Pigmentation is one of the most common — and most stubborn — skin concerns we treat at Aurelia. Sun spots, melasma, post-inflammatory hyperpigmentation: these conditions can persist for years despite diligent skincare, because the issue lies not at the surface but deeper within the skin's melanin-producing cells. Pico laser has fundamentally changed what is achievable for pigmentation treatment, offering meaningful, measurable results with minimal downtime. Here is everything you need to know.
How Pico Laser Works
The name "pico" refers to picoseconds — one trillionth of a second. This describes the duration of each laser pulse. Traditional nanosecond lasers fire pulses in billionths of a second; pico lasers fire in trillionths. While the difference sounds abstract, the practical effect is significant.
When laser energy is delivered in ultra-short bursts, it creates a predominantly photoacoustic effect — shattering pigment deposits into tiny particles through pressure and vibration — rather than a photothermal effect, which generates heat. This distinction matters for several reasons. Less heat means less risk of thermal damage to surrounding tissue, reduced likelihood of post-inflammatory hyperpigmentation (particularly important in medium and darker skin tones), and faster recovery. The shattered pigment particles are then cleared by the body's immune system over the following weeks.
Pico lasers also stimulate collagen and elastin production through a secondary mechanism, making them useful not only for pigmentation but also for skin texture, pore refinement, and overall radiance. This dual action is part of what makes them one of the most versatile tools in modern medical aesthetics.
What Types of Pigmentation Can Pico Laser Treat?
Not all pigmentation is the same, and not all pigmentation responds equally to laser treatment. Understanding the type of pigmentation you have is the first step in designing an effective treatment plan.
Solar Lentigines (Sun Spots)
The most responsive category to pico laser. These flat, clearly demarcated brown spots caused by years of UV exposure typically respond in as few as 1–3 sessions. They are often the most satisfying to treat because results are visible and relatively quick.
Melasma
A hormonally influenced pigmentation that appears as irregular patches, typically on the cheeks, forehead, and upper lip. Melasma is more complex and requires a carefully calibrated approach — aggressive treatment can paradoxically worsen it through PIH. Pico laser, particularly with a low-fluence honeycomb lens, has shown strong results for melasma when combined with a comprehensive topical program and strict sun protection.
Post-Inflammatory Hyperpigmentation (PIH)
Pigmentation that follows skin injury, inflammation, or breakouts — particularly common in medium to deeper skin tones. Pico laser is often preferred over other lasers for PIH due to its lower thermal profile and reduced risk of triggering further pigmentation. A slower, more conservative protocol is typically used.
Café-au-Lait Spots and Birthmarks
Certain types of flat birthmarks and café-au-lait macules respond well to pico laser, though results vary by lesion type and depth. A test patch is always performed before treating these.
Freckles and Uneven Tone
Epidermal freckling and generalised uneven tone caused by UV damage respond well and can be addressed alongside broader skin rejuvenation goals.
The Treatment Process
Your Consultation
Every pico laser journey at Aurelia begins with a thorough physician consultation. We assess your skin type using the Fitzpatrick scale, identify the precise type and depth of pigmentation, review your sun exposure habits and skincare routine, and discuss realistic outcomes. For patients with melasma or darker skin tones, we may recommend a preparatory period using prescribed topical agents — typically hydroquinone, tretinoin, and SPF — to pre-treat the skin and reduce the risk of PIH from the laser itself.
On the Day of Treatment
The treatment area is cleansed and a topical numbing cream is applied for 20–30 minutes prior to your session. The laser handpiece is passed over the treatment area, delivering precise pulses of energy. You will feel a sensation often described as small snaps against the skin — most patients find this very manageable. The actual laser pass takes 10–20 minutes for a full face, depending on the area being treated.
Immediately after the treatment, the skin will look slightly red and the targeted pigmented spots may appear darker — this is expected and is a sign the laser has engaged the pigment. Small pinpoint marks or mild crusting over the spots may develop over the next 24–48 hours.
In the Days Following
Redness typically settles within a few hours. Any darkening of the treated spots followed by natural flaking off — a process called "micro-crusting" — occurs over 5–7 days. This is the pigment being brought to the surface before clearing. Do not pick or rub these areas.
Essential aftercare: Apply SPF 50 every morning, keep the skin hydrated with a simple moisturiser, avoid active skincare ingredients (retinol, acids, vitamin C) for 7 days, and avoid direct sun exposure and swimming for 1–2 weeks after treatment.
How Many Sessions Will You Need?
Typical Treatment Course
Most patients with sun spots and generalised UV-related pigmentation see excellent results in 3–4 sessions. Melasma, being hormonally driven, typically requires more sessions and ongoing management — it is a condition to be managed rather than permanently cured.
Who is a Good Candidate?
Pico laser is suitable for a wide range of skin types, including medium and darker skin tones — a significant advantage over older laser technologies. Ideal candidates include:
- Patients with sun spots, uneven pigmentation, or post-acne marks
- Patients with melasma who have not achieved adequate results with topicals alone
- Anyone looking to improve overall skin tone, radiance, and texture alongside pigmentation
- Patients who want an effective treatment with minimal downtime and no surgery
Pico laser is not suitable during pregnancy or breastfeeding, immediately following significant sun exposure or tanning, or for patients with active skin infections or certain skin conditions. A thorough consultation ensures treatment is appropriate for you specifically.
Managing Expectations
Pico laser produces real, visible results — but it works progressively over a series of sessions, and the final outcome depends significantly on your commitment to aftercare, particularly sun protection. The laser can clear existing pigmentation, but it cannot prevent new pigmentation from forming if sun exposure continues unprotected. The combination of in-clinic treatment and a disciplined daily SPF habit is what produces lasting results.
We are always honest at Aurelia about what is achievable. For straightforward sun damage, the outcomes are often quite dramatic. For melasma, improvement is significant but ongoing management is part of the conversation. Every patient leaves their consultation with a clear, realistic understanding of what to expect.