Melasma
Targeted Pigment Management with Picosecond Technology
Melasma is a chronic pigmentary condition characterised by symmetrical brown or grey-brown patches, most commonly affecting the cheeks, forehead, upper lip, and jawline. It is influenced by hormonal factors, UV exposure, and genetic predisposition.
Because melasma involves both superficial and deeper dermal pigment, treatment requires a cautious, staged approach to reduce the risk of rebound pigmentation.
At our clinic, melasma management may include laser skin toning using picosecond technology, delivered via the Enlighten SR platform.
Why Picosecond Laser for Melasma?
Picosecond lasers deliver ultra-short pulses of energy measured in trillionths of a second. This rapid energy delivery produces a photomechanical effect that fragments pigment particles with reduced reliance on thermal heat.
In melasma management, this may offer:
• More precise pigment disruption
• Reduced surrounding thermal injury
• Lower risk of post-inflammatory hyperpigmentation compared with older nanosecond lasers
• Gradual, progressive lightening
Treatment is typically performed using low-fluence 1064nm settings (often referred to as “laser toning”) to minimise stimulation of melanocytes.
Suitable for Fitzpatrick Skin Types IV–VI
Melasma is more common in higher Fitzpatrick skin types. The 1064nm wavelength used in picosecond toning has lower melanin absorption compared to shorter wavelengths, which may improve safety in darker skin tones when conservative parameters are used.
However, all laser treatments carry risk, particularly in pigment-prone skin. Careful assessment, strict sun protection, and adjunctive skincare are essential components of safe treatment.
A Multimodal Approach
Melasma management rarely relies on laser alone. A comprehensive plan may include:
• Prescription topical pigment-regulating agents
• Strict daily photoprotection
• Oral or topical adjunctive therapies (when appropriate)
• Chemical peels (in select cases)
• Maintenance laser toning sessions
The goal is pigment control and stabilisation rather than permanent cure. Melasma is a chronic condition and recurrence can occur.
What to Expect
• Detailed consultation and skin assessment
• Discussion of triggers and lifestyle factors
• Series of low-fluence treatments spaced several weeks apart
• Mild redness or warmth post-treatment
• Gradual brightening over multiple sessions
Temporary darkening of pigment can occur before lightening.
Important Considerations
Laser treatment for melasma must be performed conservatively to avoid rebound pigmentation.
Potential risks include:
• Temporary redness or swelling
• Worsening pigmentation
• Post-inflammatory hyperpigmentation
• Rare blistering or scarring
Individual results vary. A full discussion of risks, benefits, and alternative options will occur during consultation.
