Melasma Laser Side Effects: Why Pushing Higher Energy Makes It Darker

Melasma Laser Side Effects:

Why Pushing Higher Energy Makes It Darker

Last Thursday, a patient came into my clinic —

a woman in her late 40s.

She had been receiving Laser toning elsewhere for nearly a year,

and told me:

"Right after each session it looks a little lighter,

but a month later it feels even darker than before."

Looking at her chart, she had been coming in

almost every two weeks without a real break.

The bottom line.

Most melasma laser side effects

come from excessive energy and sessions spaced too closely together.

What actually matters.

It's not the energy intensity —

it's the interval between sessions and the cumulative stress on the skin.

What we'll cover today.

The threshold at which melasma gets darker,

and the real clinical protocol to avoid crossing it.

What You'll Learn in This Post

• The mechanism by which melasma laser procedures

  can actually deepen pigmentation

• Why hormonal and pregnancy-related melasma

  is more prone to side effects

• Step-by-step management when side effects occur,

  and a long-term care protocol

Melasma Laser Side Effects —

Can It Really Get Darker?

Yes, it absolutely can.

While laser energy does break down melanin pigment,

that same process also delivers

micro-damage to the dermis.

When that damage triggers an inflammatory response,

melanocytes can actually become more activated —

not less.

This is what's commonly referred to as

PIH (Post-Inflammatory Hyperpigmentation).

Essentially, a new layer of pigment gets deposited on top of existing melasma.

So the assumption that "more sessions means better results"

simply doesn't hold true for melasma

in many cases.

Why Does Higher Energy

Make Melasma Darker?

"When melasma laser breaks down pigment,

it simultaneously causes skin damage —

and that damage creates a vicious cycle

of inflammation leading to increased melanin production.

More energy doesn't mean better results.

That's exactly why it can make melasma darker."

— Dr. Wi Young-jin (Beautystone Clinic, Hongdae)

You may have heard that getting melasma laser more frequently

helps it fade faster.

In reality, the opposite is true more often than not.

The key lies in the nature of melanocytes themselves.

The melanocytes responsible for melasma

are far more sensitive than those behind ordinary dark spots.

They interpret stimuli like heat, UV exposure, and hormonal shifts

as "threat signals" —

and respond defensively by producing even more pigment.

So a pattern of high-energy 1064nm Laser toning

delivered every one to two weeks

essentially keeps melanocytes in a constant state of alarm.

At a certain point, the rate of new pigment being produced

outpaces the rate at which it's being broken down.

I saw a similar case in my clinic just today.

A 46-year-old patient who had been managing melasma

along both cheekbones for over ten years.

She had undergone more than 30 sessions of Laser toning elsewhere,

yet arrived with pigmentation that had deepened

to a grayish-brown tone.

After our consultation, I advised her to pause all procedures

for about a month and simply observe.

She left that day without making a final decision.

Honestly, recommending she start again the following week

wasn't something I could do in good conscience.

After five years of focusing specifically on melasma management,

my conclusion is this:

lowering the energy and extending the interval

is the closest thing to the right answer.

I used to recommend sessions every one to two weeks,

but now I set two to four weeks as the standard baseline.

If results are slow, the answer isn't to increase energy —

it's to read that as a signal that the skin needs rest.

Key Takeaways from Dr. Wi Young-jin

• Managing melasma isn't a game of "breaking" pigment —

  it's a game of "calming" melanocytes.

• This is especially true for hormonal and pregnancy-related melasma.

• Dropping the energy level by one notch

  and extending the interval by one week

  consistently delivers better results than adding more sessions.

Pregnancy-Related Melasma —

How Is Long-Term Management Different?

With hormonal melasma, environmental management

takes priority over procedures.

Melasma that develops due to pregnancy, oral contraceptives, or menopause

involves melanocytes that are already

"calibrated to be hypersensitive."

Even with the same UV exposure,

pigmentation deepens faster than it would in other patients.

In these cases, relying solely on Laser toning

actually increases the risk of side effects.

My standard approach combines oral tranexamic acid,

Laser toning sessions spaced 2–4 weeks apart,

and adjunct Recovery procedures.

Nearly every management approach starts from the same two points:

rest and reducing energy.

Not accelerating the session schedule.

Three Frequently Asked Questions

About Melasma Laser Side Effects

Q1. I had a Laser toning session and my skin got darker a week later.

Should I go back sooner for my next session?

No — going back sooner is not the answer.

That darkening is exactly what rebound hyperpigmentation looks like.

In cases like this, I always advise

a mandatory 4–6 week break.

Q2. So how many sessions does it actually take

before I see real results?

There's no fixed number that applies to everyone.

If you've completed around 4–6 sessions

with minimal visible change,

the settings need to be re-evaluated.

Rather than simply adding more sessions,

assessing your skin's response after the first four sessions

and adjusting the approach accordingly will get you further, faster.

Q3. Can melasma laser cause the skin to go completely white,

like vitiligo?

It's uncommon, but the risk is not zero.

It has been observed in select cases

involving more than 100 cumulative sessions.

It almost always occurs in patients who have received

frequent, closely spaced sessions over an extended period.

Managing melasma isn't about winning a battle against pigment —

it's about how long you can sustain an environment

that doesn't provoke melanocytes in the first place.

In the next post, I'll cover

"When to rest and when to restart melasma laser" —

specifically how to judge the right timing.

When slow progress is actually a signal,

there's a specific rest period that matters.

This has been Dr. Wi Young-jin.