Why the type comes first
Dark patches can look alike and behave very differently. A sun spot sits in the outer layer of skin. Hori's naevus lies deeper. Melasma spans both, with hormonal, vascular and sun drivers. A seborrhoeic keratosis is a surface plaque and not a pigment deposit at all.
A laser chosen for the wrong one can make things worse. So the first step is examination, with magnification where needed, along with your history and skin type. Most patients in Singapore are Fitzpatrick III to V, and settings are adjusted for that.
Pigmentation treatment in Singapore: the short answer
Identify the pigment, stop what is feeding it, then treat conservatively. That order matters more than the machine. Procedures are described on the pigmentation treatment page. This guide explains how the types differ, and why a plan may end up with no laser at all. New, changing, bleeding or atypical lesions are examined and excised or referred, never simply lasered.
The main types and how each is approached
| Type | Where it sits | Usual approach |
|---|---|---|
| Sun spots and freckles | Epidermis | Picosecond or nanosecond pulses |
| Post-inflammatory marks | Epidermis, dermis or both | Treat the inflammation first, then gentle toning or R2 Glow |
| Melasma | Epidermis and dermis | Sun protection and medical treatment first. Managed, not removed |
| Hori's naevus | Dermis | 1064 nm in staged, conservative visits |
| Seborrhoeic keratosis | Surface plaque | Physical removal after examination |
| Pigmented moles | Needs examination | Diagnosed first. Atypical moles go for histology |
The lasers involved
Runs on the DEKA TORO, with 785 nm picosecond plus 532 nm and 1064 nm nanosecond emissions, chosen by depth. Used for sun spots and freckles.
Long-pulsed 755 nm alexandrite and 1064 nm Nd:YAG, non-ablative. Used for inflammation-driven tone. In melasma, it is used alone if a laser is used at all.
R2 Glow and T2 Frax Radiance run together.
1064 nm, for post-inflammatory marks.
Why melasma is handled differently
Melasma is managed and not removed. Heat and aggressive settings can cause rebound, so the plan starts with daily broad-spectrum sunscreen, tinted for visible light, and with avoiding heat such as saunas, hot yoga and long outdoor exercise. Creams may include supervised courses of hydroquinone with breaks, azelaic acid or cysteamine, and retinoids. Oral tranexamic acid is used only after screening for clotting risk, and it does not suit everyone. See pico laser for melasma for how laser fits, if at all. Melasma usually shows as soft-edged, roughly symmetrical patches on the cheeks, forehead or upper lip.
Why pigment can look worse after laser
Expected reaction. Leave it alone.
Post-inflammatory hyperpigmentation. Stop treatment, protect from sun, reassess.
Melasma rebound. Conservative plan, sun protection, creams.
Wrong target, or an untreated driver. Reassess the type and depth.
If your pigment has darkened
What treatment cannot do
It can be managed, not cleared for good.
Pigment under active acne or friction, or from an ongoing medicine, will keep forming.
Sun spots, freckles and melasma can return with sun, inflammation or hormonal change. Maintenance is part of the plan.
A lesion needing histology cannot simply be lasered.
Who should wait
Elective laser is generally postponed.
Treatment is deferred until the skin settles.
Inflammation is treated first.
Photosensitising medicines or a keloid tendency change timing or the plan.
Risks and aftercare
Sessions and fees
There is no fixed number of sessions. Staging is individual, and the response is reviewed before any repeat. Fees depend on the pigment type, instrument, area, skin type, cream or tablet plan, and staging. A written quote is given after assessment, and it may include the option of no laser. A per-session figure given without a diagnosis cannot be compared fairly. A consultation covers your history and medicines, examination with magnification, skin type and risk, and a written plan. Treatment follows only if advised, with review before any repeat. Cream or tablet treatment may come first, and sometimes the right decision is no laser at all. Results vary between people and between pigment types.