Laser treatment can be very effective for certain types of benign pigmentation, including freckles and sunspots. But not all pigmentation responds in the same way, and understanding what happens during treatment — and afterwards — is important for achieving realistic results.
Brown spots and uneven pigmentation are common concerns, particularly on areas of skin that have experienced years of sun exposure. Freckles, solar lentigines (sunspots) and other pigmented marks can become more noticeable over time, particularly on the face, hands, forearms and décolletage. Many people are surprised to learn that some benign pigmented lesions may respond to just one laser treatment, while others require multiple sessions or may not be suitable for laser treatment at all. The difference comes down to the biology of the pigmentation, its depth within the skin, the laser technology used and the individual's skin characteristics.
At Piko Laser Clinic, I use picosecond and Q-switched laser technology to treat selected benign pigmented lesions. However, my approach always begins with assessment — because the most important question isn't simply whether a laser can remove pigment, but whether that pigment is appropriate to treat.
How Does Laser Treatment Remove Pigmentation?
To understand how laser treatment works, it helps to understand what causes brown pigmentation in the first place. Our skin contains specialised cells called melanocytes, which produce a natural pigment called melanin. Melanin gives skin much of its colour and plays an important role in protecting it from ultraviolet (UV) radiation. However, sun exposure, genetics, hormonal influences and inflammation can cause melanin to become concentrated in particular areas. This may produce freckles, sunspots or more diffuse pigmentation.
Pigment-targeting lasers work by delivering carefully controlled pulses of light that are absorbed by melanin. The absorbed energy creates rapid changes within pigment-containing structures, allowing them to be disrupted. The body then gradually processes the affected pigment as the skin recovers.
The aim is to reduce unwanted pigmentation while minimising unnecessary injury to surrounding tissue. This principle is known as selective photothermolysis (Anderson & Parrish, 1983).
Why Are Picosecond and Q-Switched Lasers Used?
Not all lasers deliver energy in the same way. Two technologies commonly used for pigment treatment are picosecond and Q-switched lasers.
Picosecond Lasers - Picosecond lasers deliver extremely short pulses of energy, measured in trillionths of a second. These rapid pulses can produce strong photoacoustic and photomechanical effects, helping disrupt pigment-containing structures. Because the energy is delivered over such a short period, picosecond technology may reduce unwanted thermal effects in some treatment applications. However, this does not eliminate the risk of inflammation, pigmentary changes or other complications.
Q-Switched Lasers - Q-switched lasers deliver pulses measured in nanoseconds — billionths of a second. They have been used extensively in dermatology for treating selected benign pigmented lesions. These short pulses also produce rapid interactions with pigment-containing structures.
Is One Technology Better?
Not necessarily. Clinical studies have demonstrated that both picosecond and Q-switched lasers can effectively treat solar lentigines. Some comparative studies have found advantages with particular picosecond systems, but results depend on the wavelength, treatment parameters, lesion characteristics and skin type.
A systematic review by Mardani et al. (2025) identified encouraging results for both technologies while highlighting the need for further high-quality comparative research.
The most appropriate treatment is not simply the newest technology — it is the technology and treatment approach best suited to the individual lesion and patient.
Why Different Wavelengths Matter
Different wavelengths interact with melanin at different depths within the skin. At Piko Laser Clinic, the Quanta Discovery Pico provides several wavelength options, allowing treatment to be tailored to selected pigment characteristics.
· Shorter wavelengths such as 532 nm are strongly absorbed by melanin and may be useful for appropriately selected superficial epidermal pigmentation.
· The 694 nm ruby wavelength is another pigment-targeting option used in dermatology.
· Longer wavelengths, such as 1064 nm, have different absorption and penetration characteristics and may be considered for particular treatment indications.
However, wavelength selection must also account for the melanin naturally present in surrounding skin. This is especially important in darker skin tones, where inappropriate treatment parameters may increase the risk of unwanted pigmentation changes.
More energy is not automatically better. The goal is to deliver sufficient energy to affect the intended pigment while protecting surrounding tissue.
What Types of Pigmentation Respond Best?
Some benign pigmented lesions are generally more predictable to treat than others.
Freckles - also known as ephelides, are small, flat areas of increased pigmentation. They are strongly influenced by genetics and UV exposure. Because freckles generally involve superficial pigmentation, appropriately selected laser treatment may produce noticeable lightening. However, freckles can return or new freckles can develop with ongoing sun exposure.
Sunspots - also known as solar lentigines, are persistent brown spots associated with cumulative UV exposure. They commonly appear on the face, hands, forearms and upper chest. These lesions are among the more established indications for pigment-targeting laser treatment. Clinical studies have demonstrated that both Q-switched and picosecond lasers can produce substantial improvement in selected solar lentigines (Mardani et al., 2025; Vachiramon et al., 2022).
Post-Inflammatory Hyperpigmentation (PIH) - develops after inflammation or injury. It may follow acne, dermatitis, burns, trauma or cosmetic procedures. PIH behaves differently from a simple sunspot because inflammation and melanocyte activity contribute to its development. Laser treatment is not always the most appropriate first-line approach. In some cases, additional laser-induced inflammation may worsen the pigmentation.
Melasma - is a more complex pigmentation disorder influenced by UV exposure, visible light, hormones and other biological factors. It often presents as symmetrical brown or grey-brown patches across the cheeks, forehead or upper lip. Although laser treatment has been investigated for melasma, recurrence and treatment-induced worsening remain important concerns. For this reason, I approach suspected melasma cautiously and may recommend medical or dermatological management rather than cosmetic laser treatment.
Why Diagnosis Comes Before Treatment
One of the most important aspects of pigment treatment is confirming that the lesion is benign and appropriate for cosmetic laser treatment. Not every brown spot is a freckle or solar lentigo. It is a Western Australian regulation that all pigmented lesions require medical investigation prior to laser treatment. This is particularly important if they are new, changing, unusual or difficult to identify. Laser treatment can alter the appearance of a pigmented lesion, potentially making subsequent assessment more difficult.
Removing visible pigment should never take priority over establishing what the lesion actually is.
What Happens During Laser Pigment Treatment?
Once a benign lesion has been appropriately assessed and treatment suitability established, the procedure is generally straightforward.
Before Treatment - I review the pigmentation, medical history, medications, skin type and previous treatment responses. Clinical photographs are taken to document the treatment area. Treatment parameters are selected according to the lesion and individual skin characteristics. Where appropriate, cooling is used to improve comfort and protect the surrounding skin.
During Treatment - The laser delivers a series of short pulses to the selected pigmentation. Patients commonly describe the sensation as a brief snapping or flicking feeling against the skin. Treatment time depends on the number, size and location of the lesions. Small individual sunspots may require only a short treatment, while larger areas take longer.
Why Does Pigmentation Sometimes Become Darker After Laser Treatment?
This is one of the most important things for patients to understand. Treated pigmentation may initially become darker before it becomes lighter.
Following treatment, the affected pigment and surrounding epidermal tissue undergo a healing response. Depending on the laser settings and lesion type, the area may develop:
Temporary darkening
Mild redness
Slight swelling
A dry or rough surface
Fine crusting or superficial flaking
This is not necessarily a sign that treatment has failed. For some superficial pigmented lesions, temporary darkening and subsequent shedding of pigmented epidermal material are part of the expected response. However, not every lesion will crust or visibly darken, and the absence of these changes does not automatically mean treatment has been ineffective. The expected response depends on the technology, wavelength, treatment parameters and lesion characteristics.
What Does Healing Look Like?
Healing varies between individuals and treatment approaches.
Immediately After Treatment - The treated area may appear red or slightly swollen. Some pigmentation may darken immediately or over the following days. The skin may feel mildly warm or sensitive.
The First Several Days - Some superficial pigmented lesions develop a darker, dry appearance. Fine crusting or flaking may occur. It is important not to pick, scratch or deliberately remove any crusts. Allowing the skin to heal naturally helps reduce unnecessary inflammation and the risk of complications.
Over the Following Weeks - As the skin recovers, treated pigmentation may become lighter. Some lesions respond substantially after one treatment, while others require additional sessions. Pigmentary changes can also take longer to settle, particularly if post-inflammatory hyperpigmentation develops. The final result should not be judged immediately after treatment.
How Many Laser Treatments Will I Need?
There is no universal answer. Some appropriately selected superficial freckles and solar lentigines respond very well to a single treatment. Others require multiple sessions. The number of treatments depends on many factors.
A 2025 systematic review of 41 clinical trials involving 3,234 participants found that laser treatments could produce substantial improvements in solar lentigines. However, outcomes varied considerably between studies and technologies (Mardani et al., 2025). For this reason, I prefer to assess the response to treatment before recommending additional sessions.
The aim is not to perform as many treatments as possible. It is to achieve an appropriate result with the least unnecessary intervention.
Why Do Some Spots Clear More Easily Than Others?
Several factors influence how pigmentation responds.
Pigment Depth - Superficial epidermal pigmentation is generally more accessible to pigment-targeting laser treatment. Pigmentation involving deeper skin structures may respond differently and can require a different approach.
Type of Pigmentation - A solar lentigo is biologically different from melasma or post-inflammatory hyperpigmentation. Treating them as though they are identical can lead to disappointing results or complications.
Skin Tone - Darker skin contains more epidermal melanin, which can compete with the intended target for laser energy. This requires careful wavelength selection and conservative treatment parameters.
Previous Inflammation - Skin that has previously developed post-inflammatory pigmentation may have a greater tendency to respond to additional inflammation by producing more melanin.
Treatment Location - Healing characteristics vary across the body. Areas such as the hands and forearms may respond differently from facial skin. These factors are considered during treatment planning.
Can Laser Treatment Make Pigmentation Worse?
Yes. Although pigment-targeting lasers can be effective, they are not risk-free. Potential complications include:
Post-inflammatory hyperpigmentation: The treated area becomes darker because inflammation stimulates additional melanin production.
Hypopigmentation: The treated area becomes lighter than the surrounding skin due to reduced pigment production or damage to pigment-producing structures.
Prolonged redness: Inflammation persists longer than expected.
Blistering or crusting: More significant epidermal injury may occur.
Scarring: Uncommon with appropriately selected treatment, but possible.
A 2025 systematic review identified post-inflammatory hyperpigmentation, hypopigmentation and transient inflammatory reactions among reported adverse effects of pigment treatments (Mardani et al., 2025). This is why conservative treatment planning, appropriate intervals, careful aftercare and realistic expectations matter.
Why Sun Protection Is Essential
Sun protection is one of the most important factors in both preventing pigmentation and maintaining treatment results. UV radiation stimulates melanocyte activity and contributes to the development of freckles and solar lentigines. After laser treatment, newly healing skin may also be more vulnerable to unwanted pigmentary changes. For this reason, protecting the treated area from unnecessary UV exposure is particularly important.
I recommend following appropriate Australian sun-protection guidance, including broad-spectrum sunscreen, protective clothing and shade. Treatment may need to be postponed if the skin has recently been heavily sun-exposed or tanned.
Laser can address selected visible pigmentation, but it cannot remove the skin's underlying tendency to produce pigment.
Will the Pigmentation Come Back?
Sometimes. However, there is an important distinction between recurrence and new pigmentation.
Recurrence - A previously treated lesion may become visible again if pigmentation was not completely cleared or if pigment production resumes in the same area.
New Pigmentation - New freckles or solar lentigines may develop in nearby skin because the underlying influences, particularly cumulative UV exposure, remain.
This does not necessarily mean the original treatment was unsuccessful. A person may achieve excellent clearance of an individual sunspot but continue developing additional spots over subsequent years.
Long-term sun protection helps reduce further UV damage, although it cannot guarantee that pigmentation will not return.
Does Removing Pigmentation Reverse Sun Damage?
Not completely. Solar lentigines are one visible consequence of cumulative UV exposure. Laser treatment may improve their appearance, but it does not reverse all the biological changes caused by years of sun exposure. Other effects, including changes in collagen, skin texture and cellular DNA, may remain.
This is particularly relevant in Australia, where cumulative UV exposure contributes significantly to both premature skin ageing and skin cancer risk. Cosmetic pigment treatment should therefore complement — not replace — ongoing skin surveillance and sun protection.
What Results Should I Realistically Expect?
For appropriately selected benign pigmentation, laser treatment may produce:
Lightening of individual sunspots
Reduction in visible freckles
Improved uniformity of skin colour
Reduced contrast between pigmented lesions and surrounding skin
Improved appearance of selected sun-exposed areas
However, results vary. Some lesions respond quickly, while others require staged treatment.
Some forms of pigmentation may be unsuitable for laser treatment. And some patients may experience unwanted pigmentary changes despite appropriate precautions. At Piko Laser Clinic, I believe treatment success should be measured by achieving meaningful improvement while minimising unnecessary risk.
The Takeaway: Treat the Right Pigment, Not Every Pigment
Laser treatment can be an effective option for selected benign pigmented lesions, particularly freckles and solar lentigines. Picosecond and Q-switched technologies allow pigment to be targeted using short pulses of energy, and clinical research supports their use in appropriately selected patients.
However, successful treatment involves more than choosing a wavelength. It requires understanding the pigmentation, confirming that it is appropriate to treat, considering individual skin characteristics and allowing adequate time for healing.
Importantly, removing visible pigment does not remove the underlying biological tendency to develop further pigmentation. At Piko Laser Clinic, my approach is to assess carefully, treat conservatively and monitor results over time. The goal is not simply to remove a brown spot. It is to improve the appearance of benign pigmentation while protecting the health of the surrounding skin.
Scientific References
Anderson, R. R., & Parrish, J. A. (1983). Selective photothermolysis: Precise microsurgery by selective absorption of pulsed radiation. Science, 220(4596), 524–527.
https://doi.org/10.1126/science.6836297
Mardani, G., Nasiri, M. J., Namazi, N., Farshchian, M., & Abdollahimajd, F. (2025). Treatment of solar lentigines: A systematic review of clinical trials. Journal of Cosmetic Dermatology, 24(4), Article e70133.
https://doi.org/10.1111/jocd.70133
Vachiramon, V., Namasondhi, A., Anuntrangsee, T., & Jurairattanaporn, N. (2022). Randomized, evaluator-blinded comparative study of a potassium titanyl phosphate (KTP) 532-nm picosecond laser and an alexandrite 755-nm picosecond laser for the treatment of solar lentigines in Asians. Journal of Cosmetic Dermatology, 21(10), 4370–4377.
https://doi.org/10.1111/jocd.14831
Cancer Council Australia. (2026). Diagnosing skin cancer.
https://www.cancer.org.au/types-of-cancer/skin-cancer/diagnosing-skin-cancer
Medical information disclaimer: This article provides general educational information and does not replace medical diagnosis or individual clinical assessment. New, changing, suspicious or uncertain pigmented lesions require appropriate medical assessment before cosmetic laser treatment. Treatment results and healing responses vary between individuals.