"Will one laser session clear all the pigment?"
"I've kept up with toning — why hasn't it changed?"
These are what people troubled by pigment say most often.
This is Director Kwon Si-jin of DA Clinic Myeongdong.
We're getting ready to open our doors in Myeongdong soon, and since so many people have been asking about pigmentation ahead of our opening, I wanted to put this together for your information first.
Today, three things to check before you start, wherever you go.
Do they separate the type of pigmentation first?
The brown marks on a face aren't all one thing.
- Frecklesrelatively defined borders, darkening and lightening with the sun
- Age spotsclearly bordered brown patches. They don't lighten easily
- Melasmadiffuse borders spreading broadly. Stimulation can darken it instead
- The nevus of Ota familythe pigment sits in a far deeper layer, so the approach itself changes
These four differ in the depth the pigment sits at and in their nature, so the approaches diverge. Melasma in particular can darken if a strong laser is used at high output, which makes it hard to handle the way other pigment is handled.
So ask at the first consultation, "what type is my pigment?" If a treatment is recommended without dividing the types, it's worth another think.
It's often hard to separate by eye alone. Whether it sits in the epidermis or runs into the dermis changes the session count and the expectations entirely. We start by dividing it by depth with Eve-V's pigment mode.
Do they explain why this particular laser?
Pigment lasers aren't one thing either. Their character changes with how short a time the energy is delivered over and at what wavelength, and the pigment they suit divides with it.
You needn't memorise the names, but knowing the families makes consultation easier.
- Picosecond familydescribed as delivering over an extremely short time to break pigment into fine particles. Because heat has less time to spread, it's spoken of as lowering the risk of pigment rebounding after treatment
- Q-switched familylong used for toning, building up across multiple low-output passes
- Combined-wavelength familycomes up where pigment and vessels are considered together
Wavelength divides in character too.Shorter wavelengths are described as reaching surface pigment, longer ones as reaching deeper.
We have these families separated out at our Myeongdong clinic: PicoSure Pro and PicoPlus on the pico side, Hollywood Spectra for toning, and Clarity II and V-Laser where pigment and vessels are considered together.
There's a reason for having two pico devices. One uses a wavelength often cited for pigment in Asian skin; the other is described as moving between two wavelengths to handle a wider range. Which device gets reached for changes with the depth the pigment sits at.
There's one thing to check here: whether "your pigment is this type, which is why we use this laser at about this intensity" is explained as a connected line of reasoning. If device names arrive without any account of your pigment, the consultation has the order backwards.
Do they give you a sun-protection plan alongside it?
The most disappointing moment in pigment treatment isn't during the treatment but afterwards.
Sun is the largest stimulus for making pigment, so without protection it returns easily to a site you cleared. That's why it can feel like it darkens again every summer.
So a good consultation discusses this alongside the treatment plan.
- When and how often to reapply sunscreen
- What stimuli to avoid during recovery
- How many sessions are envisaged, and when the mid-course review falls
Pigment rarely finishes in one go.A place that sets out the session plan from the start is, if anything, more reassuring.
I'd add that there's a period after treatment where fine flaking appears or the pigment briefly looks darker.It's described as the pigment rising to the surface, but without being told in advance it's easy to feel it has gone wrong.Watch for whether this is explained first too.
Why several sessions
"Can't you just go strong once?"
An entirely understandable question — but with pigment it doesn't work well.
Going in strongly once may break the pigment, but the surrounding skin takes the stimulation too.And that stimulation can come back as new pigment.That's especially so with sensitive pigment such as melasma.
So approaching it safely across sessions turns out faster.Surface pigment responds relatively quickly; where the nature differs, as with melasma, it's approached little by little across several sessions.
How the days after the treatment run
With pigment treatment, half of it is what happens afterwards.Knowing the course in advance saves unnecessary alarm.
- The day itselftemporary redness or warmth is possible, generally settling within the day
- 2 to 3 daysfine flaking may appear. Described as the skin sorting itself out
- 1 to 2 weeksthe pigment looks briefly darker, then fades
The most common mistake here is picking at the flaking.Forcing it off makes a mark likely.Moisturise well and let it come away on its own.
And missing sun protection in this period can bring pigment back to a site you worked hard to clear.These few weeks sometimes shape the result more than the treatment did.
That said, if redness runs severe beyond three days, if blisters form, or if pain steadily worsens, don't wait — contact where you had the treatment.
There's no need to rush in these cases
Honestly, if your skin is sensitised right now or you've had a lot of sun recently, waiting may serve you better.
Layering pigment treatment onto an area with lingering inflammation can leave marks that last longer.
And please do tell us in advance if any of the following apply.
- If you're taking any medication that increases light sensitivity
- If you're on, or recently stopped, an oral acne medication (the isotretinoin family)
- If you have a keloid tendency
- If you're pregnant or breastfeeding
- If there's an active condition such as herpes or eczema in the treatment area
In my experience, a place that says "calming the skin comes first right now" tends to be the more trustworthy one.
- Not which laser, but what your pigment actually is
- Hear the reason why this laser
- Get a sun-protection plan along with it
Frequently asked questions
Q. How many sessions are needed?
A. It varies widely with the type and depth of pigment.Shallow pigment responds relatively quickly; where the nature differs, as with melasma, it's approached little by little across several sessions. It's often described as management rather than clearing it in one go.
Q. I've developed a scab after the treatment.
A. Don't pick it off. Letting it come away naturally reduces the mark. Sun protection matters especially in this period.
Q. Won't a brightening cream do it on its own?
A. It can help with light surface pigment, but reversing deeply settled pigment with skincare alone is difficult.Its role in aftercare, though, is clear.
Q. My melasma looks darker.
A. Early in a course there's a period where pigment rises to the surface and looks darker for a time. If it only ever darkens, though, the intensity or method may not have suited, so it's safer to have it checked where you had it done.
Q. I've kept having toning — why is it the same?
A. Two things need separating.The pigment type may not have suited toning, or sun management may not have held, so as much came back as was cleared.Checking these two before adding more sessions is the right order.
Q. Can it not be done in summer?
A. The measure isn't the season so much as how well you can keep sun exposure off. If it's a period with a lot of outdoor activity, protection is hard and postponing may be better.
With pigment, not making it beats clearing it
Treat pigment for long enough and you arrive at the same conclusion: slowing the rate at which new pigment forms changes the result more than the speed of clearing it.
One last thing.
That's usually why the same treatment for the same number of sessions produces different results. The difference between applying sunscreen once in the morning and reapplying through the day comes back as a visible difference months later.
So a consultation that goes through how you've spent the last few months is genuinely more useful than a request for more sessions.
What is my pigment
Put together, it comes to this.
With pigmentation, knowing what your pigment is shapes the result more than knowing which laser you'll receive.
If you see it a little differently now than before you read, I'm glad.
DA Clinic Myeongdong is set to open soon.We'll share news of our opening and treatment information first on our blog and Instagram ^^
Thank you for reading.This was Director Kwon Si-jin of DA Clinic Myeongdong.
This column is an informational article meant to provide general medical information, and the effects and side effects of treatments may vary by individual. DA Clinic Myeongdong is set to open soon. (Medical Service Act Art. 56)