The short answer
Melasma is a long-term condition that is managed rather than removed. Pico laser has a small and careful role in that plan. It is not a cure, and it does not work alone.
Before any laser is discussed, Dr Sin Yong confirms the diagnosis from the pattern, your history and an examination. Sun spots, post-inflammatory marks and Hori's naevus can look similar, and each is handled differently. If your melasma is already responding to a topical plan, you may simply continue without laser. See melasma treatment for the wider plan.
How pico laser for melasma is used
The pico laser runs in a low-energy toning mode across the whole patch. It is not used as a spot treatment here. Settings favour a longer wavelength that surface melanin absorbs less strongly, low fluence, a larger spot and long gaps between visits. These settings are chosen for each person. A small test area may be treated first, and the response at review decides whether to continue. Darkening after a session is a reason to pause, not a reason to repeat treatment.
Who may be considered, and who should wait
Stable melasma in the upper skin, already managed with sun protection and topical therapy. Toning is approached conservatively even here.
Melasma that is working on the topical plan. It may continue without laser.
Melasma that is actively flaring.
Pregnancy or breastfeeding, and skin that was recently peeled, resurfaced or sunburnt.
Melasma with a strong vascular component. The R2 Glow laser may be considered first or instead.
A patch that darkened after an earlier laser. It is reviewed, not treated over.
What it cannot do
Melasma has hormonal, vascular and ultraviolet drivers, and pico laser treats none of them. It can only act on pigment already in the skin. So lightening can return if those drivers continue. Deeper pigment such as Hori's naevus sits in the dermis and is a different condition, which is why diagnosis comes first. No laser setting makes melasma go away for good, and any plan should be read with that in mind.
Risks to weigh
Heat or inflammation can darken melasma. Post-inflammatory hyperpigmentation can then layer over it.
Frequent, repeated toning has been linked to pale spots. This is one reason toning has a stopping point.
A brief snapping feeling, mild warmth and redness that settles. There should be no crusting at toning energy.
How a plan usually runs
Care that does the main work
Daily broad-spectrum sunscreen with visible-light protection, reapplied outdoors, sits at the centre of the plan. Hats, shade and avoiding heat such as saunas also help. Prescription creams such as hydroquinone or tretinoin, and oral tranexamic acid, may be discussed after assessment. These are prescribed and monitored by the doctor, not chosen from a list.
Sessions, recovery and fees
No fixed number of sessions is given, because toning is not an open-ended schedule. It has a defined stop point and review, with intervals long enough for the skin to settle. Strict sun protection follows each visit. Fees are set in writing after assessment, and the factors are explained then. Singapore's rules prevent prices from being advertised. You can arrange a consultation to have the patch examined.