Melasma vs Sunspots: Why Correct Diagnosis Matters Before Laser Treatment

Two common conditions that look alike

Brown patches on the face are often lumped together as "pigmentation", but melasma and sunspots are different conditions with different causes. They can look similar in photos, and many people have both at once. Laser treatment that works well for one can sometimes make the other worse. That is why diagnosis comes before any laser is switched on.

Diagnosis is usually based on a close examination in good light, your history, and how the pigment has behaved over time. Some clinics also use magnification or skin imaging to see the pattern more clearly. For international visitors, it is common to arrive having already been told one thing by a previous clinic or by an online search. A fresh look from a doctor can confirm it or change the plan, which is worth doing before you commit to a course of sessions.

What sunspots are

Sunspots, also called solar lentigines or age spots, are flat brown spots caused by cumulative ultraviolet exposure.

Appearance. Distinct, well-defined spots with clear edges, often round or oval.
Location. Areas that get the most sun: cheeks, temples, nose, forehead, hands, shoulders.
Behaviour. They tend to stay fairly stable or slowly increase with age and sun.
Response to laser. Often respond well to targeted laser treatment, sometimes in few sessions, though new spots can form with continued sun exposure.

What melasma is

Melasma is a chronic pigment condition influenced by hormones, sun and visible light, heat, and genetics.

Appearance. Blotchy patches with blurry, irregular edges, often symmetrical on both sides of the face.
Location. Cheeks, forehead, upper lip, nose bridge and jawline.
Triggers. Pregnancy, hormonal contraception, sun, heat, and skin irritation.
Behaviour. It can fade and darken over time and tends to recur.
Response to laser. Strong heat or aggressive treatment can worsen it. Gentle, low-energy toning is often used as one part of a broader plan.

Read more on our melasma treatment page.

Why correct diagnosis matters

If melasma is mistaken for sunspots and treated with strong spot-targeting energy, the skin may react with inflammation and become darker. If sunspots are mistaken for melasma, they may be treated too gently and take longer to clear. Correct diagnosis also helps a doctor identify:

Mixed pigmentation. Sunspots sitting within melasma patches, which need different handling in the same face.
Other look-alikes. Post-inflammatory marks, freckles, deeper pigment such as Hori's nevus, or raised lesions like seborrheic keratoses.
Lesions that need medical attention. Any spot that is changing, irregular, bleeding, or new and unusual should be checked by a doctor rather than lasered.

How treatment plans differ

Once the diagnosis is clear, plans usually look different:

For sunspots. Targeted laser treatment for individual spots, sometimes with toning for overall tone. Expect small crusts that shed over about a week.
For melasma. A series of low-energy toning sessions, careful spacing, topical care and very consistent sun protection.
For both. The doctor may treat clear sunspots cautiously while managing melasma gently around them.

At Daybeau Clinic Seomyeon, Pico Light Black Toning is KRW 29,000, first-visit, VAT excluded (10% VAT added at payment), checked October 2026. See our pico toning page and the full price list. The doctor confirms which approach, and how many sessions, suit your pigment.

Whichever diagnosis applies, expect some short-term effects. Toning usually causes mild redness for a few hours. Targeted spot treatment can leave spots looking darker for several days before small crusts shed. Avoid picking at crusts, keep the area moisturised, and use sunscreen every day. Results vary, and the doctor will review how your skin responds before adjusting the next session.

What you can do before your appointment

Track changes. Note whether patches darken in summer, during pregnancy, or with medication changes.
Bring photos. Older photos help show how pigment has changed over time.
Protect your skin now. Daily sunscreen and shade help both conditions.
Avoid harsh home treatments. Strong peels or scrubs can irritate melasma.