Dark Marks · Cause First · Pacific Plaza
Pico laser for post-inflammatory hyperpigmentation (PIH) is considered at Atelier only once the inflammation that left the mark is under control, because a laser is also a controlled injury and can add pigment of its own. This page covers which existing marks Dr Sin Yong treats with pico laser, how depth changes the outlook, and what does most of the work alongside it.
A PIH mark is extra melanin left after something inflamed the skin: acne, eczema, an insect bite, a burn, friction, a peel or an earlier laser. The first question is whether that cause is still active. A mark that is still being fed will not clear, whatever is done to it.
Once the cause stops, many marks fade with time and sun protection. Pico toning, low-energy passes across the mark that break up pigment by pressure rather than heat, is kept for marks that persist after the cause is controlled and look likely to respond. It is not the first step.
At A Glance
What It Suits
Brown marks with a crisp edge sit in the upper skin and usually clear faster. Grey or slate-blue marks with a soft edge sit deeper and clear slowly, sometimes only in part; for these, the longer wavelengths (1064 nm or 785 nm) are chosen and a test area is often treated first. Pink or red marks are vessels, not pigment; see red versus brown marks. Melasma is ruled out before anything is treated. The condition itself is explained on post-inflammatory hyperpigmentation.
| Mark | Pico laser? | Instead, or alongside |
|---|---|---|
| Brown, edged, cause stopped | Toning considered, with a stop rule | Time, sun protection, topicals |
| Cause still active | Not yet | Control the acne, eczema or friction first |
| Grey or slate-blue, soft-edged | Cautiously, if at all | Realistic expectations; longer wavelengths |
| Pink or red | No | A vascular approach |
| Fitzpatrick IV–V, darkened before | After a test area | Prescription topicals may be used |
| Recent tan, photosensitising drug or isotretinoin | Deferred | Wait, protect, then reassess |
The Decision
Every plan starts with the cause: acne control, eczema care, removing friction (as in dark underarms) and no squeezing. Daily broad-spectrum sun protection follows. Prescription creams such as hydroquinone, tretinoin or azelaic acid may be discussed; each has side effects, and whether one suits you is decided at a consultation. Only then is laser considered, and some marks never need it.
Dr Sin Yong holds a Key Opinion Leader appointment with DEKA.
On The Day
Risks
Too much energy, stacked passes, a repeat session before the skin has settled, sun on treated skin and treatment over active inflammation can all add fresh PIH. Frequent repetition can leave pale or mottled spots. Redness and warmth are expected; blistering or pinpoint bleeding are uncommon at toning energy. Picking, scrubbing or restarting exfoliating acids too soon adds inflammation.
Darkening that appears weeks later is assessed, not treated over; pigmentation worse after laser explains why.
Continue
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9 Scotts Road, Pacific Plaza #12-01A, Singapore 228210 · +65 8023 7170
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