Key facts
- First 24 hours
- Cool compress, gentle cleanser, plain moisturiser; no heat, sweat, alcohol or actives
- First week
- Crusts flake on their own; no picking, scrubs, retinoids, acids or facials
- Sun
- Broad-spectrum sunscreen every morning, reapplied outdoors; hat and shade; no tanning
- Make-up
- After toning, once the skin is calm; after spot or fractional treatment, once the surface has closed
- Normal
- Redness and warmth; treated spots darken and crust; pinpoint redness and roughness after fractional mode
- Call
- Thick, yellow or oozing crusts, blisters, pain or swelling that increases, new dark patches weeks later
What should you do in the first 24 hours after pico laser?
In the first 24 hours after pico laser, keep the skin cool, clean and left alone. A picosecond pulse fragments pigment mainly by a pressure effect, so after low-energy toning there is usually nothing on the surface but redness and warmth; a cool compress eases both. After spot treatment of a sun spot or freckle, the mark darkens within hours, which is expected and is the pigment lifting rather than a sign of damage. After fractional treatment there is pinpoint redness, mild swelling and a sandpaper feel while the skin renews.
Cleanse with lukewarm water and a gentle, fragrance-free cleanser, pat rather than rub, and apply a plain moisturiser. Leave out retinoids, exfoliating acids, vitamin C, brightening creams and scrubs. Avoid hot showers on the face, saunas, steam and heavy sweating for the rest of the day, and avoid alcohol, because heat and flushing prolong redness and, in Fitzpatrick III to V skin, add to the inflammation that drives pigment.
Written aftercare for the mode used is given before you leave and takes priority over this page.
What should you avoid in the first week after pico laser?
For the first week, do not pick. Treated spots form a fine crust that lifts on its own over days; pulling it off early removes the new surface beneath and is one of the commonest reasons a treated spot heals darker or lighter than the skin around it. Let crusts shed in the shower and on the pillow in their own time. Do not use scrubs, cleansing brushes, peels, retinoids or exfoliating acids until the surface is intact and no longer pink.
No facials, extractions, microneedling or other laser or light treatments over the same area in the first week, and no swimming while there is any crusting. If you use prescription creams for pigment, such as hydroquinone or tretinoin, ask when to restart rather than assuming; the answer depends on the mode used and how your skin is behaving.
Do not treat over any new darkening yourself with stronger brightening products. Darkening that appears after the crust has gone is a reason for review, not for more actives.
“A pico laser breaks up pigment that is already there. It does nothing about the reason your skin made it — which is why melasma comes back and a sun spot usually does not.”
Dr Sin YongOn what the technology does and does not reach
How should you handle sun, make-up, exercise and sleep?
Sun protection after pico laser is part of the treatment, not an extra. Skin that has just been treated is inflamed at a level you may not see, and ultraviolet over inflamed skin is what tells melanocytes to make more pigment. Apply a broad-spectrum sunscreen every morning, reapply if you are outdoors, and wear a hat and keep to shade in the middle of the day. If melasma was part of the plan, a tinted sunscreen containing iron oxides also blocks visible light, which is a trigger in its own right. No deliberate tanning while the skin is recovering, and ideally not between visits either.
Make-up after toning can go on once the skin is calm, usually the next day. After spot or fractional treatment, wait until the surface has closed and any crusts have gone, because make-up over an open surface traps bacteria and makes crusts harder to shed.
Light exercise is fine from the next day. Hard exercise, hot classes and anything that leaves you flushed and sweating are better left for a few days, because sweat stings a fresh surface and heat prolongs redness. Sleep face-up on a clean pillowcase while there are crusts, so they are not rubbed off overnight.
What is normal after pico laser, and what is not?
Normal after pico laser depends on the mode. Toning leaves redness and warmth that settle over hours. Spot treatment leaves the treated mark darker than before, with a fine crust that flakes away on its own; the skin beneath can look pink for a while before it blends in. Fractional treatment leaves pinpoint redness, mild swelling, a rough texture and sometimes a bronzed look as the treated columns shed. Mild itching while the skin heals is also common.
Not normal is a crust that is thick, yellow or oozing, a blister, pain or swelling that increases instead of easing, spreading redness, or a cold sore around the mouth. These point to infection or to energy that was too high for the skin and need to be looked at rather than covered up. Darkening that appears weeks after treatment, once the skin had seemed to settle, is usually post-inflammatory hyperpigmentation; it should be reviewed, not treated over, and strict sun protection matters in the meantime. Pale, mottled spots after repeated toning are a separate problem and are one reason toning is not run on an open-ended schedule.
What you see in the first week is healing, not the result. Pigment clears as fragments are carried away over the following weeks, and the review is timed to see that, not the crust. The article on pico laser and Asian skin sets out why settings and sun carry more weight than the device name.
When should you call the clinic after pico laser?
Call or message +65 8023 7170 during clinic hours (Monday to Friday 10am to 8pm, Saturday 11am to 3pm) if you notice any of the following:
Crusts that become thick, yellow or oozing, or any blister.
Pain, swelling or warmth that is increasing instead of settling.
Redness spreading beyond the treated area, or a cold sore near it.
A treated spot that heals noticeably darker or paler than the surrounding skin.
New dark patches appearing weeks after treatment, particularly over the cheeks.
Any raised, firm or thickened area where a spot was treated.
Outside clinic hours, the complication care page sets out which signs cannot wait. Most messages after pico laser describe expected crusting or redness, and you will be told plainly whether what you describe sounds ordinary, needs to be seen, and how soon.
What happens at the review, and what if you were treated elsewhere?
The review checks that the skin has healed before anything further is planned. Dr Sin Yong examines the treated area in good light, with a dermatoscope where needed, compares it with the photographs in your medical record and asks about sun exposure since the visit. Whether a further pass, a different wavelength, topical therapy or simply more time is appropriate is decided then. Melasma in particular is managed as a longer plan built on photoprotection and topicals, and the melasma treatment page explains why.
If you were treated at another clinic and your skin has darkened or healed unevenly, the same rules apply: contact the clinic that treated you, or another doctor, rather than adding products. Bring the device name, the mode and wavelength if you know them, and the date. The page on post-inflammatory hyperpigmentation explains what the darkening is and why patience and sun protection come before any further laser.
