When visiting a dermatologist for concerns like spots or hyperpigmentation,
many people begin receiving laser toning treatments.

 

As explained in a previous post,
the principle of laser toning is to prevent melanin pigment from transferring to the epidermis,
thereby improving overall pigmentation on the face.

 

However, laser toning is not always a cure-all.

 

There are cases where it may not be effective,
and in some situations, it may even be contraindicated.

 

In this post, we’ll discuss situations in which laser toning is not recommended.

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Laser toning can sometimes make pigmentation treatment more difficult

 

Laser toning can lighten dark pigmentation.

 

You might think, “Isn’t it a good thing for the pigmentation to become lighter?”

While it would be ideal if the pigment disappeared completely,
if it only becomes lighter, it may actually have the opposite effect.

While it’s good if the pigmentation can be improved,
the problem is that as the pigment lightens and begins to resemble the surrounding skin tone,
it becomes increasingly difficult to achieve complete removal.

 

These types of cases are not the result of toning alone,
but rather a combination of intensive treatments using high-energy lasers and brightening skin boosters.

 

However, let’s take a look at the following case as an example of a less favorable outcome.

 

Freckles (Ephelides)

This patient is a case of freckles.

 

Ideally, instead of starting with low-energy toning,
this was a case that should have been treated more aggressively from the beginning.

 

However, as in the example above, if only toning is performed,
the freckles themselves may lighten and the patient might be satisfied,
but from my perspective, it becomes a case where I worry about "how to remove the remaining pigmentation."

This case is similar as well.

 

The patient has been receiving laser toning for freckles.

Although the pigmentation has lightened after two sessions,
a more aggressive treatment from the beginning would likely have been better for complete removal.

This is the final case.

 

At first glance, this patient may also appear to have achieved a good result,
but due to the remaining patchy, light pigmentation, the skin does not look truly clear.

 

If stronger treatment had been performed from the beginning,
the pigmentation could likely have been completely removed in a shorter period and at a lower cost.

 

Senile Lentigines (commonly known as "age spots")

※ Image not available

 

Senile lentigines (commonly known as "age spots") are not only caused by an increase in melanin,
but also involve the thickening of the epidermis due to hyperplasia of keratinocytes.

 

They are often confused with solar lentigines (commonly known as "sun spots"),
and although both appear as dark, round spots,
there is a clear difference when you touch them.

 

Solar lentigines have the same texture as the surrounding skin,
whereas senile lentigines feel raised and have a different texture.

 

As for removal methods, senile lentigines can be easily treated by shaving them off with a CO₂ or Erbium laser,
or by burning them away using a long-pulse laser.

 

However, if toning is performed to lighten the pigment,
not only does it become harder to distinguish senile lentigines,
but because long-pulse lasers react better to darker pigments,
removal may become more difficult.

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Summary in 3 Lines

1. Laser treatment is more effective when the pigmentation is darker.

2. Lighter pigmentation is harder to remove—conditions like freckles or senile lentigines, which are normally easy to treat, may take more time and money if lightened by toning.

3. In addition to freckles and senile lentigines, if you have any dark pigmentation on your face, toning may not always be the right solution—consult with a medical professional.

 

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I hope this post serves as a helpful reference for many people.

 

If you have any questions, feel free to click the “like” button or leave a comment—I’ll be happy to respond personally.

Thank you very much.

 

📍 Primi Clinic
3F, 52 Seongsuil-ro, Seongdong-gu, Seoul (Primi Clinic)