What is ADM? Detailed explanation of how to distinguish it from blemishes.

Please use the contents of this column as a source of information about ADM treatment, although our clinic does not currently handle lasers for ADM treatment.

I wonder if my spots are ADM?"

I need to know how to tell ADM from other spots."

What is ADM anyway?"

How are we going to treat them?"

Hello, I am a doctor at Smart Skin Clinic.

Do you have any of these problems?

There are many different types of spots, whether they are melasma or ADM? It is hard to tell, isn't it?

Therefore, a cosmetic dermatologist will explain ADM from a professional standpoint in an easy-to-understand manner.


What is ADM?

In a word, ADM is one of the "spots".

A blemish is "an increase in melanin in the skin.

This may sound a little difficult, but while other spots have increased melanin in the "epidermis", ADM has increased melanin in the "dermis".

Although not fully understood, the mechanism seems to be that some stimulus activates previously dormant dermal melanocytes, resulting in an excessive increase in melanin in the dermis.

Features of ADM

Prevalence of 20 years of age or older

Bilateral symmetrical spots

The following 6 sites are frequently affected

6 favorable sites

(1) Zygomatic protrusion 85%

(2) Lower eyelid 24%

Nasal root 7%

(4) Nasal wing 14%

(5) Temple to outer upper eyelid 11%

⑥Front outer forehead 28%

*[%] is the frequency of appearance of each site when 509 ADM patients were examined at Kasai Plastic Surgery.

How to distinguish ADM from other spots

Particular attention should be paid to distinguishing it from melasma.

This is because there is a very high risk of exacerbating melasma because it is treated with high-energy irradiation, as will be discussed later. Basically, conservative treatment, not laser treatment, should be pursued for melasma.

Treatment of ADM

Since ADM is an increase in melanin in the dermis (dermal melanocytosis), a laser that can reach the dermis is the treatment of choice.


Q-switched laser

High fluence pico laser irradiation (10 J/㎠~) (low fluence is difficult to treat)

Either of these treatments can cure the disease completely. Conversely, there is no need to take other treatment options because these treatments will cure the disease.

As a precaution, it should be noted that melanin is stored in the dermis, not the epidermis, so it takes time for it to be expelled after treatment. Specifically, it takes about 6 months.

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