External and Internal Causes of pigmentation
There are many reasons why pigmentation is caused, one of the main causes being ultraviolet (UVA,UVB) rays. There are external and internal causes of pigmentation.
External Causes
Ultraviolet (UVA, UVB) Rays
Melanin is formed in the melanocite cells of the skin. Melanin protects the skin from ultraviolet rays. However, once the system of producing and discarding melanin becomes unbalanced, melanin will become concentrated in one area and become a spot.
Stimulation of Skin
Stimulation of the skin caused by acne, eczema, and burn scars can cause inflamation, leading to pigmentation. Using cosmetics that don't match your skin type, or washing the face the wrong way can also cause pigmentation.
Internal Causes
Aging
With age, skin cells divide at a slower rate... so the skin's turnover rate slows as well. Older cells containing melanin are not discarded and stay on your skin, causing pigmentation. Ultraviolet rays will accumulate deeper in the skin with age, making new spots as well as turning spots that are already there darker.
Hormones
An unbalance of female hormones caused by periods, period irregularity, pregnancy, menopause, birth control pills can cause pigmentation.
Pigmentation caused by the above is called melasma (liver spots).
Stress
An increase in cortisol-stimulating adrenocorticotropic hormones caused by stress will over-stimulate and activate the melanin-producing melanocyte cells. A stressful, unbalanced life can lead to a tendency to get even more pigmentation
Lifestyle
A well-balanced lifestyle that factor in diet, sleep, and exercise are important to the body's health. The same can be said for the skin's health, and an unbalanced lifestyle can delay the turnover of the skin, unbalancing the system of discarding unneeded melanin, leading to skin with at tendency for spots.
Types of Pigmentation and Recommended Treatments

Age Spots
With the natual aging process and repeated sun exosure, the skin ages and pigmentationd spots will form. These usually can be seen in people in their 40's. Some people will see the beginnings of these as early as their 20s and 30s. Otherwise known as "sun spots" or "solar lentiges,". they are circular, brownish spots that can seen on the face, back of the hands, and on the back.
These characteristically appear all over face, on the backs of hands, and have a clearly definded edge.
Treatment Options
Photofacial, Alexandrite laser, Whitening Peel,etc.

Freckles
The medical term for this is "melasma," and they are brown spots between 1 to 4 mm on the skin. In many cases it will appear on the symetrically on the cheeks and on the nose, but it will also appear o the decollete, the chest, shoulders, and neck. It usually appears in areas where there is everyday UV exposure.
Freckles appear in early childhood, darken in adolescence, but it is may become lighter with the age.
Treatment Options
Photofacial, Alexandrite laser, etc.

Liver Spots
Liver spots (chloasma) are patches of pigmentation spread usually symmetrically on either cheeks or on the forehead of women in their 30s and 40s. Pigmented spots in general are usually caused by sun exposure, aging, and/or hormones. Liver spots are closely related to UV rays and hormonal unbalances (due to pregnancy, childbirth, contraceptive use.) Liver spots difficult to remove completely, but improvement in is possible. Colors will vary according to the individual, and may change depending on the health status and menstrual cycles of the person.
We can make recommendations for treating these spots tailored to your lifestyle.
Treatment Options
Photofacial, Alexandrite laser, Oral medications, Whitening Peel,Topical Products

Post Inflammatory Hyperpigmentation(PIH)
These are pigmented patches which form after inflammation in reaction to skin injury; i.e. acne, eczema, burns, etc.
These patches have a defined edge, and occur after injury to the skin, and can usually be seen on the face or hands
Treatment Options
Chemical peeling, CET, Topical medicine, Whitening Peel,etc

Pigmentatio Pedaloides Actinica
These freckles may appear after a sunburn caused by UV rays. They are brown or blackish brown in color and usually appear on the chest and shoulders.
Treatment Options
Alexandrite Laser, Photofacial

Acquired Dermal Melanocytosis
ADM is an abbreviation for Acquired Dermal Melanocytosis, its Japanese name literaly translates to "acquired bilateral nevus of Ota-like macules".
They are small brown or grayish pigmentation on the cheekbones on both sides of the face that increase in number starting after puberty. When on the cheeks, they are often mistaken for liver spots.
They are genetically inherited but are also linked to aging, sunburns, and hormonal imbalances.
Treatment Options
Q Switch Ruby Laser

Riehl Melanosis
Riehl Melanosis happens after exposure to certain ingredients in cosmetics. Mild contact dermatitis (rash) occurs and will gradually darken the skin. Also called pigmented cosmetic contact dermatitis.
It is facial pigmentation with fuzzy edges, is dark-brown to grayish-brown in color, and occurs on the forehead, cheekbones, in front of the ear, and on the hairline.
Treatment Options
Topical medicines, Photofacials, Whitening Peel, Chemical Peeling
Azabu Skin Clinic Treatment Options for Pigmentation
- Trial
- ¥12,000(tax-exclusive)
- 1 Times
- ¥15,000(tax-exclusive)
- 1 Box
- ¥169,000(tax-exclusive)

Risk / side effects
※There are cases of burns and subsequent pigmentation, but they are very rare compared to laser treatment.
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- ¥56,100(tax-exclusive)
800mg Trial ¥4,500 | |
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5 session¥20,000 | 10 session¥37,000 |
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5 session¥30,000 | 10 session¥56,000 |
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5 session¥39,500 | 10 session¥74,000 |
2000mg Trial ¥1,2000 | |
5 session¥50,000 | 10 session¥95,000 |
Additional Vitamin C(1g)+¥2,500
Additional Vitamin C(3g)+¥4,800
Frequently Asked Questions
Q1 I am suffering with blotches and freckles. What kind of treatment is available?
There is laser treatment / photo facial for treatment method. Laser treatment is usually improved once, but after surgery only medication is needed in the affected area. If the photo facial reacts to the stain, you can make sandy scabs, but makeup is possible.
Q2 The acne scar on the back has become black like a stain. How long does it take if I treat it?
In case of pigmentation after inflammation such as acne, treatment is effective with peeling ・ external medicine. It usually treats at a pace once every two weeks, and it depends on the condition regarding the number of times.
Q3 I am currently pregnant, but is it possible to treat stain?
People who are pregnant, peeling treatment ・ topical medicine is possible.
Q4 Originally the skin is pretty black, is there treatment or care recommended as a skin whitening care?
Recommended treatment method is peeling ・ CET hyperthermia ・ introduction of vitamin C ・ oral administration ・ white spot injection is effective. Also, it is more effective to use sunscreen / vitamin C blended skin care in common use.
Q5 Is there pain in treatment of spots?
There is no bleeding or scar remains in treatment. Also, there is no worry about side effects on the human body.