultation/treatment plan
We explain the proposed sequence and likely number of treatments based on the type of pigmentation and acceptable downtime.
Treatment
Treatment may include laser therapy, transdermal delivery or topical medication, selected according to the skin condition that day.
Aftercare and re-evaluation
Continue sun protection and moisturizing. At review, we adjust settings, intervals and combinations according to the response.
DOWNTIME & RISKS
Downtime and risks
Low-fluence full-face laser treatment
You may experience redness, flushing, dryness, tingling, and spotted scabs.
Spot irradiation
Pain, redness, swelling, scabs, and post-inflammatory pigmentation may occur and protective tape may be required.
Overall device treatment
Possible adverse effects include rash, blistering, burns, hyperpigmentation, hypopigmentation, scarring or worsening symptoms.
Post-treatment precautions
Avoid strong sunburn, friction, and forced peeling of scabs, and continue moisturizing and sun protection.
Please let us know before treatment
Treatment may be postponed or modified during pregnancy or breastfeeding, or with recent sunburn, dermatitis, infection, photosensitizing medication, relevant illness or a previous adverse laser reaction.
FAQFor the treatment of pigmented spots and dullness
For the treatment of pigmented spots and dullness
Frequently asked questions
What should I choose for my spots/dullness treatment?
Options differ for defined spots, diffuse uneven tone, melasma and redness. We select treatment after assessing color, distribution, redness and treatment history.
Can pigmented spots be removed in one session?
Spot treatment may be considered for localized lesions, while diffuse uneven tone or melasma may require a staged course. The number of treatments depends on the type and response.
Can I get laser treatment even if I have melasma?
Because irritation can worsen melasma, laser candidacy requires careful assessment. Topical or oral medication, Mesona J, POTENZA or ADVATx may take priority, with fractional ruby laser treatment considered only when appropriate.
Can I apply makeup immediately after treatment?
Makeup may be possible on the same day after low-fluence full-face or transdermal delivery treatment if the skin is stable. Spot irradiation requires attention to protective tape and scabs.
Will the pigmented spots recur?
New pigmentation or uneven tone can develop with ultraviolet exposure, friction and aging. Continue sun protection, moisturizing, friction avoidance and maintenance when needed.
Can I discuss pigmented spots and dullness at the same time?
Yes. We assess defined dark spots separately from diffuse dullness, uneven tone, redness and dryness, then plan targeted and skin-conditioning treatments.
COUNSELINGWhat to choose
What to choose
For those who don't know
You are welcome to consult us if you are unsure whether you have melasma or which approach suits your pigmentation. We discuss your goals and acceptable downtime, assess candidacy and may recommend delaying laser treatment.
