Why did my spots suddenly increase? What are the possible causes and how can I deal with them without downtime?

Every time I look in the mirror, I worry about my blemishes. Many women today are troubled by the fact that they feel a sudden increase, but cannot take any downtime due to work or child-rearing. In recent years, in particular, stress, hormonal imbalance, and ultraviolet rays have been accelerating the appearance of blemishes at a rapid pace.

However, advances in cosmetic medicine have led to the emergence of treatments that can be undergone with virtually no downtime. Here, we will explain in detail, based on our professional knowledge, the causes that those who feel a sudden increase in blemishes should know first, as well as the types of blemish treatments that can be performed without downtime and precautions that are actually taken in the medical field.

 

Is spot removal without downtime really possible?

When a person feels a sudden increase in spots, the first concern for many is the appearance of the spots after treatment. In the field of cosmetic medicine, treatments are now available without downtime and without the redness and scabbing associated with conventional treatments, minimizing the impact on daily life.

Here we explain what downtime is in the first place, and "can spots really be treated without downtime?" from a medical perspective.

What is downtime in cosmetic medicine in the first place?

In cosmetic medicine, "downtime" refers to reactions such as redness, swelling, scabbing, and internal bleeding of the skin that temporarily appear after a procedure. These reactions are a natural process of skin inflammation caused by the irritation of the procedure and are also a process of healing and regeneration.

However, there are many cases where daily life is interfered with, and especially with facial procedures, "not being able to go out for a few days" or "not being able to cover up with makeup" can be a problem.

Treatments medically defined as "no downtime" are those that act on a very shallow layer of the skin (epidermis) and cause little or no inflammatory reaction. In many cases, these treatments are so minimally invasive (physically damaging to the skin) that makeup and face washing can be performed immediately after irradiation.

What is the rationale for "no downtime" treatment?

Can it really be done with zero downtime?" The evolution of cosmetic medicine has provided an answer to this question with solid evidence.

Recent laser devices are structured to allow very fine control of wavelength and pulse width (irradiation time), making it possible to target only melanin pigments by focusing on the required depth and intensity. This allows for a selective approach that breaks down only the pigment without damaging normal skin tissue.

For example, "picotoning" irradiates the skin surface at extremely low power to gradually fade blemishes without causing skin redness or scabbing. Light therapy (IPL) can also approach multiple skin problems while reducing inflammation through its output and filter design.

In other words, no downtime is not a pipe dream, but a medically feasible treatment, thanks to the selectivity of wavelengths and advances in output control technology.

 

What are the main blemish treatments available without downtime?

In the previous chapter, we reported on the question, "Can spots really be treated without downtime?" I informed you that it is possible due to the advances in cosmetic medicine and the selectivity of equipment. However, it is also true that "any treatment can be completed without redness," and each treatment method has its own characteristics and precautions.

treatment	Recommended number of times	down time	Adaptation Stains
picotoning	5 to 10 times	Almost none to within 1 day	Melasma, dullness, uneven coloration
IPL (Rumekka)	3-5 times recommended	Redness: a few hours / Scab: 2-7 days	Early spots, uneven coloration, red face
Q-switched ruby	1-2 times	Scab: about 7 days	Dark spots/ADM
chemical peeling	3-6 times or more	alopecia minor	Pigmentation, pores, dullness
LED/Internal	continuation	nashi (Pyrus pyrifolia, esp. var. culta)	Postoperative care, inflammation control, recurrence prevention

Here, we will explain in detail the main treatments with less downtime that are actually offered at cosmetic clinics, based on domestic information and clinical results. We will provide you with easy-to-understand and organized information on how the effects are produced, the types of spots for which they are indicated, the number of treatments, and even points to be aware of.

Picotoning｜Low irritation laser suitable for melasma and uneven coloration

Picotoning is a treatment method that irradiates a laser with an extremely short pulse width of picoseconds (one trillionth of a second) evenly over a wide area at very low power. The melanin is microparticulated and discharged, allowing the pigment to gradually fade away without placing a burden on the skin.

Below are the features and effects.

• Indicated for irritability spots such as melasma, dullness, and uneven coloration
• Almost no downtime. Redness may occur, but only for a few hours to a day at most.
• Many people feel changes after the 3rd or 4th session, aiming for clear improvement after 5-10 sessions.

The following are precautions to be taken in the treatment

• Depending on the output setting, there is a risk of melasma worsening. Irradiation by an experienced physician is a prerequisite.
• Not suited to the needs of those who "want it gone right away." Recommended for those who enjoy gradual changes.

IPL (Photofacial), Lumecca｜Light therapy for overall tone

Intense Pulsed Light (IPL) is a non-laser treatment that delivers flash light with multiple wavelengths. The main attraction of this treatment is that it can simultaneously improve pigmentation, capillaries, dullness, and freckles spreading throughout the skin.

LUMECCA" is the latest IPL equipment with high output and excellent wavelength design, and is said to produce effects faster than regular IPL, and changes can be felt after fewer sessions.

Below are the features and effects.

• Widely indicated for early age spots, freckles, redness and uneven skin tone
• Changes can be seen with 1-3 times, but 3-5 times is recommended.
• Overall skin brightness and clarity is also easily improved.

The downtime and precautions for light therapy are described below.

• Redness and burning may occur, but most subside within a few hours to a day.
• Microcrusts (fine scabs) may appear at the irradiated area, which will peel off spontaneously in 2 to 7 days.
• May not be suitable for melasma, and misdiagnosis or mis-irradiation can cause worsening
• *Because Lumecca is an unapproved device in Japan, it is important to make sure to have a doctor's explanation before the procedure.

Q-switched ruby laser｜Pinpoint removal of dark, prominent spots

The Q-switched ruby laser is a treatment that targets dark, well-defined spots by utilizing a wavelength of 694nm, which has extremely high absorption for melanin. It is particularly effective for deep pigmented spots such as senile pigmentation and ADM (acquired dermal melanocytosis).

Below are the features and effects.

• Visible changes can be obtained after one or two irradiations.
• Fractures only the melanin pigment and causes minimal irritation to the surrounding skin

In addition, downtime and precautions are as follows

• After irradiation, a scab forms and peels off in about a week.
• Reactions such as pigmentation and bleaching may be temporary and last for several months
• UV protection and post-treatment protective tape management required.
• Not indicated for melasma or indistinct pigmentation

Chemical peeling, LED therapy, and oral medication｜Adjuvant therapy to improve skin texture from the foundation up

The causes of blemishes are not only "pigmentation," but also "disturbed skin metabolism," "inflammation," "sensitivity to ultraviolet rays," and many other factors. Supplementary treatments and care approach these backgrounds.

Typical auxiliary treatments include the following

• Chemical peeling (AHA/BHA): Removes dead skin cells and normalizes turnover. Downtime is mild peeling.
• LED therapy (red/near-infrared): Inhibits inflammation and promotes cell repair. Completely no downtime.
• Oral and topical tranexamic acid and vitamin C: effective in preventing melasma, uneven coloration, and recurrence.

These procedures can be incorporated before or after laser treatment to contribute to overall skin quality improvement and prevention of blemish retention.

One change at a time? Or more than once?

Unlike intense lasers that work deep into the skin, non-invasive procedures such as picotoning and IPL (photofacial) are designed to "reduce melanin in stages while improving the skin's natural tone. Therefore, rather than a dramatic change in a single session, the changes are experienced gradually over a number of sessions.

For example, picotoning is considered to be performed "5 to 10 times as a basic treatment frequency" by major cosmetic dermatologists in Japan, and it is said that many patients experience a change in skin tone and improvement in unevenness of color after the third treatment.

Similarly, IPL is "only partially felt after one session," and statistics have been published showing that 85% of patients experienced results after about five sessions every four weeks. As this information shows, it is the essence of a reliable, unhurried, no-downtime treatment.

On the other hand, the Pico-Spot and Ruby lasers irradiate dark spots at high power, making it easy to notice a clear change even with a single treatment. However, these may involve several days of downtime (redness and scabbing), so it cannot be said that they are completely "downtime-free. It is important to make a comfortable choice according to the condition of your skin and your life background.

 

What are the guidelines for each symptom and frequency?

The number of treatments required and the speed of improvement will vary greatly depending not only on which treatment method is chosen, but also on which type of blemish it is performed on. Here, we will organize the typical types of blemishes and the recommended treatments and number of treatments based on case studies published by medical institutions in Japan.

Type of stain	Recommended Treatment	Approximate number of times	feature
chloasma	Picotoning, combined with internal medicine	6 to 10 times	Susceptible to irritation, a slow approach is essential.
Solar pigmentation (senile pigmentation)	IPL, picospot	3-5 times	Caused by ultraviolet light. Relatively rapid response, but risk of recurrence.
post-inflammatory hyperpigmentation	Picotoning + internal/introduction of whitening	4-6 times	Caused by acne scars and friction. Recovery takes longer depending on skin type.
Freckles	IPL, Ruby Laser	3-6 times	Hereditary nature is common, and ongoing treatment is recommended, including prevention of recurrence

These figures are only an average guideline and may vary from person to person depending on skin type, lifestyle, and exposure to UV rays. Melasma, in particular, may be aggravated by irritation, so the output settings and intervals between visits should be carefully adjusted.

In addition, what is common to all treatments is that it is important to have an attitude of cultivating the "overall health of the skin" over the medium to long term, rather than being happy or sad about the results of a single treatment. Cosmetic medicine is not "magic. That is why the most natural and beautiful results are achieved when the effects are nurtured over a number of treatments under the supervision of a trusted doctor.

 

Things to check and be aware of before treating blemishes

We have shown that even spot treatments with little or no downtime can be highly effective with proper treatment selection and continuity. So, what are some things to look for before actually undergoing treatment?

Since cosmetic medicine is a "medical procedure," it is essential to ensure not only the content of the procedure, but also the expertise of the physician providing it, and the accuracy and safety of the equipment. In particular, for treatments that require delicate reactions, such as blemish treatment, making an easy decision based solely on "price" or "speed" can often lead to unexpected skin problems.

Here, we will carefully explain the key points for choosing a reliable clinic and the side effects and contraindications that you should know about, with examples of actual cases.

Criteria to identify a reliable clinic

First of all, as a prerequisite, the legitimacy of the equipment installed by the medical institution is an important item to check. In particular, some of the laser treatments that have been increasing in recent years are counterfeit products that are unapproved or inexpensive in Japan. Make sure in advance that you are using legitimate products.

The next thing to check is the specialty area and practice experience of the physician in charge. Doctors who are board certified in cosmetic dermatology and plastic surgery have a high level of knowledge of skin structure and ability to diagnose pigmented lesions, enabling them to select the correct treatment and respond to problems. Especially in procedures where it is important to distinguish between melasma and senile pigmentation, this "diagnostic accuracy" greatly influences the results.

In addition, the quality of counseling should not be overlooked. A medical institution that does not offer one-sided explanations or induce contracts in a short period of time, but rather conducts careful interviews and presents multiple options, is worthy of trust. Cosmetic medicine should be "interactive medicine," and proceeding with treatment based on conviction and peace of mind will lead directly to results.

Know about side effects and contraindications.

Even procedures that claim no downtime are not completely risk-free. Undergoing a procedure based on correct information and understanding will lead to safe treatment and increased satisfaction.

The following is a list of typical side effects and measures to deal with them, compiled from publicly available information from major cosmetic dermatologists in Japan.

Risks and Side Effects	frequency of occurrence	Coping method / Remarks
Redness/swelling	slight degree	Usually disappears spontaneously within a few hours to the next day
Temporary hyperpigmentation	rare	Thorough UV protection is important. SPF 50 or higher recommended when outside.
Dry and rough skin	rare to moderate	Often improves within a week with the use of moisturizers
Very minor burns and depigmentation	extremely rare	Only at high power irradiation. Minimize risk with authorized equipment and technology.

In addition, if any of the following contraindications apply, be sure to consult your physician in advance.

• Pregnant or nursing
• Those taking medications that increase photosensitivity (e.g., antibiotics, antimicrobials)
• Skin condition immediately after intense sunburn
• When active acne is extensive

This information is also consistent with the medical safety guidelines set forth by the Ministry of Health, Labor and Welfare and the Japanese Dermatological Association, and should always be confirmed and shared before the procedure.

 

How to make blemish treatment more effective? Includes tips on aftercare and more!

In the previous chapter, we explained how to identify a reliable clinic and the side effects and contraindications associated with the procedure. However, the results of cosmetic treatment are not determined solely by the procedure itself. The way you spend your time after the treatment and the presence or absence of appropriate concomitant care will greatly determine the effectiveness of the treatment.

Here, we provide detailed information from a professional perspective on the aftercare and concomitant treatments necessary to maximize satisfaction even with treatments that require little downtime.

What should I do for skin care after the treatment?

After laser or phototherapy, the skin is temporarily sensitive to external stimuli. In particular, IPL and picotoning, which target the epidermal layer, have less downtime, but still require careful attention to UV rays and dryness.

UV protection is paramount.

UV rays are a "hidden risk" for the skin after the procedure. To prevent pigmentation and post-inflammatory redness from worsening, it is strongly recommended to use a high-performance sunscreen with SPF50+ and PA++++. The standard instruction at cosmetic dermatologists in Japan is "use from the day of treatment" and "reapply every 2 to 3 hours.

In addition, physical shading such as hats, parasols, and UV-blocking masks are also effective when used in combination to completely block UV rays.

Moisturizing is the key to "soothing" and "strengthening the barrier

To prevent dryness and stiffness, use hypoallergenic, fragrance-free, non-alcoholic moisturizers. Products containing the following ingredients are particularly useful

• Ceramide: Supports skin's moisture retention function
• Hyaluronic acid: High water retention ability to maintain moisture
• Vaseline: effective in restoring barrier function (but be careful if you don't like stickiness)

It is important to moisturize "twice a day, morning and night" plus frequently "when you feel dry".

Recommended treatment for concomitant use

In many cases, spots and dullness are caused by a complex interplay of melanin and inflammation within the skin, so there are limits to what one treatment alone can do. This is why the combination of "medical treatment × aftercare × combined treatment" is attracting attention.

(1) Ion induction and electroporation

This technology allows active ingredients such as vitamin C and tranexamic acid to penetrate the skin after the laser without physical stimulation. The following operations are common in Japan.

combination method	Main Introductory Ingredients	Recommended Frequency	Main Purpose
ion implantation	Vitamin C derivative/tranexamic acid	About once a week	Melanin suppression and dullness prevention
electroporation	High molecular weight whitening ingredients (e.g., arbutin)	Once every two weeks	Improved penetration and moisturizing effect

When performed after laser or IPL, it is expected to have a synergistic effect that leads to clearer skin while reducing inflammation.

(2) Physician-prescribed oral medication (for melasma and uneven coloration)

Especially for melasma, since laser alone carries the risk of inflammation recurrence, a combination of internal therapy is commonly used. The recommended prescriptions in Japan are as follows

• tranexamic acid
• vitamin C
• yubela (species of African cichlid, Cichlus yubela)

These have been reported to improve melasma by up to 80% or more when taken internally continuously for 3 months or more.

 

summary

When you feel a sudden increase in blemishes, it is the right time to properly address the signs from your skin. Today, treatments with no downtime have been established that allow patients to return home without redness or scabs, making it possible to take care of blemishes with peace of mind and without disrupting daily life.

However, not all treatments are universal, and the best method of treatment depends on the type of blemish and skin condition. That is why it is important to first receive an accurate diagnosis at a reliable clinic and choose the best method for your skin. The knowledge you gain here will help you make a step forward, and the choice you make will make a big difference to your skin in the future.

At Aladdin Aesthetic Clinic, based on our many years of experience in cosmetic medicine and cosmetic dermatology and the knowledge of our doctoral degree, we provide counseling that aims to be "only one", offering the best treatment for each person we meet. We offer only the necessary treatments without any unnecessary information or suggestions.

Feel free to use our official LINE account for 24-hour counseling and reservations. Please feel free to contact us for free counseling for the first time or if you have any concerns.