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Different Lasers Treatment for Different Pigmentations

Choose the Right Laser Treatment for Pigmentation Problems 

Life in modern times is exciting. And it’s certainly hectic. It can also get exhausting. Despite our best efforts to beat back the vagaries of time and nature, we realize it’s a losing battle we’re fighting. And it’s the face and skin that first fall victim to factors such as the weather, pollution, and lifestyle issues. Skin that tends to sag, the fine lines and wrinkles that mar the face’s beauty, skin conditions such as pigmentation and melasma – the problems are many.  While there are many pigmentation lasers in the market, they each target the skin layer's different depth. So how do we decide which is the best laser treatment for your pigmentation concerns?

Hyperpigmentation Explained 

Hyperpigmentation is a skin condition that develops following the excess production of melanin in the body. Constant exposure to sunlight and other traumas such as pollution, hormonal inconsistencies, inflammation, and usage of some drugs, leads to the formation of sporadic dark patches on those areas of the skin – mostly the face, neck and arms.   

While there are many types of hyperpigmentation, it is melasma, solar lentigo and post-inflammatory hyperpigmentation (PIH) are the most commonly seen skin complaints in this category. 

Apart from being an eyesore, hyperpigmentation could well be an indicator of some underlying health issues, sometimes with potentially serious implications. It certainly makes sense from the cosmetic as well as the health perspective, to get professional advice and help.   

Types of Hyperpigmentation
Melasma is one of the most challenging skin pigmentation conditions for patients and doctors alike, as this chronic skin disease is unstable and can recur easily. It is a progressive pigmentary condition arising from a variety of factors like genetics, sun exposure, female hormones and birth control pills or pregnancy.  Melasma appears in the form of brown or brown-grey colored patches that are predominantly on the face. These spots form on facial areas such as the forehead, cheeks, bridge of the nose, upper lip, and the chin. Melasma spots are also formed on body parts such as the neck and arms. 
Solar lentigo

Also known as lentigines or senile frecklessolar lentigos are darkened skin patches that form on skin surfaces exposed to ultraviolet (UV) radiation. The condition develops because UV rays cause local proliferation of melanocytes and melanin accumulation within the keratinocytes or skin cells. Since the skin condition is generally observed in older people in the above 40 age group, solar lentigos are also known as an “old age spots”. 


Better known as liver spots, these flat and brown coloured spots resemble large freckles that are more common in people who cross the age of 40. The condition manifests on skin surfaces on the face, the neck, arms, and the backs of our hands. That is because these areas tend to get exposed to harsh and intense sunlight.  

Post-inflammatory hyperpigmentation (PIH)

This type of pigmentation is the dark marks or spots left behind after an injury or inflammation, such as acne, atopic dermatitis (Eczema), cuts and burns heals.This type of skin issue is generally more common in people who are relatively more dark-skinned. It can affect the both the face and the body.

Naevus (Ota, Ito, and Hori)

A hyperpigmentation condition that occurs due to malformation of melanocytes in the skin, appearing as stable and circumscribed spots. Brown birth marks are formed at the time of birth.  

Birth marks are formed on different parts of the body. These spots are known as Naevus of Ota, Naevus of Ito, or Naevus of Hori. Naevus of Ota appears on the upper parts of the face – usually the forehead and around the eyes. It may also cover parts of the eye, such as the sclera, cornea, iris, retina. Naevus of Hori affects the two sides of the face while Naevus of Ito appears on the shoulder and shoulder girdle areas. 

Laser Treatments for Pigmentation to the Rescue 

Fortunately, these modern times have also given us wonderful pigmentation removal solutions that can erase the blemishes and turn back the years seemingly by magic. When they made their appearance on the scene a few decades ago, LASERS or Light Amplification by Simulated Emission of Radiation beams were innovations with industrial and technological applications. Cut to the present, and lasers are our best friends when it comes to fighting the battle against ageing, pollution, and stress. 

Depending upon the type of skin pigmentation issues, there are different lasers treatment for different pigmentation issues.  These treatments act by focusing different types of laser beams, in a specific predetermined wavelength, on the affected skin surface. Laser treatments for pigmentation set the rejuvenation process in motion, prompting the generation of new skin cells to form, and stimulates new collagen synthesis.  

Difference between ablative and non-ablative lasers  

The medical-grade lasers deployed for pigmentation treatment, are broadly categorized under ablative and non-ablative lasers. Both these lasers can be applied in fractionated or unfractionated form. They can be used in combination with other energy-based devices like ultrasound or radiofrequency technologies.   

Ablative Laser

To understand the distinction between these, ablative lasers act on the skin’s upper layers by vaporizing them and inducing the growth of new skin cells. The newly formed skin is noticeably tighter and has a better texture. While ablative treatments are comparatively harsher than non-ablative laser, they are known to give quicker and significant outcomes for unstable conditions, but recovery takes some time. Fractioned lasers target a fraction of the area leaving normal skin in a grid pattern. For Asian skin, the fractionated ablative lasers are used on this is safer and gives shorter downtime. They are particularly effective in treating severe conditions like atrophic old acne scars and stubborn age wrinkles. 

Non-Ablative Laser

On the other hand, non-ablative lasers work on the dermis to decrease pigmentation, and also to tone the skin by boosting collagen growth. They are relatively gentler on the skin and offer faster recovery time. Often, there is no downtime. These lasers are used in treating different skin conditions and complement the ablative lasers. This type of laser is good for treating pigmentation conditions such as melasma, PIH, and solar lentigines. 

Laser Equipment Explained 

There are a variety of lasers which have been developed for treating different aspects of pigmentation problems. Some of the important lasers include: 

  • Long pulsed ND: YAG Laser

    A prime example of non-ablative lasers is the ND: YAG Laser used in the long-pulsed mode. This laser stimulates collagen production, tightens pores, and aids in skin quality revival. 
  • Nanosecond Q-Switched Nd: YAG Laser 

    It is effective in cases of superficial as well as deep skin discoloration situations. This pigment-seeking laser produces two wavelengths in nanosecond bursts. The 532 nm wavelength beams for treating skin lesions at the superficial level, and 1064 nm beams for deeper skin lesions. 
  • Picosecond Q-switched Nd:YAG or 755nm Alexandrite Lasers

    Also, a pigment-seeking laser variety, they emit picosecond energy bursts, a pulse duration of 1000 times shorter compared to the Q-switched variety. The picosecond laser works at such high-speed frequencies such that there is comparatively less thermal energy and more photoacoustic energy delivered. By generating a powerful acoustic wave, picosecond lasers physically shatter the pigments, thus clearing areas of hyperpigmentation caused by sunspots.
  •  577nm “Yellow” Laser

     As the name indicates, it is a yellow laser with enhanced blood absorption capability. This laser is good for targeting abnormal blood vessels, like dilated small facial veins. 
    Melanocytes are the cells that produce pigmentation. Yellow Laser also helps to reduce blood supply to the overactive melanocytes. Thus decreasing the production of pigmentation by these cells.  

So Which is the Right Laser Treatment for My Pigmentation? 

Although they work on the same principle, laser devices are available in many configurations to effectively treat the different types of skin issues. Each laser device in the clinic has a specific purpose or role in treating a specific part of the skin problems. Depending upon variables such as laser type, pulse, duration, energy, probe type, and laser wavelength, your doctor will choose the appropriate devices to address individual skin and aging complexities. But while lasers are routinely used in multiple skin treatments, it would be unrealistic to expect these wonder rays to be effective in all scenarios. For instance, while lasers can be immensely useful in clearing away the sunspots, supplementary laser devices may need to be added for the optimal treatment for pigmentation. 

Multiple skin conditions and variable factors are taken into consideration to determine suitable laser treatments for pigmentations. The permutations and combinations of treatments are mind-boggling. Therefore, that's something that is best left to the professionals.

In his past experiences handling laser treatments for pigmentation, Dr Thean has rarely come across entirely identical skin problems. Nor does he use exactly the same treatment for all his patients. For the uninitiated, all lasers may seem alike. However, pigmentation is a complex subject, and only the experienced doctor can help decide a treatment modality that can deliver tangible results in each individual case.  

Post-Procedural Scenario 

  • Some patients notice pigments visibly lighten after undergoing the first session. Thereafter, over the remaining sessions, the results will keep on improving. As the results begin to set in, remember that you may experience slight redness on the face that may subside after a couple of hours.
  • Keep away from sunlight in the initial period after treatment. Later ensure sun-protection in the form of sunscreen with a minimum SPF of 30 and above, along with other protective gears. 
  • To maintain moistness, apply soothing gel or serum on the treatment area and use gentle soap for cleansing. 

The Journey to Rejuvenated Skin 

As we can see, effectively resolving skin pigmentation issues involves accurate assessment, appropriate treatment, proper post-treatment care, and counseling. It is therefore important to connect with experienced doctors who handles pigmentation cases regularly to obtain advice and guidance.  Seek out the experienced doctor who can help you conquer hyperpigmentation.  


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