Pigment Laser

Pigment laser treatment aims to attenuate brown spots and cutaneous pigment deposits (lentigines, age spots, sun spots, certain types of melasma) by selectively targeting melanin. It is suited to individuals concerned with evening their skin tone, treating localised spots on the face, décolleté, or backs of the hands, and preventing the appearance of sun-induced hyperpigmentation. The approach aims for naturalness and facial harmony, with a personalised protocol based on skin morphology. This text is intended for general guidance.

Principles of Treatment

• Mechanism: pigment laser works on the principle of selective photothermolysis: a wavelength is chosen to be preferentially absorbed by melanin. The energy of the beam fragments the pigment into smaller particles that are progressively eliminated by natural mechanisms (phagocytosis, epidermal renewal).
• Types of devices: commonly used technologies include Q-switched (nanosecond) and picosecond lasers. The choice of device depends on the type and depth of pigmentation, as well as skin phototype.
• Personalisation: the protocol is adapted based on the type of spot (solar lentigo, post-inflammatory hyperpigmentation, melasma), location, and skin colour. A prior assessment is necessary to reduce risks and optimise safety.

Session Process

• Prior consultation: during the initial consultation, the physician performs a detailed skin examination, clarifies the patient's history (phototypes, sun exposure, current treatments), identifies contraindications, and explains alternatives (peels, depigmenting creams, photoprotection). A personalised treatment plan is proposed.
• Before the session: avoiding sun exposure, tanning sessions, and certain treatments (retinoids, recent hair removal) for several weeks may be required. A test on a restricted area may be performed to assess the skin's reaction.
• Process: the session generally lasts between 10 and 30 minutes depending on the area treated. The skin is cleaned; cooling devices or anaesthetic creams may be used to improve comfort. The practitioner adjusts the energy and appropriate wavelength. Laser impacts are felt as tingling or mild electric sensations.
• Comfort and precautions during the session: protective glasses are worn. It is important to mention any intense pain, history of infection, or use of photosensitising medications.

Post-treatment Course and Results

• Immediate post-treatment effects: redness, slight swelling, possibly a "burnt" superficial effect, or a darkening of the spot before its elimination (darkening effect). Very superficial crusting may form for a few days.
• Onset of results: spot attenuation may appear within a few days to several weeks, depending on pigment depth. Some superficial spots respond in 1 to 2 sessions; others, notably melasma, require a progressive approach and several spaced treatments.
• Duration of results: duration is variable and depends on the cause of pigmentation, sun exposure, and post-treatment care (photoprotection). Sun-related spots may reappear without adequate sun protection.
• Individual variability: responses are individual; the physician specifies realistic expectations during the consultation.

Contraindications and Precautions

• Main contraindications: pregnancy and breastfeeding, active skin infection in the area, recently tanned skin, recent isotretinoin use (depending on protocol), history of keloid scarring or severe healing disorder without specialist evaluation.
• Darker phototypes: darker skin (phototypes IV–VI) carries a higher risk of post-treatment hypo- or hyperpigmentation; a prior test and increased caution are necessary.
• General precautions: discontinue irritating treatments (retinoids, exfoliants) before and after the session as recommended; avoid sun exposure and apply high SPF photoprotection (SPF 50+) after treatment; avoid tanning sessions or UV exposure.

Risks and Possible Side Effects

• Common and transient effects: redness, swelling, sensation of warmth, transient darkening of the spot, formation of small crusts.
• Less frequent risks: superficial burn, local infection, scar, depigmentation (lighter patch), or post-inflammatory hyperpigmentation. These effects may sometimes require additional treatment.
• Management of complications: risks and their prevention are explained during the consultation. In case of persistent adverse effects, medical follow-up is organised.

FAQ (Frequently Asked Questions)

Is pigment laser painful? The sensation varies between individuals and by area: many describe tingling or brief electric sensations. Cooling devices and, if needed, local anaesthesia can improve comfort.

How many sessions are needed? The number of sessions depends on the type and depth of pigmentation: some superficial spots may improve in 1–2 sessions, while others require several sessions spaced 4–8 weeks apart. The plan is individualised.

When can I resume make-up and work after a session? Light make-up can often be resumed after redness and crusting have resolved, usually 24–72 hours or as per the physician's advice. Return to work is generally quick, except after more aggressive treatments where a longer delay may be recommended.

Can laser treat melasma? Melasma is a chronic and sometimes recurrent pigmentary condition. Laser may be proposed in some cases but often requires a combined approach (strict photoprotection measures, topical treatments, regular follow-up). The risk of recurrence or worsening must be assessed.