Why one laser does not fit every brown mark
Pigment sits at different depths and has different causes. A freckle, a Hori's naevus and a melasma patch can look similar in a mirror, yet a setting that helps one can worsen another. So the first step is an examination, not a device.
Dr Sin Yong looks at the pattern, depth and spread of the pigment, with magnification where a lesion needs it. A dermatoscope is used where brown marks could be confused. Only then is a plan set, and that plan can be no laser at all.
Pigmentation removal Singapore: which method fits which type
| Pigment type | Where it sits | Usual method | Note |
|---|---|---|---|
| Melasma | Treated as a long-term condition | Sun protection and medical treatment first. Laser, if any, begins with R2 Glow alone | Managed, not removed. It can rebound after heat or aggressive settings |
| Freckles | Upper skin (epidermis) | Picosecond or nanosecond pulses on the DEKA TORO | They run in families and can return |
| Sun spots (solar lentigines) | Upper skin (epidermis) | 785 nm picosecond, with 532 nm nanosecond for the most superficial spots | They can return without sun protection |
| Age spots that are raised (seborrhoeic keratosis, or age wart) | A surface plaque, not a pigment deposit | CO2 laser, radiofrequency or shave after examination | Laser pulses that fragment pigment do nothing to it |
| Hori's naevus | Dermis | 1064 nm in staged, conservative visits | Creams and 532 nm do not reach dermal pigment |
| Post-inflammatory marks | Follows inflammation | Treat the inflammation first, then gentle toning or R2 Glow | Active inflammation keeps producing pigment |
| Pigmented mole | Varies | Dermatoscope first, then mole assessment | Atypical moles are excised for histology, not lasered |
Melasma, freckles and Hori's naevus are not the same problem
Melasma is managed, not removed. Sun protection and medical care come first, and a laser is only an add-on. Read the melasma guide for the wider plan. Creams that may be used include supervised hydroquinone with breaks, azelaic acid, cysteamine and retinoids. Oral tranexamic acid needs clotting-risk screening and does not suit everyone. Freckles sit in the upper skin and respond to short laser pulses, but they tend to run in families and can come back. Hori's naevus sits deeper in the dermis, so it needs 1064 nm and spaced, conservative visits. Creams will not reach it.
Age spot removal and sun spots
Age spot is an everyday phrase, not a diagnosis. It may describe a flat sun spot, which is pigment. It may also describe a raised seborrhoeic keratosis, sometimes called an age wart, which is a plaque of surface cells. This difference matters for age spot removal. A laser can fragment pigment in a sun spot, but it cannot fragment a keratin plaque. That lesion has to be lifted off physically with a CO2 laser, radiofrequency or a shave. A keratosis that does not look typical may be excised for histology or referred.
The devices and wavelengths used
On the DEKA TORO, with 785 nm picosecond pulses and 532 nm and 1064 nm nanosecond emissions chosen by depth. See the pico laser page.
Long-pulsed 755 nm alexandrite and 1064 nm Nd:YAG. It is non-ablative and aimed at inflammation and uneven tone.
R2 Glow and T2 Frax Radiance combined, where a plan calls for both.
Low-energy 1064 nm passes. See laser toning.
532 nm for pigment in the epidermis, 755 nm for epidermal or dermal pigment, and 1064 nm for dermal pigment.
Who it suits, by skin type
Most patients in Singapore are Fitzpatrick III to V, and skin type shapes every setting. In types II and III, 532 nm can be used for superficial spots. In type IV, longer wavelengths and lower fluence are used, and treatment is staged. In type V, 1064 nm and picosecond delivery are favoured, with test areas and more space between visits. It suits people with a confirmed diagnosis who will use sunscreen daily and who accept that maintenance is part of the plan.
Who should wait or choose another path
Elective laser is generally postponed.
Treatment is deferred until the skin has settled.
Acne, eczema or infection is treated first.
Photosensitising medicines or a keloid tendency change the timing or the plan.
A mark that bleeds, changes or looks atypical is examined or excised, not lasered.
Maintenance is part of care, so this is a poor fit if you want one final session.
What pigmentation treatment cannot do
It can be managed, but it is not taken away.
Pigment driven by inflammation, friction or medicines keeps forming until the cause is addressed.
It is a surface plaque rather than a pigment deposit.
Unclear lesions need examination first.
Sun spots, freckles and melasma can all recur.
Risks and side effects
Post-inflammatory darkening is the main cosmetic risk in Fitzpatrick III to V skin. Melasma can rebound after heat or aggressive settings. Over-aggressive treatment can leave pigment darker than it was, so any worsening is reassessed. Darkening is managed with gentle toning and topical treatment. Test patches are used where appropriate, and eyes are protected during laser. Report lasting redness or later darkening to the clinic.
What recovery looks like
Sessions and fees
There is no fixed number of sessions. Visits are staged and spaced, and the plan follows the response at each review. Fees depend on the pigment type, the instrument, the area, your skin type, any creams or medicines, and review. A per-session figure means little on its own, so fees are set out in writing after assessment, and that plan includes the option of no laser.