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Hello!

I am Dr. Ayeri Yokoyama, a cosmetic dermatologist.

 

 

It's that time of year when the effects of summer's strong UV rays start showing on your skin.

Many people are concerned about dark spots, aren't they?
However, even though we simply call them "spots," there are actually various types of pigmented lesions.

Freckles? Is this melasma? What the heck is ADM?!

Perhaps some of you are facing such concerns.
Actually, these pigmented patches areEven if they look similar, their causes and treatments are completely different.That's it.
In this article, we'll clearly explain the differences between four types of pigmentation issues from a specialized aesthetic dermatology perspective!

 

 

Age spots (senile lentigines)
【Features】

・The most common type of pigmentation, strongly influenced by ultraviolet rays.

・in one's thirties and beyondbecomes more noticeable.

・The pigmented patch has distinct borders,Circular to elliptical brown spots。

・High cheekbones, temples, and the back of the handsAreas prone to sunburnare common.

【Cause】

・Due to UV radiation exposureMelanocyte activation

・Changes in hormone balance, friction, and inflammation can also be contributing factors.

【Treatment】

・PicoSpot・Q-switched ruby laser, etc.Melanin-Destroying Laseris effective.

・If you want to avoid downtime, use IPL (like Lumecca or Photo) over multiple sessions to gradually fade the hair.

・Combination Care: Hydroquinone, tretinoin, and topical vitamin C.

・To prevent recurrenceUV protection and friction avoidanceis required.

 

 

Freckles (ephelides)

【Features】

・Highly hereditary,Appears from childhoodThere's a lot to do.

・Centered on the nose and cheeks,Small spots scattered here and thereDo.

・Tends to darken under ultraviolet light,Most noticeable in spring to summer。

【Cause】

・A constitution with genetically high melanocyte activity.

・UV exposure temporarily increases melanin production.

【Treatment】

・PicoSpot and IPL are effective.

・Complete removal is somewhat difficult.。Make it thinner and less noticeableIt is possible.

・From an early stageSun protectionheavy要。

 

 

Liver spots

【Features】

・A typical example is on both cheekssymmetricalspreads out.A hazy, pale brownpigmentation。

・Women in their 30s to 50sOften associated with pregnancy, birth control pills, stress, and other hormonal factors.

・It tends to worsen with UV exposure and friction (from washing your face or cleansing).

【Cause】

・The influence of female hormonesresulting in an excessive reaction of melanocytes.

・Worsens due to UV rays, friction, and stress.

【Treatment】

・Avoiding stimulation is the top priority.Strong lasers are contraindicated.

・Oral and topical use of tranexamic acid and vitamins C/E is recommended. Topical vitamin A is also recommended. If no allergies exist, topical hydroquinone is also recommended.

・Treatments include peels, Mesona J, glutathione IV drips, etc.Defensive TreatmentSo.

・While suppressing skin inflammation,Aim for gradual improvementThat's the golden rule.

 

 

Acquired Dermal Melanocytosis (ADM)

【Features】

・Unlike other pigmented lesions,dermisCells containing melanin increasein the state of doing.

・In typical cases, gray to bluish-brown pigmentsScattered below the cheeks and under the eyes。

・Late 20s to 30soften occurs.

・At first glance, it resembles freckles or melasma, butThe laser reaction is completely different.。

【Cause】

・Genetic predisposition + ultraviolet rays and inflammatory stimuli.

・Melanocytes exist in the deeper dermis rather than the epidermis, making conventional whitening agents less effective.

【Treatment】

・Pico laser and Q-switched ruby laseris the first choice.

・Topical treatments alone are unlikely to be effective, and for refractory cases, even laser therapyMultiple treatments are required.。

・Cases often overlap with melasma, and misdiagnosis carries a risk of worsening.

 

 

🔬Summary of Pigment Spot Differences

 

 

🩺 Comment from a Cosmetic Dermatologist

Pigmented patches may appear similar at first glance,The treatment approach is completely opposite.may occur.
Especially with "liver spots" and "ADM," choosing the wrong laser candeteriorationThere is a risk of complications, so it is dangerous to undergo laser or light treatments indiscriminately.

It is crucial to receive a thorough examination by a specialist physician, obtain an accurate diagnosis, and begin treatment!
Identifying "which segment has the problem" and "which type is the primary cause" is the most efficient way to achieve the quickest, lowest-risk improvement.

 

 

💡 Summary

・Freckles, age spots, melasma, and ADM are,Even if they look similar, the causes and treatments are different.。

・While exceptions exist, it is possible to distinguish them to some extent based on "position, color, shape, and symmetry."

・However, there are also many mixed examples,Professional diagnosis is paramount。

 

If you're interested in spot treatment, please come in for a consultation. We warmly welcome you even if you're just seeking advice.

 

 

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【Profile】

Plastic Surgeon/Cosmetic Dermatologist Dr. Ayuri Yokoyama

Japan's Leading Clinic for Beauty and Health Regenerative Medicine｜BIANCA CLINIC GINZA/OMOTESANDO　

In my previous role, I was involved in establishing a clinic as a cosmetic dermatologist, from its inception to opening, and served as its director for three years.
Having worked with approximately 20,000 patients' skin and faces, contributing to the clinic's development.

To further expand the scope of treatment, I have now transitioned to BIANCA CLINIC, a leading aesthetic and regenerative medicine clinic in Japan.

We provide the latest aesthetic medical treatments for well-aging, encompassing not only cosmetic dermatology but also cosmetic surgery and internal medicine.

 

【Career】

2020 Graduate of the School of Medicine, Hiroshima University

2020: Worked at JCHO Tokyo Shinjuku Medical Center and affiliated hospitals (National Center for Global Health and Medicine Hospital, Tokyo Yamate Medical Center)

2022: Joined ELM Medical Corporation Served as Director of Azabu Clinic

2025: BIANCA joins the company

【Professional Affiliations/Qualifications】

The Japanese Society of Aesthetic Dermatology

Japanese Society of Anti-Aging Medicine

Occupational Physician Certification

【SNS】

Instagram account　

https://www.instagram.com/dr.airi