Pigmentation is not simply a brown spot sitting on the surface of the skin.
Pigmentation is the visible result of melanin, the pigment produced by melanocytes, being overproduced or unevenly distributed within the skin. Where that pigment sits, what has triggered it, your skin type and how long it has been present all influence how it should be treated.
Pigmentation can be caused or influenced by many different factors, including cumulative sun exposure, hormones, inflammation, ageing, genetics and certain medications. It can look completely different from one person to another, and you can even have several different types of pigmentation occurring on the same face.
This is why pigmentation removal is rarely a matter of simply finding a brown spot and treating it with one laser.
Pigmentation treatment can be appropriate for a range of unwanted pigmentation, including sun spots, age-related pigmentation, freckles, uneven sun damage and some forms of post-inflammatory pigmentation.
The important distinction is that not all pigmentation behaves in the same way. Some pigment is more superficial, while other pigmentation can sit deeper within the skin. Hormonal changes, inflammation, cumulative sun exposure, genetics, skin type and even your environment can all influence how it develops and how it responds to treatment.
Before your first treatment, please have your GP or dermatologist check the spots you'd like treated, especially anything new, changing, crusty or bleeding.
At this stage, I treat Fitzpatrick Skin Types I to III. I won't treat if you're pregnant or breastfeeding, have epilepsy, or are taking photosensitising medication. Recently tanned, sun-exposed or compromised skin may also need to wait.
I have also chosen to step away from treating melasma for now. I found it particularly challenging to manage, especially in our Australian environment where UV exposure is an ongoing factor.
There are some interesting newer approaches and products available, including herbs to peel protocols, and I may reintroduce melasma treatment in the future.
Sometimes knowing when not to treat is just as important as knowing how to treat.
The aim of laser treatment is to selectively target the unwanted melanin while being mindful of the surrounding skin. Depending on the wavelength and modality used, the laser energy is absorbed by the pigment and breaks it down into much smaller particles. The body can then gradually clear and process that pigment, while the skin continues its normal renewal process.
The response depends on what type of pigmentation we are treating, how deep it is, your skin type and how your skin responds.
There is no single laser wavelength that is ideal for every type of pigmentation.
I have access to multiple wavelengths and treatment modalities, which allows me to approach pigmentation selectively rather than treating every case in exactly the same way.
Before treating, I look at what type of pigmentation I'm seeing, where it sits within the skin, your skin type, your history, previous treatments and what may be contributing to it. This allows me to determine which wavelength, laser or combination of modalities is most appropriate.
I look at the type of pigmentation, where it is sitting in the skin, your skin type and the result I'm trying to achieve, and then I choose the technology and wavelength I believe is most appropriate for you.
For example, some superficial pigmentation may respond beautifully to a wavelength that specifically targets melanin, while deeper or more diffuse pigment may require a different wavelength, energy level or treatment strategy. Sometimes I will use one modality initially and then address the remaining stubborn pigment with another.
I may also treat the overall area first, rather than simply chasing individual brown spots. Once the broader pigmentation has improved, I can reassess the skin and, where appropriate, selectively treat the areas that remain.
This layered approach is important because pigmentation is often a combination of different pigment patterns rather than one isolated problem.
With the right treatment strategy, we can often achieve a very significant reduction in pigmentation, and in some cases the pigment can be completely cleared. However, pigmentation can also be recurrent because the factors that created it in the first place, particularly sun exposure and hormonal influences, may still be present.
That is why I don't simply treat the pigment and send you on your way. I look at the skin as a whole, consider what is contributing to the pigmentation, select the appropriate wavelength or combination of modalities, and then reassess how your skin has responded.
My approach is simple:
Understand the pigment. Understand the skin. Choose the right wavelength. Then treat accordingly.
The cost varies depending on which modality we use and what area of the body we are treating.
Because every pigmentation concern is different, I'll assess the area first and decide which technology and treatment approach I believe is most appropriate. We'll then go through the cost of your particular treatment during your consultation.
Call me for a clear picture of current pricing.
The thing I find myself repeating over and over again is that pigmentation is not a one-treatment-fits-all situation.
Not all brown spots are the same, and what works beautifully for one person or one area may not be the right treatment for another.
I also want people to understand that pigmentation doesn't always disappear overnight. Sometimes the pigment darkens and forms a fine crust. Other times the changes are much more subtle and the pigment is gradually cleared by your body over the following weeks.
Often, we can also see lines of demarcation following treatment. There's no need to panic if you notice them. They can occur as the treated pigmentation clears and they are addressed at your subsequent treatment session.
So my biggest message is: trust the process and understand that the right treatment is the one that's right for your particular skin and pigmentation, not necessarily the one that gives you the most dramatic reaction straight away.
Yes. I can show you exactly how to cover the treated area without interfering with the results, so you don't necessarily have to go around with your skin looking like you've had a treatment.
You can cover it up, so you generally won't need to be out of action. If you choose not to cover it, you'll probably look like you've had something done to your face for around five days, depending on the severity of the sun damage.
The more sun damage you have, the messier it's generally going to look after that first treatment. When we're treating brown spots, they should get darker before they get lighter and eventually shed away. Some people have very little visible reaction, while others will have more noticeable darkening and surface changes.
The good thing is that the consecutive treatments are usually much less scary-looking because we've already taken out the bulk of the pigmentation in that first treatment.
That said, I can go lighter with the treatment if that's what you prefer. The trade-off is that instead of perhaps needing three treatments, you might need six. It really depends on your goal and how much clearance you want.
Some people just want a sweep of the pigmentation and a fresher-looking complexion, while other people want me to really chip into it and remove it. We can tailor the treatment to what you're comfortable with and what you're trying to achieve.
Once you've completed your recommended series, maintenance will depend on your skin and how much sun exposure you're getting. Because we live in Australia, some people like to have maintenance treatments every three months, others every six months, and some once a year.
Personally, because I take such good care of my skin and protect it from the sun, I'm now at a point where I might do it around twice a year. When I first started, I was doing maintenance every 3 months without fail.
The important thing is that pigmentation is something you manage over time, particularly living in Australia. Once we've achieved the level of clearance you're happy with, we can work out a maintenance schedule that suits your skin and your lifestyle.
Results vary from person to person.
| Activity | When |
|---|---|
| Makeup | Next morning |
| Gym | Day 5 |
| Swimming | After 48 hours |
| Sauna | Ask me first |
| Sun | Ask me first |
| Alcohol | Ask me first |