{"id":11743,"date":"2026-09-05T16:28:22","date_gmt":"2026-09-05T07:28:22","guid":{"rendered":"https:\/\/kojihifu.com\/english\/?p=11743"},"modified":"2026-09-05T16:28:23","modified_gmt":"2026-09-05T07:28:23","slug":"melasma-treatment-tokyo-causes-solutions-3","status":"publish","type":"post","link":"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions-3\/","title":{"rendered":"Melasma Treatment in Tokyo: Causes and Real Solutions"},"content":{"rendered":"<p><script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"MedicalWebPage\",\"@id\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/#webpage\",\"url\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/\",\"name\":\"Melasma Treatment in Tokyo: Causes and Real Solutions\",\"inLanguage\":\"en\",\"isPartOf\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#website\"},\"about\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#clinic-biotope\"},\"reviewedBy\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"lastReviewed\":\"2026-09-05\"},{\"@type\":[\"Article\",\"MedicalWebPage\"],\"@id\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/#webpage\"},\"headline\":\"Melasma Treatment in Tokyo: Causes and Real Solutions\",\"url\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/\",\"inLanguage\":\"en\",\"author\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"reviewedBy\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"publisher\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#organization\"},\"mainEntityOfPage\":{\"@id\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/#webpage\"},\"description\":\"Melasma treatment in Tokyo: what causes it, why it returns, and which topical, oral and laser options have real evidence. Book an English-speaking consult.\",\"datePublished\":\"2026-09-05\",\"dateModified\":\"2026-09-05\",\"lastReviewed\":\"2026-09-05\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/kojihifu.com\/english\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Skin & Dermatology\",\"item\":\"https:\/\/kojihifu.com\/english\/column\/skin-dermatology\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Melasma Treatment in Tokyo: Causes and Real Solutions\",\"item\":\"https:\/\/kojihifu.com\/english\/melasma-treatment-tokyo-causes-solutions\/\"}]}]}<\/script><br \/>\n<script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\", \"@type\": \"FAQPage\", \"mainEntity\": [{\"@type\": \"Question\", \"name\": \"How long before I see results?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Most protocols are assessed at 8\u201312 weeks, which matches the treatment durations used in the published trials. Melasma is a slow-responding, chronic condition, and maintenance is expected rather than optional.\"}}, {\"@type\": \"Question\", \"name\": \"Will melasma come back after treatment?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Recurrence is common \u2014 studies of laser monotherapy report rates of roughly 59\u201381 per cent within a year. Ongoing photoprotection and maintenance therapy are what keep results stable, and no clinic can promise permanent clearance.\"}}, {\"@type\": \"Question\", \"name\": \"Is there downtime with laser toning?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Low-fluence laser toning typically involves mild transient redness and warmth rather than true downtime, and most patients return to normal activity the same day. Device treatments such as RF microneedling involve more visible redness for a few days.\"}}, {\"@type\": \"Question\", \"name\": \"Can I be treated while pregnant or breastfeeding?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Melasma often appears or worsens during pregnancy, but most active treatments \u2014 including oral tranexamic acid and topical retinoids \u2014 are not appropriate at that time. Photoprotection and gentle skincare are the mainstays until after breastfeeding, when a fuller plan can be discussed.\"}}, {\"@type\": \"Question\", \"name\": \"Do I need to speak Japanese to be treated?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"No. Both clinics in the group provide English-language consultation, and enquiries can be made in English via LINE or WhatsApp.\"}}]}<\/script><\/p>\n<h2>Melasma Treatment in Tokyo: Causes and Solutions<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Melasma treatment Tokyo: causes and solutions \u2014 Melasma Treatment in Tokyo: Causes and Solutions\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_36602572_1788568749.webp\" alt=\"Melasma treatment Tokyo: causes and solutions \u2014 Melasma Treatment in Tokyo: Causes and Solutions\" \/><\/figure>\n<p><em><strong>Melasma<\/strong><\/em> is one of the most frustrating skin conditions to live with \u2014 it fades, then returns after one sunny weekend, and the products that clear ordinary sun spots often make it worse.<\/p>\n<p>If you are living in or visiting Tokyo and looking for a considered, medically grounded approach, this article explains what melasma actually is, why it behaves the way it does, and which treatments have real evidence behind them.<\/p>\n<p><strong>What you&#8217;ll learn in this article:<\/strong><\/p>\n<ul>\n<li>What melasma is and how it differs from ordinary sun spots and freckles<\/li>\n<li>The hormonal, ultraviolet and visible-light triggers that drive it<\/li>\n<li>Which treatments are supported by clinical evidence \u2014 topical, oral and device-based<\/li>\n<li>Realistic costs, session counts and downtime in Tokyo<\/li>\n<li>Two common misconceptions that lead patients to over-treat and worsen their pigmentation<\/li>\n<\/ul>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>What Is Melasma?<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Melasma treatment Tokyo: causes and solutions \u2014 What Is Melasma\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_3064717_1788568750.webp\" alt=\"Melasma treatment Tokyo: causes and solutions \u2014 What Is Melasma\" \/><\/figure>\n<p><strong>Melasma (\u809d\u6591, <em>kanpan<\/em> in Japanese)<\/strong> is a chronic disorder of pigmentation that produces symmetrical brown or grey-brown patches, usually on the cheeks, forehead, upper lip and jawline. Unlike a solar lentigo \u2014 the discrete, sharply bordered &#8220;sun spot&#8221; \u2014 melasma tends to appear as broad, diffuse, mirror-image patches with soft edges.<\/p>\n<p>Dermatological references describe three distribution patterns: centrofacial (forehead, cheeks, nose and upper lip), which accounts for roughly 50\u201380 per cent of cases; malar, over the cheeks and nose; and mandibular, along the jawline. Lesions are also classified as epidermal, dermal or mixed, with the mixed type being the most common \u2014 a distinction that matters because dermal pigment responds far less predictably to treatment.<\/p>\n<h3>Who develops melasma<\/h3>\n<p>Melasma affects women far more often than men, with typical onset between the ages of 20 and 40. It is most common in Fitzpatrick skin phototypes III and IV \u2014 the range into which most East Asian skin falls \u2014 and less common in very fair or very deeply pigmented skin. Around 60 per cent of patients report an affected family member, which suggests a meaningful genetic contribution.<\/p>\n<h2>What Causes Melasma?<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Melasma treatment Tokyo: causes and solutions \u2014 What Causes Melasma\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_14198477_1788568751.webp\" alt=\"Melasma treatment Tokyo: causes and solutions \u2014 What Causes Melasma\" \/><\/figure>\n<p><strong>Melasma<\/strong> is best understood as an overactive, hypersensitive pigment system rather than simple sun damage. Melanocytes in affected skin are larger and more reactive, and the surrounding keratinocytes, blood vessels and even the dermal layer participate in keeping the pigment switched on.<\/p>\n<p>The three most consistent drivers are ultraviolet and visible light exposure, hormonal influence, and heat or inflammation. Pregnancy and oral contraceptives are implicated in approximately one quarter of affected women, and thyroid disorders show an association. Scented cosmetics and certain medications can also act as triggers.<\/p>\n<p>Visible light deserves particular attention. Standard SPF ratings measure protection against ultraviolet radiation only, so a sunscreen can be labelled SPF 50+ and still allow the high-energy visible light that provokes melasma to reach the skin. For a reader in Tokyo, this is relevant year-round \u2014 commuting on foot, cycling and even light through office windows all contribute.<\/p>\n<p>At <strong>BIOTOPE CLINIC<\/strong> in Shirokanedai, we frequently see patients who have spent months on aggressive brightening routines aimed at &#8220;sun spots,&#8221; only to find the patches on their cheeks have widened rather than faded. In most of those cases, the underlying diagnosis was melasma, and the treatment plan had been working against the condition rather than with it.<\/p>\n<h2>How Melasma Is Treated: What the Evidence Shows<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Melasma treatment Tokyo: causes and solutions \u2014 How Melasma Is Treated: What the Evidence Shows\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_6048006_1788568752.webp\" alt=\"Melasma treatment Tokyo: causes and solutions \u2014 How Melasma Is Treated: What the Evidence Shows\" \/><\/figure>\n<h3>1. Photoprotection \u2014 the non-negotiable foundation<\/h3>\n<p>No melasma protocol works reliably without daily broad-spectrum sun protection, and evidence suggests that protection against visible light adds something meaningful. In a 2025 randomised, investigator-blinded study of 42 women followed through a Mediterranean summer, both tinted (iron-oxide, visible-light protective) and untinted sunscreens reduced mMASI scores, with no significant difference between the groups on that measure. However, the colorimetric contrast between affected and unaffected skin was significantly reduced only in the tinted group.<\/p>\n<p>The practical reading: consistent sunscreen use matters most, and a tinted formulation may offer an additional advantage in evening out tone.<\/p>\n<h3>2. Topical therapy<\/h3>\n<p>Triple combination cream \u2014 hydroquinone, tretinoin and a moderate-potency topical corticosteroid \u2014 remains the reference topical treatment, with clearance or substantial improvement reported in roughly 60\u201380 per cent of patients. It requires physician supervision, because prolonged unsupervised use of hydroquinone or steroids carries its own risks. Medical-grade topical programmes such as Zo Skin Health are one route we discuss with patients at consultation.<\/p>\n<h3>3. Oral tranexamic acid<\/h3>\n<p>Tranexamic acid interferes with the plasminogen\u2013plasmin pathway, dampening the keratinocyte-to-melanocyte signalling that drives melanin production, and it also has an anti-angiogenic effect that can reduce the redness component of melasma. A 2026 literature review reports typical dosing of 250\u2013500 mg twice daily, with one trial showing a 49 per cent reduction in mMASI at three months versus 18 per cent in controls.<\/p>\n<p>Safety is the question most patients ask about. A 2025 multicentre propensity score\u2013matched cohort of 1,364 patients found venous thromboembolism at 120 days in 1.6 per cent of both the tranexamic acid group and the matched control group (risk ratio 1.01; 95% CI 0.42\u20132.41). Clinical reports indicate no observed increase in short-term thromboembolic risk among appropriately screened patients \u2014 screening for clotting history, and for the use of oestrogen-containing contraceptives, remains essential.<\/p>\n<h3>4. Lasers and energy devices \u2014 helpful, but easy to overdo<\/h3>\n<p>Low-fluence Q-switched Nd:YAG laser, marketed in Japan as &#8220;laser toning&#8221; (\u30ec\u30fc\u30b6\u30fc\u30c8\u30fc\u30cb\u30f3\u30b0), is the most widely used device approach. A systematic review covering 42 studies and 1,736 melasma patients found most studies reported 30\u201360 per cent MASI improvement, typically over 5\u201315 sessions (most often 9\u201310) at one- to two-week intervals.<\/p>\n<p>The same review documents the risks candidly: mottled hypopigmentation in 5\u201321.9 per cent of patients, rebound hyperpigmentation in 5\u201314.1 per cent, and post-inflammatory hyperpigmentation in 2\u20136 per cent. Recurrence within a year was reported as high as 58.8\u201381 per cent when laser was used alone. Notably, combining laser with other modalities reduced the rate of mottled hypopigmentation and rebound to 1.1 per cent, compared with 14.1 per cent for monotherapy.<\/p>\n<p>A 2025 network meta-analysis of 14 trials and 738 women ranked intradermal platelet-rich plasma, and intradermal PRP combined with oral tranexamic acid, at the top of the SUCRA rankings, ahead of several device-only approaches. The consistent theme across the literature is that combination therapy outperforms any single modality.<\/p>\n<table style=\"border-collapse: collapse; width: 100%; margin: 20px 0; font-size: 0.95em; border: 1px solid #ccc;\">\n<thead>\n<tr>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Approach<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Typical course<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Evidence signal<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Main cautions<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Broad-spectrum \/ tinted sunscreen<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Daily, indefinitely<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Improves tone uniformity; foundation of every protocol<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Must be reapplied; not sufficient alone<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Triple combination cream<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">8\u201316 weeks, supervised<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">60\u201380% clearance or improvement reported<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Irritation; requires physician oversight<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Oral tranexamic acid<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">8\u201312 weeks typical<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">~49% mMASI reduction vs 18% control at 3 months in one trial<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Screening required; mild GI upset, menstrual changes<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Laser toning (low-fluence QS Nd:YAG)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">5\u201315 sessions, 1\u20132 weeks apart<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">30\u201360% MASI improvement in most studies<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Mottled hypopigmentation 5\u201321.9%; high recurrence as monotherapy<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Pico toning \/ RF microneedling<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Course-based, physician-planned<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Combination protocols reduce adverse events markedly<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Same overtreatment risks; requires conservative settings<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Who is a good candidate \u2014 and who should wait<\/h3>\n<p>Good candidates are patients with a confirmed melasma diagnosis who can commit to daily photoprotection and a multi-month course. Those who should postpone or avoid certain elements include women who are pregnant or breastfeeding, patients with a personal or family history of thrombosis or who are on oestrogen-containing contraception (relevant to oral tranexamic acid), and anyone with active facial inflammation, recent isotretinoin use or a recent tan.<\/p>\n<h2>Cost of Melasma Treatment in Tokyo<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Melasma treatment Tokyo: causes and solutions \u2014 Cost of Melasma Treatment in Tokyo\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_7607173_1788568753.webp\" alt=\"Melasma treatment Tokyo: causes and solutions \u2014 Cost of Melasma Treatment in Tokyo\" \/><\/figure>\n<p>Melasma care in Japan is, in almost all cases, self-pay. The following figures are from our group&#8217;s current published price list and are tax-inclusive.<\/p>\n<ul>\n<li>Consultation (initial or follow-up): \u00a53,300<\/li>\n<li>Laser toning, full face: \u00a515,000 per session; \u00a5135,000 for a course of 10<\/li>\n<li>Pico toning, full face: \u00a525,000 per session<\/li>\n<li>Photofacial M22 (IPL), full face: \u00a528,000 per session; \u00a5126,000 for 5<\/li>\n<li>POTENZA (RF microneedling), full face skin rejuvenation: \u00a539,800<\/li>\n<\/ul>\n<p>Because melasma responds to combinations rather than single treatments, budget realistically for a multi-month programme combining topical and oral therapy with a device course. Prices are subject to change \u2014 please see the clinic&#8217;s official price page or contact us for a current quote. For an accurate quote, please book a consultation.<\/p>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>What People Often Get Wrong About Melasma<\/h2>\n<h3>Misconception 1: &#8220;Tranexamic acid for melasma is covered by Japanese health insurance.&#8221;<\/h3>\n<p>It generally is not. The approved indications on the prescription tranexamic acid product information in Japan cover conditions such as abnormal bleeding, pharyngolaryngitis, stomatitis and urticaria \u2014 melasma is not among them, so prescribing it for melasma is off-label and self-pay. Separately, an over-the-counter formulation is approved as a \u7b2c1\u985e\u533b\u85ac\u54c1 (Class 1 OTC medicine) with the indication \u300c\u3057\u307f\uff08\u809d\u6591\u306b\u9650\u308b\uff09\u300d \u2014 spots, limited to melasma \u2014 dosed as two tablets twice daily over an eight-week programme. Approval as an OTC product for melasma and insurance coverage for a prescription are two entirely different things.<\/p>\n<h3>Misconception 2: &#8220;More laser sessions will clear it faster.&#8221;<\/h3>\n<p>This is the single most damaging assumption in melasma care. The systematic review data above links excessive cumulative laser energy to mottled hypopigmentation \u2014 white speckling that is considerably harder to correct than the original pigment. Restraint, conservative settings and combination therapy consistently outperform intensity.<\/p>\n<h2>Where to Get Melasma Treatment in Tokyo<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Melasma treatment Tokyo: causes and solutions \u2014 Where to Get Melasma Treatment in Tokyo\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_21939826_1788568754.webp\" alt=\"Melasma treatment Tokyo: causes and solutions \u2014 Where to Get Melasma Treatment in Tokyo\" \/><\/figure>\n<p>Within our clinic group, both BIOTOPE CLINIC (Shirokanedai, Minato-ku) and Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Chiyoda-ku) offer English-language consultation with Dr. Jun Karibe&#8217;s team. Melasma treatment \u2014 laser toning, pico laser, RF microneedling, medical topical programmes and oral therapy \u2014 is handled at BIOTOPE CLINIC in Shirokanedai, where Dr. Karibe personally consults. Insurance-covered general dermatology, such as eczema, acne or rashes, is handled at the Kojimachi clinic, the group&#8217;s main office. Bookings and enquiries in English: LINE or WhatsApp.<\/p>\n<p>If you are unsure whether your pigmentation is melasma or something else, a diagnostic consultation is the sensible first step \u2014 treatment for sun spots and treatment for melasma pull in opposite directions.<\/p>\n<h2>Frequently Asked Questions<\/h2>\n<dl class=\"kj-faq\">\n<dt>Q. How long before I see results?<\/dt>\n<dd>Most protocols are assessed at 8\u201312 weeks, which matches the treatment durations used in the published trials. Melasma is a slow-responding, chronic condition, and maintenance is expected rather than optional.<\/dd>\n<dd><\/dd>\n<dt>Q. Will melasma come back after treatment?<\/dt>\n<dd>Recurrence is common \u2014 studies of laser monotherapy report rates of roughly 59\u201381 per cent within a year. Ongoing photoprotection and maintenance therapy are what keep results stable, and no clinic can promise permanent clearance.<\/dd>\n<dd><\/dd>\n<dt>Q. Is there downtime with laser toning?<\/dt>\n<dd>Low-fluence laser toning typically involves mild transient redness and warmth rather than true downtime, and most patients return to normal activity the same day. Device treatments such as RF microneedling involve more visible redness for a few days.<\/dd>\n<dd><\/dd>\n<dt>Q. Can I be treated while pregnant or breastfeeding?<\/dt>\n<dd>Melasma often appears or worsens during pregnancy, but most active treatments \u2014 including oral tranexamic acid and topical retinoids \u2014 are not appropriate at that time. Photoprotection and gentle skincare are the mainstays until after breastfeeding, when a fuller plan can be discussed.<\/dd>\n<dd><\/dd>\n<dt>Q. Do I need to speak Japanese to be treated?<\/dt>\n<dd>No. Both clinics in the group provide English-language consultation, and enquiries can be made in English via LINE or WhatsApp.<\/dd>\n<\/dl>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Summary<\/h2>\n<p><em><strong>Melasma<\/strong> <\/em>is a chronic, hormonally and light-driven pigmentation disorder, not a collection of sun spots, and it rewards patience over intensity. The strongest evidence supports a layered approach: daily broad-spectrum photoprotection, supervised topical therapy, oral tranexamic acid where appropriate after screening, and conservative device treatment used as part of a combination rather than alone.<\/p>\n<p>Equally important is what to avoid \u2014 aggressive single-modality laser courses, unsupervised long-term hydroquinone or steroid use, and the assumption that faster is better. Realistic expectations, set at a proper diagnostic consultation, are the difference between steady improvement and a setback that takes longer to repair than the original condition.<\/p>\n<p>If you have questions about melasma treatment in Tokyo, both <strong>BIOTOPE CLINIC<\/strong> (Shirokanedai, Minato-ku) and <strong>Kojimachi Dermatology &amp; Plastic Surgery Clinic<\/strong> (Ichigaya, Chiyoda-ku) offer English-language consultation with Dr. Karibe and his team. Melasma treatment is primarily handled at BIOTOPE CLINIC in Shirokanedai. English enquiries: LINE or WhatsApp.<\/p>\n<div class=\"kjmc-en-booking-box\" style=\"background: linear-gradient(135deg,#f1faf3 0%,#e6f3ea 100%); border-radius: 14px; padding: 32px 24px; margin: 36px 0 24px; border: 1px solid #c5dccd; text-align: center;\">\n<h3 style=\"margin: 0 0 8px; color: #3a6e3a; border: none; padding: 0; font-size: 1.3em;\">24\/7 Consultation &amp; Booking<\/h3>\n<div style=\"width: 48px; height: 2px; background: #3a6e3a; margin: 0 auto 22px;\"><\/div>\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 1.1em; font-weight: bold;\">Book a Consultation or Treatment<\/p>\n<p style=\"margin: 0 0 24px; color: #2c4a35; line-height: 1.75;\">Our English-speaking team responds via LINE or WhatsApp \u2014 usually the same day.<\/p>\n<p style=\"margin: 0 0 10px; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #06C755; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(6,199,85,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #25D366; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(37,211,102,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>References<\/h2>\n<ol>\n<li>Lee YS, Lee YJ, Lee JM, Han TY, Lee JH, Choi JE. The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review. Medicina (Kaunas). 2022;58(7):936.<\/li>\n<li>AlJabr A, AlAnazi AMI, AlEtebi RAA. Tranexamic Acid for Hyperpigmentation Disorders: A Literature Review on Efficacy and Safety in Melasma and PIH. Journal of Cosmetic Dermatology. 2026.<\/li>\n<li>Hernandez T, Penny K, Culotta N. Oral tranexamic acid use for melasma is not associated with thromboembolism: Findings from a multicenter propensity score\u2013matched electronic health record cohort. JAAD International. 2025.<\/li>\n<li>Leung JH, Leung HWC, Wang SY, Jang YC, Chan ALF. Efficacy and Safety of Different Treatments for Melasma: Network Meta-Analysis of Updated Data. Diseases. 2025.<\/li>\n<li>Polena H, Queille-Roussel C, Graizeau C, Duteil L, Sayag M, Passeron T. Comparison of Visible Light-Protective Tinted Sunscreen to Untinted Sunscreen to Protect Melasma Patients During Summer: A Prospective Randomized Investigator-Blinded Study. Journal of Cosmetic Dermatology. 2025.<\/li>\n<\/ol>\n<h2>Related Articles<\/h2>\n<p>You may also find these articles useful.<\/p>\n<ul>\n<li><a href=\"https:\/\/kojihifu.com\/english\/tranexamic-acid-serum-melasma-guide-tokyo\/\" target=\"_blank\" rel=\"noopener\">Tranexamic Acid Serum: How It Differs from Oral Tranexamic Acid and Its Role in Melasma Treatment<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/english-speaking-dermatologist-tokyo-melasma\/\" target=\"_blank\" rel=\"noopener\">English-Speaking Dermatologist Tokyo: Melasma &amp; Pigmentation<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/dark-spot-removal-tokyo-laser-2\/\" target=\"_blank\" rel=\"noopener\">Dark Spot Removal Tokyo: Laser Treatment Options<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/picoway-laser-tokyo-pigmentation-tattoo-removal\/\" target=\"_blank\" rel=\"noopener\">PicoWay Laser Tokyo: Pigmentation and Tattoo Removal<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/laser-skin-treatment-tokyo-guide-2\/\" target=\"_blank\" rel=\"noopener\">Laser Skin Treatment Tokyo: English-Speaking Clinic Guide<\/a><\/li>\n<\/ul>\n<div style=\"margin: 2.5em 0 1em; padding: 1.5em; border: 1px solid #d5d5d5; border-radius: 10px; background: #fafafa; font-size: .9em;\">\n<p style=\"font-size: .72em; font-weight: bold; color: #888; margin: 0 0 1.2em; letter-spacing: .08em;\">SUPERVISED BY<\/p>\n<div style=\"display: flex; align-items: flex-start; gap: 1.2em; flex-wrap: wrap;\">\n<div style=\"flex-shrink: 0; text-align: center; min-width: 110px;\"><img decoding=\"async\" style=\"width: 100px; height: 100px; border-radius: 50%; object-fit: cover; object-position: top center; display: block; margin: 0 auto; border: 3px solid #e0e0e0;\" src=\"https:\/\/kojihifu.com\/hon\/wp-content\/uploads\/2022\/01\/photo-karibejun-400-3_re-300x300.jpg\" alt=\"Dr. Jun Karibe MD \u2014 Board-certified Plastic Surgeon, Director of Kojimachi Dermatology &amp; Plastic Surgery Clinic\" \/><\/p>\n<p style=\"margin: .6em 0 .1em; font-weight: bold; font-size: .95em; color: #222;\">Dr. Jun Karibe<\/p>\n<p style=\"margin: 0 0 .1em; font-size: .75em; color: #999;\">MD<\/p>\n<p style=\"margin: 0; font-size: .75em; color: #555; font-weight: bold;\">Director<\/p>\n<\/div>\n<div style=\"flex: 1; min-width: 200px;\">\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Education &amp; Career<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Juntendo University School of Medicine<\/div>\n<div>Department of Plastic Surgery, University of Tokyo Hospital<\/div>\n<div>Assistant Professor, Plastic &amp; Cosmetic Surgery, Saitama Medical University<\/div>\n<div>Assistant Professor &amp; Chief Resident, Yamanashi University Hospital<\/div>\n<div>2019: Founded Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Tokyo)<\/div>\n<div>2021: Founded BIOTOPE CLINIC Shirokanedai (Minato-ku, Tokyo)<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Certifications<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Specialist \u2014 Japan Society of Anti-Aging Medicine<\/div>\n<div>Certified Industrial Physician \u2014 Japan Medical Association<\/div>\n<div>Allergan VST-certified Injector (Botox &amp; Hyaluronic Acid)<\/div>\n<\/div>\n<\/div>\n<div style=\"background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Awards<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Best Presentation Award \u2014 Dept. of Plastic Surgery, University of Tokyo (2016)<\/div>\n<div>Excellence Award \u2014 Japan Society of Plastic and Reconstructive Surgery (2018)<\/div>\n<div>Featured Presentation \u2014 ASPS Annual Scientific Meeting, USA (2018)<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px solid #e8e8e8; display: flex; flex-wrap: wrap; align-items: center; gap: .5em;\"><a style=\"display: inline-block; background: #e1306c; color: #fff; padding: .4em .9em; border-radius: 4px; text-decoration: none; font-size: .8em; font-weight: bold;\" href=\"https:\/\/www.instagram.com\/dr.jun_\/\" target=\"_blank\" rel=\"noopener noreferrer\">Instagram<\/a><\/p>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px dashed #d5d5d5; font-size: .78em; color: #555; line-height: 1.7;\">\n<p style=\"margin: 0 0 .3em; font-size: .72em; font-weight: bold; color: #888; letter-spacing: .08em;\">MEDICAL REVIEW<\/p>\n<div><strong>Jun Karibe, MD<\/strong> \u2014 Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Medical Director, BIOTOPE CLINIC<\/div>\n<div>Last medically reviewed: 2026-09-05<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"Melasma treatment in Tokyo: what causes it, why it returns, and which topical, oral and laser options have real evidence. Book an English-speaking consult.","protected":false},"author":4,"featured_media":11742,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[891,353,102,90,93,26],"class_list":["post-11743","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-skin-dermatology","tag-tranexamic-acid","tag-sun-protection","tag-skin-pigmentation","tag-laser-toning","tag-hyperpigmentation","tag-tokyo-clinic"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11743","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/comments?post=11743"}],"version-history":[{"count":1,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11743\/revisions"}],"predecessor-version":[{"id":11744,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11743\/revisions\/11744"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media\/11742"}],"wp:attachment":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media?parent=11743"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/categories?post=11743"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/tags?post=11743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}