Chamjin Korean Medicine Clinic
ACNE & CHARMJIN
[Health Week] Misconceptions and Truths About Black
Lentigines, black or brown spots that appear on the skin in various forms, have different characteristics depending on the type. Let's learn about the causes, characteristics, and treatments of lentigines with Dr. Lee Jin-hyeok of Chamjin Oriental Medical Clinic.

Q. What are lentigines?
A. Lentigines are pigmentation caused by excessive accumulation of melanin. They appear as brown or black spots, most commonly on the cheekbones, forehead, and cheeks. While overexposure to UV rays and aging are the primary causes, they can also develop during inflammation, the healing process after injury, or due to genetic factors.

Q. What is the difference between melasma and lentigines?
A. Lentigines are different from melasma and lentigines. Lentigines usually appear after UV exposure or inflammation, and are not symmetrical but appear in a specific area. They are distinct brown spots with narrow borders and a smooth surface.

In contrast, melasma often occurs in a larger area than lentigines, forming a butterfly-shaped pattern on the cheekbones or cheeks. While melasma is influenced by UV rays, it's often also caused by hormonal changes. Therefore, melasma that occurs during pregnancy is sometimes classified as pregnancy melasma.

Lentigo is a more distinct difference. Caused by aging or genetic factors, it typically appears after middle age and is raised on the skin's surface. They are black or dark brown in color, and can appear in areas where skin folds, such as the neck and armpits, rather than on the face.

Q. Can they appear at a young age?
A. If melasma is viewed solely as a sign of aging, younger people tend to have better resilience, making it much more likely for their skin to recover after UV exposure. However, melasma caused by an inflammatory response can occur at any age.

Q. Can acne develop into melasma?
A. We sometimes get asked whether acne can develop into melasma, but acne does not. Acne scars initially remain red and sometimes develop into black pigmentation. It's best to seek treatment before that happens. If pigmentation persists, choose a treatment appropriate for your skin type.

Q. Can lentigines be treated on acne-prone skin?
A. You can receive lentigine removal treatment even if you have acne or acne scars. However, several factors must be considered. First, assessing your skin condition is crucial. If you have severe active acne, it's best to first treat the acne and then proceed with lentigine removal. If you have both acne scars and lentigines, treatment that addresses both issues simultaneously is recommended for optimal outcomes. We recommend a thorough consultation with a specialist before treatment to determine the optimal treatment method for your skin type.

Q. Can lentigines be removed at home?
A. It's virtually impossible to completely remove lentigines at home. I've heard of folk remedies like applying vinegar or crushed garlic to the lentigines, but neither is recommended. Pigmented areas already have weakened skin, so if something as acidic as vinegar touches them, it could be incredibly irritating. It could even worsen symptoms or trigger other skin conditions.

Q. Is the popular belief that "left-untreated lentigines can lead to skin cancer" true?
A. This is a misconception. lentigines do not naturally develop into skin cancer. However, it is important to distinguish between lentigines and malignant melanoma. If what was previously considered a lentigine suddenly changes in size or color, grows rapidly, or is accompanied by symptoms like itching or bleeding, it could be malignant melanoma, so it's best to see a specialist. However, general lentigines are not a serious health issue, but rather a cosmetic concern, so there's no need to worry too much.

Q. Principles of lentigine treatment
A. Lentigines are a superficial skin condition that has already formed. They only affect the surface of the skin and don't penetrate deeper layers. They are usually located in the epidermis, not the dermis. Therefore, a treatment that breaks down pigments is recommended. It works by selectively targeting and destroying melanin pigments, allowing the destroyed pigments to be naturally eliminated from the body.

Q. Which treatment is more effective, peeling or laser?
A. Laser is more effective for treating lentigines. Peeling can sometimes irritate the affected area, darkening the pigment. Furthermore, peeling alone is unlikely to provide complete improvement.

Q. What type of laser is used to treat lentigines?
A. There are two main types of lasers used to treat lentigines. One method burns the pigment away, while the other burns it away. The former is typically performed with a Q-switched laser, and the latter with a long-pulse laser. Laser treatment, which involves baking away lentigines, is safer and more effective.

Q. Precautions for lentigines treatment
A. Unlike melasma, lentigines are often treated in one or two sessions rather than in multiple sessions. However, if the practitioner is overly aggressive and uses high energy, side effects can occur. It's best to use an appropriate energy level, and if the pigment persists after healing, it's best to complete the treatment with another session.

When treating lentigines with a long-pulse laser, the pigment often falls off like a scab after a certain period of time. It's crucial to allow the pigment to slowly fade. Therefore, you should apply a generous amount of moisturizer to the treated area and protect it from direct sunlight.

Q. Is there a specific season for lentigines?
A. Pigmentation treatments are best performed in the fall or winter, when UV rays are relatively weak, to reduce the risk of post-treatment side effects and additional pigmentation.

Q. How can I prevent lentigines?
A. Sunscreen is essential for preventing lentigines. It should be used consistently, even when indoors. UV rays entering through windows can have an effect, as can blue light from artificial lighting and electronic devices.

Using skincare products containing whitening ingredients can also be helpful. Vitamin C serums are effective. Consuming plenty of foods rich in vitamin C and antioxidants is also beneficial. If possible, the most effective treatment is to receive regular skin booster treatments to prevent hyperpigmentation.

Source: Health Week - https://www.healthweek.co.kr
Original article: https://www.healthweek.co.kr/news/view.php?bIdx=7986
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