How Effective are Laser Treatments On Melasma and Pigmentations

How Effective are Laser treatments on Melasma and Pigmentations

How Effective are Laser treatments on Melasma and Pigmentations

Laser treatments help to improve and lighten pigmentations, and in some instances, permanently remove them. The road to even skin involves combining lasers, topical treatments, peels, sun protection and healthy lifestyle.


Pairing up the right laser with your pigment condition allows for best results to be achieved. By using the correct wavelength and intensity, the laser is able to target pigments in different layers of the skin as well as break down the various pigment colours ranging from grey, brown, blue, red, orange, purple or green. There is not one laser machine which can address all pigmentation issues. It Is important to consult an experienced and reputable medical practitioner to analyse your skin, identify your condition, and provide a responsible treatment plan to treat the pigments effectively.


Patients become very excited prior to treatment with the prospect of having a clear face but leave disappointed because the results did not live up to their expectation. Lets dispel the myth that laser treatments will magically remove pigmentations and it’ll never come back. It’s important for the physician to draw up a treatment plan and effectively communicate what realistic results to expect. In the hands of an experienced physician, they will be able to identify the cause and type of your pigments (hormones, sun damage, hereditary aging and inflammation) and determine a suitable course of treatments.

Lasers work by shattering and breaking down the melanin into tiny fragments while the body’s immune system naturally target these fragments as waste, and it’s slowly remove from the skin. The top 3 melanin-targeting wavelengths used in lasers include 532nm, 755nm and 1,064nm and the top 2 laser pulse durations used include the q-switch nano second and the picosure pico-second technology. Correct skin diagnosis along with selecting the right laser settings could determine whether you’ll see successful results.


As a general guide, the q-switch or pico laser in the 532nm wavelength is better suited to treating pigments at a superficial epidermal level. The following types of pigments will see positive results when paired with this wavelength:

Lentigines – sunspots, liver spots, brown patches with clear defined edges and present on skin with frequent sun exposure.

Seborrheic Keratosis – slightly elevated pigmented spots

Freckles – small cluster of light brownish spots on the skin and more common on people with fair skin.

Dermatosis Papulosis Nigra – small, black marks and commonly seen on people of Asian or African descent.

Telangiectasia – facial spider veins caused by a dilation of capillary vessels or arterioles.

Cherry Angiomas – flat or slightly raised red lesions and is commonly found on the face and trunk of the body.

Spider Naevi – slightly raised, red spider-like lesions. The short wavelength is extremely well absorbed by both oxyhaemoglobin (in bright red blood cells carrying oxygen) and melanin (black or brown color pigment found in the skin).

694nm and 755nm WAVELENGTH LASER

The 694nm ruby or 755nm Alexandrite Q-switch may be more suitable for darker skin patients as the longer wavelength is less harsh on the skin and significantly reduces the risk of PIH development. Alexandrite lasers cause very precise tissue destruction of the lesion and leave the tissue in the surrounding area undamaged.

Just like the 532nm, the 694 and 755nm can be effective at targeting lentigines, seborrheic keratosis, freckles, dermatosis papulosis nigra, telangiectasia, cherry angiomas or spider naevi

Shorter 532nm wavelengths are more strongly absorbed by melanin pigment and pose a higher risk of post-inflammatory hyperpigmentation (PIH). The longer 755nm wavelength will target the pigmented spots but cause less tissue damage and epidermal tissue destruction.

The longer medium wavelength is also beneficial for treating melasma as it can penetrate deep enough to take out superficial melasma pigmentation located in the epidermis and the deeper melasma pigmentation located deeper in the dermis.



The 1064 nm QS-Nd:YAG and 1064nm Picosure being a longer wavelength penetrates deeper into the skin and targets dermal melanin more effectively with minimal damage to epidermal layers. The low-dose QS Nd:YAG laser shatters the melanosomes causing fragmentation and rupture of melanin granules into the cytoplasm. This effect is highly selective for melanosomes as this wavelength is well absorbed by melanin relative to other structures. There is also subcellular damage to the upper dermal vascular plexus which is one of the pathogenetic factors in melasma. A mix of 694nm, 755nm and 1064nm should be used in combination to target different skin layers to deliver the best results.

Collagen Stimulation

The micro injury to the dermal layers of the skin stimulates collagen formation resulting in brighter more youthful looking skin. A course of 3 – 6 sessions will see an improvement in skin tone, texture, reduction in fine lines for a more youthful complexion.


Pre-operative preparation and post-operative maintenance are necessary to reduce complications and reduce the risk of a relapse and PIH.

Strict sun avoidance, along with the application of topical depigmenting agents and sunscreen 2 months before laser treatment is a must.

After the laser sessions are complete, a maintenance skincare regimen including lightening and brightening agents, will minimize the risk of a pigmentation relapse from occurring.

The majority of physicians will prescribe a hydroquinone cream as a topical agent to use pre and post treatment. But use this product with caution as there has been many reported side effects that come with long term use of this cream.


Laser treatments are successful for only a small percentage of those with melasma. Topical and oral treatments on the other hand have shown to be more effective in treating melasma for the medium to long term.

For a natural and more effective alternative to hydroquinone, products which contain kojic acid, ferulic acid, azelaic acid, arbutin, vitamin C, retinol, licorice root extract, salicylic acid, glycolic acid, and niacinamide provide a much better long term solutions.


Stay away from IPL and BB light IPL (or intense pulsed light) and BB (broad band) light should be avoided in people with skin of colour due to its potential to cause scarring. Furthermore, these types of light sources can worsen melasma and make it next to impossible to treat and control so should be avoided in people with melasma.

Sake Kasu is rich with kojic acid, ferulic acid and arbutin

Vitamin C Serum provides protection against free radical damage, reduces the appearance of fine lines, loss of firmness, uneven skin tone & premature signs of aging.

One thought on “How Effective are Laser Treatments On Melasma and Pigmentations

  1. Misspony

    Lasers has its place. But keep in mind that it is not a long term permanent solution. If your skin is susceptible to pigmentation, the only true solution is to avoid the sun and use lightening products that will inhibit melanin growth. I’ve had laser done with pico (3 sessions) and the results were great. But slowly the pigmentations came creeping back one by one. What you need is to be consistent and take it one day at a time, putting on your products, exfoliate, regenerate, and wait. Laser is like bang bang zap zap.


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