Laser for Hyperpigmentation: Your Pigmentation Type Matters More Than You Think 

Laser treatments are often the first words on people’s lips when it comes to treating pigmentation; a high-tech intense pulsed light treatment that zaps away post-acne marks, uneven skin tone and sun damage that skincare serums just aren’t shifting. But here’s the thing most blogs (and some clinics) won’t tell you: pigmentation isn’t the same for everyone. And there isn’t just one way to treat it.

At our Care Quality Commission regulated clinic in St. Albans, we’ve worked with some of the most advanced and data-supported laser technology in the world. Our MD, Nurse Jane, has even trained doctors internationally on how to use some of them. But going to a clinic that has the technology is just as important as your practitioner knowing when and how to use it. More importantly, it’s knowing when not to.

Why Have I Got Hyperpigmentation?

Hyperpigmentation is a broad, blanket term that is referring to areas of skin that has become darker than the surrounding skin. Hyperpigmentation happens when, for different reasons, the skin produces excess melanin, the pigment that gives your skin its colour.

Here are some of the main causes:

Sun damage. Exposure to UV rays can leave brown marks on the skin know as solar lentigines, or sun spots. Sun exposure can also stimulate freckles (yes, they’re a form of hyperpigmentation!) or a general uneven skin tone.

Melasma: This is a form of hyperpigmentation usually caused by internal factors such as hormones, medications, or hypothyroidism. Exposure to the suns UV rays usually makes the condition more obvious.

Post-inflammatory hyperpigmentation (PIH): Hyperpigmented marks left behind after inflammation, or trauma, to the skin. For example, after acne or after a cut.

Hyperpigmentation can sit on different layers of your skin, the epidermis and or the deeper dermis. This matters when choosing your hyperpigmentation treatment.

How Laser Treatment for Skin Pigmentation Works

Lasers break down pigmentation clusters by going into the skin at precise depths. After the laser treatment, the body naturally starts to remove it from your skin tone.

There are different types of laser for pigmentation:

Fraxel Dual laser: This is a globally respected, non-ablative fractional laser. Fraxel Dual has two wavelengths i.e. depths the laser will go into the skin; the 1550nm which allows us to reach the deeper dermis, ideal for deep hyperpigmentation, as well as collagen remodelling to improve scars and deeper wrinkles. The second wavelength, 1927nm, helps with pigmentation that is sat more superficially in the skin, as well as superficial textural issues.

Both Fraxel wavelengths create tiny columns of thermal ‘damage’ in the skin so that the body creates healthy new skin cells and collagen, allowing the old, hyperpigmented cells to rise to the surface and be removed.

This versatility allows us to treat sun damage, uneven tone, poor skin texture and quality with precision and safety. Another important fact about Fraxel laser is that it’s target in the skin is water (all lasers have a target, some blood, some melanin and so on); this means that Fraxel dual can treat ALL skin colours (Fitzpatrick Type 1-VI) safely and effectively.

If you’d like to see Fraxel Dual laser before and after photos, you can do so here.

Clear and Brilliant laser: This is also a fractional laser, using the same technology as the Fraxel Dual. It’s often referred to as the ‘Baby Fraxel’ because it uses the 1440nm wavelength and so is more superficial in the depth it penetrates the skin, ideal for superficial hyperpigmentation.

Clear and Brilliant is also great for improving enlarged pores, very early signs on skin ageing, and boosting overall skin radiance. It’s often used as a preventative skin treatment, especially on younger skin, or a maintenance treatment post Fraxel Dual.

Much like the Fraxel laser, the Clear and Brilliant laser can treat all skin tones safely and effectively.

See Clear and Brilliant laser before and after photos here, alongside a Clear and Brilliant review from our patient having been treated for post-inflammatory hyperpigmentation after acne.

PicoLasers: PicoLasers are good for treating stubborn areas of pigmentation (including tattoo removal) and depending on the type of PicoLaser it may sends shockwaves or traditional laser into the skin to efficiently break up pigmentation clusters and stimulate collagen.

Q Switched laser: An example of a Q Switched laser is the ND:Yag. It uses short bursts of intense laser energy to break (blast) up clusters of pigmentation. PicoLasers work similarly to Q Switch laser but it has a shorter pulse duration (measured in picoseconds, where as the Q Switch is nanoseconds)

“Laser is a fantastic tool; in fact, I've been using them in dermatology and aesthetic medicine since the very early 1990s... but it’s not a one-size-fits-all fix. It should be recommended following a thorough consultation, similarly to a medication, so that you fully understand the potential benefits and possible risks rather than being picked like a facial,” says Nurse Jane.

What Laser Can Help With (Brilliantly)

Lasers are exceptional, when used appropriately, at treating:

Sun damaged skin: Sunspots, freckles, general uneven tone. Hyperpigmentation resulting from sun damage, as well as other concerns from sun damage such as thinning skin and wrinkles, responds well to laser treatment.

Post inflammatory hyperpigmentation: Brown marks and dark patches that remain after the injury, such as spots or a cut, has healed.

If required, you can combine laser facial treatments with other skin regenerating methods, such as polynucleotides or Thermage skin tightening, completely dependent on your needs and desires.

“Lasers are about breaking down and lifting away the hyperpigmentation whilst also improving your skins texture and luminosity,” explains Nurse Jane. “You can successfully spot treat some individual pigmented lesions, like large sun spots, but the real ‘wow’ comes from improving the damage on a wider scale.”

Laser for Post Inflammatory Hyperpigmentation Treatment Review

“I decided to have a Fraxel treatment at the clinic and have to admit to being somewhat nervous, as I have never had any skin treatments previously. But, I have just reached 60 yrs old and was very aware that my skin was sun damaged; I had lots of very visible age spots and pigmentation, open pores, and wrinkles and my skin complexion was generally dull.

The treatment was uncomfortable but not painful, and very bearable. It was very hot for a few hours afterwards but cool lotion helped. I looked like my husband does after a day in the sun! Over the next few days, it peeled leaving pink, smooth skin underneath.

It’s now been 9 days post treatment and I couldn’t be more thrilled. Age spots gone, skin looking healthy and significantly more youthful. Friends are saying they’ve not seen me look so well for years.

The clinic environment, staff, care and consideration were fabulous and I would recommend this clinic, Jane and the treatment to anyone considering this. I feel so grateful to have had such an improvement in my appearance and I want to use this opportunity to thank Jane again. She genuinely went above and beyond what I expected and the results of the treatment significantly exceeded my expectations.” Catherine

When Lasers Can Make Pigmentation Worse

This is where nuance matters. Laser pigmentation removal firstly requires a trained eye to understand the type of hyperpigmentation you are experiencing.

If your pigmentation is actually melasma, this can be made worse by laser treatment with some patients experiencing rebound hyper-pigmentation issues following treatment.

Post treatment care, such as avoiding the sun, should be carefully followed.

“Even the best laser in world can make pigmentation worse if you don’t understand what you’re treating.” Says Nurse Jane, “That’s why it’s important to get a diagnosis for your form of hyperpigmentation, preferably with a skin scanner so that you can see what layers of the skin your pigment is sitting in, before you decide upon a treatment plan.”

If your hyperpigmentation turns out to be melasma, laser may not be your best friend. You can read more about that, and what we do recommend, in our melasma blog here.

We Don’t Just Use Lasers, We Prescribe a Personalise Solution

At The Skin to Love Clinic in Hertfordshire, we don’t sell treatments. We listen, assess, and offer safe and effective treatment options that are backed by clinical studies and our expertise and vast experience. If our patients decide to go ahead with treatment, together we build a skin plan that feels right to both them and their medical practitioner.

This might mean:

• Using laser pigmentation removal with full medical supervision.

• Combining laser with other treatments.
• Skipping the laser entirely and focusing on prescription skincare.

“I’m not afraid to say that we’ve turned people down for laser if it wasn’t right for them,” adds Nurse Jane. “That’s what ethical practice looks like. However, we are very lucky at Skin to Love to have a vast number of options in our treatment armoury. We purposefully invested in these many options because we know that one treatment doesn't suit all and we want to be able to offer the best and the safest solution to each patient.”