Pigmentation

What is pigmentation?

Pigmentation refers to the colouring of the skin. Your skin gets its colour from a pigment called melanin, produced by special cells called melanocytes. When these cells become damaged or overactive, they can produce too much melanin, leading to pigmented lesions or dark spots (hyperpigmentation). 

Hyperpigmentation can affect all skin types and can appear on the face, hands, and other parts of the body frequently exposed to the sun.

 

Types of hyperpigmentation

  • Melasma: Often triggered by hormonal changes, melasma appears as symmetrical brown or grey patches, usually on the face.
  • Sunspots (Solar Lentigo): Caused by sun exposure over time, these appear as flat brown spots, typically on areas frequently exposed to sunlight.
  • Post-Inflammatory Hyperpigmentation (PIH): Dark patches that appear after inflammation or injury to the skin, such as acne, eczema, or cuts.
  • Freckles: Small, flat brown marks often found on sun-exposed skin; can be genetic or caused by sun exposure.
  • Age Spots: Common in older adults, these are a result of cumulative sun exposure and aging.
  • Birthmarks

 

What causes hyperpigmentation?

  • Sun exposure (UV rays increase stimulate melanin production, leading to dark spots or uneven skin tone).
  • Hormonal changes (pregnancy, birth control, menopause).
  • Skin trauma or inflammation/Post-Inflammatory Hyperpigmentation/PIH (dark spots that follow an injury or inflammation, such as acne, eczema, or a cut)
  • Medications (some drugs can increase photosensitivity or stimulate melanin production).
  • Genetics (a predisposition to certain types of pigmentation can be inherited).
  • Aging (as skin ages, pigmentation irregularities can become more prominent).

 

How does laser hyperpigmentation treatment work?

 

The Q-Switched Nd:YAG laser is a clinically proven and widely used technology for treating hyperpigmentation. It works by delivering short, high-energy pulses of light that target & break down pigment particles in the skin without damaging the surrounding tissue.

How It Targets Pigment:

  • The laser emits short, powerful pulses of light that penetrate the skin.
  • The energy from the laser is absorbed by the excess melanin in the pigmented areas.
  • The rapid pulses cause the pigment to break down into smaller particles. 
  • Over time, your body's natural healing process gradually removes these fragments, leading to a more even skin tone.

 

What are the benefits?

  • Visible Reduction in Pigmentation: Gradual fading of dark spots and discolouration, restoring a more even skin tone.
  • Non-Invasive and Precise: No cuts, stitches, or anaesthetic needed. The laser targets pigment precisely without affecting healthy skin.
  • Stimulates Collagen Production: In addition to treating pigmentation, the laser promotes collagen regeneration, improving overall skin texture and tone.
  • Quick Recovery Time: Most patients experience only mild redness or swelling, which subsides within hours to a few days.
  • Long-Lasting Results: With proper aftercare and sun protection, results can be maintained effectively over time.

 

Why is melasma not suitable for laser treatment? 

  • It's a more complex form of pigmentation than isolated pigmented spots
  • It usually involves multiple layers of the skin, and pigment deep within the dermis (making it difficult for lasers to reach and target effectively).
  • It's often caused by a combination of factors, including hormonal changes, inflammation, and sun exposure (making it more challenging to treat with a single laser treatment).
  • Laser treatments can cause inflammation & heat which are known triggers for melasma. 
  • Due to it's complex nature, melasma should be assessed by a doctor or dermatologist so that it can be treated appropriately & effectively, and should not be treated with laser unless part of a full treatment plan by a doctor or dermatologist. 

Does the treatment hurt?

No, it can sometimes cause a mild, temporary sensation, often described as a "rubber band snap" or a "stinging sensation". Some people find the treatment barely noticeable, while others describe it as mildly uncomfortable.

How many treatments will I need?

The number of laser treatments needed for hyperpigmentation varies depending on the type of pigmentation being treated, the size & depth, and severity, as well as your skin type.

Generally, for optimal results, 1-3 sessions are recommended for mild pigmentation and 4-6 sessions for moderate to severe pigmentation. Treatments are typically spaced 4 weeks apart to allow the skin to heal and pigment to fade gradually.

Will I see immediate results?

No, in most cases it takes 1-2 weeks for the treated skin to gradually break down and flake off, after which you'll notice a visible difference to the skin beneath

Can anyone have laser treatment for hyperpigmentation?

    Melasma should not be treated with laser unless part of a full treatment plan by a doctor or dermatologist. This is because melasma is a more complex form of pigmentation & often involves multiple layers of the skin, and pigment deep within the dermis, making it difficult for lasers to reach and target effectively. Additionally, melasma is often caused by a combination of factors, including hormonal changes, inflammation, and sun exposure, making it more challenging to treat with a single laser treatment.

    Unfortunately there are some medical conditions that would make laser treatments unsafe, these are;

    • Lupus
    • Immunosuppressive diseases (such as aids/HIV)
    • Keloid scarring
    • Bleeding/clotting disorders
    • Uncontrolled hypertension
    • Anticoagulant/blood thinning medication
    • Uncontolled diabetes 
    • Skin cancer 
    • Melasma or psoriasis in the treatment area
    • Photosensitivity, or any sensitivity to the sun that causes a rash or allergic reaction
    • Gold therapy or methotrexate
    • Immunosuppressive medications
    • Liver disease, such as hepatitis
    • History of hyperpigmentation or hypopigmentation

    There are also some medical conditions and medications that prevent laser treatments in the short-term, but providing you have none of the above, you could commence treatment once they were resolved. these are;

    • Preghnancy & breastfeeding
    • Active skin infections (e.g. eczema, herpes/colds sores)
    • Oral Isotretinoin or other prescription acne medication (such as Accutane/Roaccutane) in the last 6 months
    • Medical chemical peel, dermabrasion, laser skin resurfacing or face lift at site of treatment in the last 6 months
    • Light sensitive medications/herbal supplements, or perfumes/cosmetics/skincare that affect sensitivity to light
    • Use of NSAID's in the last week
    • Surgery or anaesthetic in the last 2 weeks
    • Open lacerations or abrasions in the treatment area
    • Botox or fillers in/under the treatment area
    • Chemical peel, microdermabrasion, or radio frequency treatment in the last 4 weeks
    • Some types of antibiotics

    Is there anything I should or shouldn't do before a treatment?

    • No sun-tanning or self-tanners 3-4 weeks prior to treatment  (Includes spray tans, tanning lotions, tanning beds, sun bathing, etc), and wear sunscreen when out in the sun 

    • Avoid treatments that may irritate the skin for 1-2 weeks prior to treatment (waxing, depilatories, etc.)

    • Discontinue use of retinol, glycolic acid, or salicylic acid 7 days before treatment

    • Avoid alcohol, smoking and strong painkillers for 24 hours prioir to your appointment 

    • Ensure your skin is clean and free of any makeup or lotions before arriving

       

    Is there anything I should or shouldn't do after treatment?

    Yes, there are some important ways to take care of your skin and aid healing after treatment, these are;

    • Avoid direct sun exposure (sunbathing, holidays, sun beds) for 14-30 days post-treatment
    • Use broad-spectrum sunscreen (SPF 50 or higher) daily
    • Avoid active skincare (retinols, AHAs, BHAs), as well as any products containing high levels of vitamin A and glycolic acid for at least 5 days
    • Keep the treated area clean and moisturised with a gentle product
    • Don’t exfoliate you skin within the first 7 days as it may cause irritation
    • Do not pick or scratch at any scabs, crusting, flaking skin or blisters
    • Avoid strenuous exercise, hot showers/baths, saunas, steam rooms and hot tubs for a minimum of 48 hours
    • Do not apply makeup for 24–48 hours, or until skin sensitivity has fully resolved
    • Avoid harsh skincare or cosmetics on the area until fully healed
    • Apply cool compresses as needed for discomfort or swelling

    Are there any side effects?

    Common side effects can include; temporary darkening of pigmented spots (this is normal and fades), mild redness and sensitivity, light flaking or crusting as pigment lifts from the skin.

    Most side effects are mild and temporary, resolving within a few hours to a few days.

    Does everyone need a consultation & patch test before treatment?

    Yes, all laser treatments require a full consultation & patch test before the first treatment can go ahead. 

    During the consultation we'll discuss your medical history, medications and other influencing factors, to make sure laser is a safe and suitable treatment for your goals.

    We will then carry out a patch test to assess your skin sensitivity & response to the laser. This helps determine the appropriate settings for the laser & identify any potential adverse reactions or side effects. 

    Please allow up to an hour for the initial consultation appointment.