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14 Minute ReadEducation by Jess Lacey
18.05.22 (Updated 03.04.24)
Pigmentation is amongst the top skin concerns reported across the globe, and for good reason. Firstly, because all skin suffers from pigmentation, no matter your ethnicity or skin type and secondly because unwanted pigmentation is arguably the most complex-to-treat of all dermal concerns. But how best to fade out unwanted pigmentation safely and effectively? Laser skin treatment is widely considered the best treatment for unwanted pigmentation and recommended by all top dermatologists.
Hyperpigmentation is an umbrella term for discolouration and darker patches of skin and depending on what type you have, and to what degree will decide the level of laser treatment needed. It is possible for lasers to significantly fade or remove hyperpigmentation altogether, depending on both the size and intensity of the hyperpigmentation in question. In-clinic lasers overall achieve the most impressive pigmentation fading and removal results, though results depend greatly on the power and precision level of the laser used.
Lasers are prolific in their application but not every laser treatment works for every skin pigmentation condition. Hyperpigmentation is such a broad term, referring to any skin darkening or discolouration, that it’s essential to diagnose the exact type and cause of the pigmentation when selecting an effective laser therapy technique.
White sunspots, (formal name idiopathic guttate hypomelanosis) occur after years of compound sun exposure. Often referred to as hypopigmentation, these white spots are another pigmentation condition but unlike dark patches, this discoloration signals an absence of pigment in the skin. IPL can be used to fade the darker skin surrounding the white spots, allowing the spots to blend in better with the rest of your skin. Alternatively, active skincare is a good option. Vitamin C will brighten skin and Retinol will exfoliate discoloration. Retexturizing and exfoliating skincare products such as glycolic acid will even skin tone and create a more unified appearance, lessening the visibility of white spots.
Target: Image showing pigmentation and wrinkles on chest wrinkles from accumulated sun damage.
Results: Skin texture is improved by use of LYMA Laser for chest wrinkles and pigmentation now appears smoother, with a brighter skin tone.
Treatment: From 30 minutes daily use, over three months.
Q-Switched lasers such as the Nd: Yag are often considered the most effective professional lasers for pigmentation removal due to their longer wavelength that's more easily absorbed by the skin. Classed as non-ablative lasers, so cause less destruction to the skin than ablative lasers but are also less effective. Non-ablative lasers do create thermal damage to the skin to trigger regeneration which causes trauma to the skin and can be extremely painful. These lasers are generally deemed very safe to use on most skin tones but they also come with a high associated level of potential post-treatment risk of swelling and potential infection.
It’s very common to amass hyperpigmentation across the chest area and a common in-clinic laser for pigmentation on the chest is the PicoSure. This laser although non-ablative is still invasive, highly painful and results following laser treatment will appear worse before they look better. In addition, due to the chest being such a large and delicate area, the cost of fractional laser treatment is often much higher and multiple sessions may be needed.
Ablative lasers
are at the most extreme of the laser resurfacing treatment spectrum and are often advocated only for cases of extensive hyperpigmentation. Ablative lasers achieve impressive results for pigmentation removal but because they resurface the skin by removing the top epidermal layer, they also create acute wounding. CO2 lasers and the Erbium are the most widely administered for significant dark spot removal but the pain, downtime and cost are often the reason people seek more natural ways to remove pigmentation.
Laser pigmentation removal can be carried out in clinics using either an ablative or non-ablative resurfacing laser. With either approach, initial consultations are often free of charge but a course of treatments is most commonly required, each one costing hundreds of pounds. It’s also usual for a practitioner not to know the rate of effectiveness, so courses may have to be re-evaluated and possibly extended to achieve the desired results.
Due to pigmentation naturally presenting in multiple areas across the face, neck and chest, treatments are usually grouped into sections such as:
Here’s a quick-look guide to what you can expect to pay for laser pigmentation removal in the UK.
| Laser Type | Average Cost per Session | Average Sessions Needed p.a. | Est. Cost Over 5 Years |
| Fully Ablative CO2/Erbium Laser | £2723* | One-off treatment | £6,808** |
| Non Ablative / Fractional Laser | £338* | 3-6 Sessions | £5,070*** |
| IPL Rejuvenation | £153* | 4-9 Sessions | £3,825**** |
| LYMA Laser (LLLT) | £1999 (one time fee) | Daily use | £1,999 |
* Average prices calculated from the prices published on 6 skin clinics websites across the UK on 20/10/2021.
** Total cost estimation based on the assumption that on average patients would need 2.5 sessions over 5 years.
*** Total cost estimation based on the assumption that on average patients would need 15 sessions over 5 years.
**** Total cost estimation based on the assumption that on average patients would need 25 sessions over 5 years.
As with any skin treatment, the more extreme the approach, the more extensive the associated risks and complications. Doctors and dermatologists offer a wealth of information and advice on which treatment could be right for you but should also warn you of the complications. Lasers for pigmentation removal vary greatly both in their impact to the skin and resulting efficacy, but also in their associated downsides. Some lasers are more fine-tuned for targeting tiny areas of hyperpigmentation, whilst others achieve full removal results in a much faster time frame. With all clinical laser treatment for pigmentation, there needs to be a balanced view of the benefits and drawbacks.
Laser treatment for pigmentation achieves great results but clinical lasers, whether ablative or non-ablative, can cause considerable discomfort and disruption to skin. In the bid to remove pigmentation patches, in-clinic lasers that cause heat damage in order to generate new collagen production inadvertently cause scarring, bruising and additional discolouration.
The biggest limitation to using lasers to remove pigmentation is that many lasers cannot detect pigmentation variants in darker skin tones due to there being more pigment in the background of darker skin. Furthermore, darker skin types are more susceptible to post-treatment scarring following intense laser application.
This means that for many ethnicities, many laser treatments are not a viable option. This is where the LYMA Laser comes into its own because the technology is so advanced that it can treat pigmentation on any skin tone. There are no side effects and no risk of post-inflammatory scarring as with many in-clinic ablative and non-ablative lasers.
2. Downtime can be extensive
The downtime following in-clinic laser treatment for pigmentation is a complication that should not be underestimated. Regardless of laser type, skin undergoes notable trauma and needs time to repair. Life is disrupted in the immediate ensuing weeks and full recovery often takes months before skin returns to normal. There are also considerable risks of ablative laser resurfacing treatment including swelling, itching, hypersensitivity, infection, scarring and post-inflammatory darkening of the skin.
3. Preparation and aftercare need careful consideration
Experts advise avoiding sun exposure for two weeks prior to undergoing ablative laser skin treatment. In the weeks leading up to in-clinic laser for pigmentation treatment, active skincare should not be applied and medications need to be checked with the practitioner. Painkillers are often required to prep before treatment which is quite painful.
After undergoing ablative laser skin treatment, skin is left raw, bleeding and entirely unprotected, so the patient is usually house-bound for up to two weeks. Recovery from non-ablative in-clinic laser treatment is shorter and less extreme but still involves a prolonged period indoors and out of direct sunlight. Aftercare with all clinical laser rejuvenation treatment is mandatory and complex, involving a rotation of cold compresses, prescribed pain relief and topical skincare which all come at an additional cost.
4. The risk of Post-Inflammatory Hyperpigmentation (PIH)
Post-inflammatory hyperpigmentation is an associated risk of in-clinic laser skin resurfacing to remove hyperpigmentation. Skin’s inflammatory response following the intense thermal damage of the laser, can cause cells to produce more pigmentation, therefore worsening the condition that’s been treated. Darker skin tones are far more likely to experience PIH and this is the reason why many lasers aren’t suitable for black skin.
Although laser treatment for pigmentation is the most popular choice and recommended by most dermatological experts, there are plenty of different treatment choices for pigmentation removal.
Microneedling to remove pigmentation is a popular treatment option for those with skin of colour because it doesn’t carry the same risk of post-inflammatory hyperpigmentation as with in-clinic laser treatment. However, microneedling is still highly invasive and creates hundreds of miniscule punctures in the skin so as to trigger collagen and elastin production. A modern approach is to immediately treat the compromised skin with PRP (Platelet Rich Plasma) that’s rich with growth factors to support the skin’s rejuvenation process. Further approaches combine microneedling with deep dermal heating or radiofrequency waves to enhance the controlled skin injury effects. Particularly for hyperpigmentation marks following acne, microneedling has shown to improve
acne scarring and its associated hyperpigmentation.
An important consideration of microneedling is the depth to which the needles travel into the skin, which varies with each condition and skin type being treated so as not to cause too much damage and also mitigates the risk of infection.
Fractional radio-frequency resurfacing is a popular alternative treatment for hyperpigmentation, commonly used to fade out age spots and sun damage. Tiny pins deliver waves of energy into the skin’s epidermal layer and much like an in-clinic laser approach, these pins create miniscule wounds in the skin, triggering the skin’s repair response to increase collagen production. Sessions usually last between 25-40 minutes depending on the area size being treated.
Although more inclusive than laser resurfacing due to it being safe to use on all skin tones and ethnicities, radio-frequency resurfacing still causes controlled damage to the skin and comes with the associated pain. Topical anaesthetic creams can be applied to mitigate the discomfort. Recovery time is moderate and skin will be red for the first 24 hours, often with some mild swelling lasting 3-7 days. With more extensive RF treatments, skin can continue flaking for up to 5 days. Sun exposure is to be avoided during the healing period.
Ultherapy is a non-invasive approach to skin rejuvenation, which is why it’s often preferred as a more natural option. However, patients still report a tingling sensation and some experience varying levels of pain and discomfort, sometimes requiring local anaesthesia to be administered.
LED devices are not lasers and are far less capable in treating any skin concern including pigmentation. LED light is not a singular, continuous beam as laser but is widely dispersed and therefore unable to travel as far into the skin’s layers. This means that though LED light can give skin an overall more even tone, it is unable to fade light brown spots or even small areas of pigmentation.
There is a world of topical creams and skincare for fading pigmentation and unsurprisingly, there are vast inconsistencies in efficacy. Unilateral brightening ingredients including Vitamin C, Niacinamide, Retinol, Azelaic acid and Kojic acid are formulated into serums, creams and masks to lessen the appearance of discolouration and create a more unified skin tone. A step on from these beauty counter actives is prescription skincare which is far more concentrated and targeted. Hydroquinone being the most commonly prescribed, prescription skincare for dark spots and hyperpigmentation is often astringent and not suitable for sensitive skin types and often prohibits sun exposure entirely.
Professional laser skin treatment remains remarkable but the aesthetic rewards still carry their risks. Intense heat, thermal destruction of skin cells, downtime, financial expense and long courses of treatment are not for everyone. Many traditional clinic lasers are also not suitable for melanin-rich skin types for fear of post-inflammatory scarring. Moreover, never before had scientists been able to convert a clinic grade, clinical laser into a format safe enough for consumers to use in their homes.
Until now…
What sets the LYMA Laser apart is that it’s the only clinic grade laser that’s entirely risk free. Devoid of heat, totally pain-free and no injury caused to the skin means no associated downtime. It’s an at-home beauty device that can be used daily in any location, anywhere on the body and for as long as you like.
Through working to reawaken skin cells rather than cause controlled damage, the LYMA Laser poses no risk of post-inflammatory hyperpigmentation, therefore it’s considered by experts as the best laser for pigmentation on dark skin. What’s more, because the LYMA Laser is a form of low-level laser therapy, delivering energy deep into the lower skin layers, it can work to remove pigmentation just as effectively on any skin tone.