Pigment Problems · Stop First · CityLink Mall
Four problems account for most pico laser complications, particularly in Fitzpatrick III to V skin: darkening, pale spots, melasma that returns darker, and burns. This page explains how Dr Sin Yong works out which one you have at Atelier, what happens first, what can and cannot be undone, and which signs need a same-day call.
A picosecond pulse breaks pigment mainly by pressure, with less heat than a nanosecond pulse, as the pico laser page explains. Less heat is not the same as none. Every pulse is still a small, controlled injury, and in Fitzpatrick III to V skin injury readily turns into pigment.
When pico laser goes wrong, the cause usually comes back to dose, interval, diagnosis or sun. Settings and timing matter more than the device.
Types
Expected effects after pico laser are short-lived: some redness, temporary darkening over treated spots and fine flaking. The four problems below are different, and each is handled in its own way.
The Decision
At Atelier, Dr SY first identifies what the pigment now is, in good light and with a dermatoscope where needed, and asks what was done and when. Sun spots, freckles, post-inflammatory marks, melasma and deeper dermal pigment are separated, because each is handled differently.
The order after that does not change. No more energy goes in, the skin is shielded from the sun, and only then is the pigment looked at again. More laser is not the first answer to a laser complication.
Once the skin is calm, any further pigment work is chosen to fit the diagnosis and spaced generously: low-fluence laser toning, a conservatively dosed pico laser, or no device at all. Atelier's pico laser is the DEKA TORO; Dr Sin Yong holds a Key Opinion Leader appointment with DEKA. Toning is judged across a course and paused at the first sign of pigment loss, not continued to a fixed number of sessions. Melasma follows the melasma guide, and existing darkening the post-inflammatory hyperpigmentation page.
| Problem | First steps | What to expect |
|---|---|---|
| Darkening (PIH) | Sun protection, topical therapy and time; any later laser is low-energy and chosen once the skin has settled | Fades slowly; how slowly depends on how deep the pigment sits |
| Pale or confetti spots | Toning stopped; the skin is protected and watched, with no further toning to that area meanwhile | Often lasting and hard to reverse; some repigment slowly, while in published reports others persist |
| Rebound melasma | A melasma plan built on sun protection and topical therapy; laser, if used at all, is low-fluence toning, usually at 1064 nm | Melasma is chronic, so the aim is control |
| Burn or thick crusting | Seen the same day and treated to limit scarring | In Fitzpatrick III to V skin, pigment change or a scar can follow healing |
| A lesion that was never simple pigment | Referral for dermatological assessment of anything changing, bleeding or unlike its neighbours | No laser until the diagnosis is clear |
Safety
Redness, fine flaking and brief darkening over treated spots are expected. The signs below are not.
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Atelier Aesthetics · Owned by AYA
1 Raffles Link, #B1-28, CityLink Mall, Singapore 039393 · +65 8023 7170
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