What Singapore forums ask about pico laser:
a doctor answers

Does pico laser actually clear melasma, or does it just come back?

Pico laser does not clear melasma, and the forum pattern of improvement followed by return is the condition behaving as expected. Melasma is chronic, with hormonal, vascular and ultraviolet drivers that no laser touches, and it is provoked by heat; a picosecond laser fragments pigment that is already present and does nothing about the reason the skin made it. That is why a sun spot usually stays gone and melasma usually does not.

Where laser has a role in melasma it is conservative: typically low-fluence 1064 nm work at gentle energies that spare the melanin-rich epidermis, as one component of a longer plan built on daily photoprotection, including visible light, and topical therapy prescribed by a doctor. Aggressive settings can leave melasma darker than before. The melasma treatment page sets out the full plan and why diagnosis comes before any device; a clinic that promises to remove melasma is promising a relapse.

My pigmentation got darker after pico laser. Is that normal, and will it fade?

Darkening after pico laser is usually post-inflammatory hyperpigmentation, and whether it fades depends on what caused it and what happens next. Skin that is injured makes more melanin, and Fitzpatrick III to V skin makes it readily. The usual causes are energy too high for the skin, treatment repeated too soon, ultraviolet on freshly treated skin, and melasma treated as if it were a sun spot. It often appears with a delay, because skin can look cleaner straight after treatment and darken over the following weeks.

Post-inflammatory darkening tends to fade with time and strict sun protection, but that can take months, and reaching for a second laser or a strong active while the skin is still inflamed adds the signal that caused it. It should be reviewed rather than treated over, and the review distinguishes it from melasma that has rebounded, which is managed differently. The page on post-inflammatory hyperpigmentation explains the condition, and the article on pico laser on Asian skin explains the settings that lower the risk in the first place.

“Melasma is managed, not cured. A clinic promising a cure is promising a relapse.”

Dr Sin YongOn pigmentation assessment

How much downtime is there really? Can I go to work the next day?

Downtime after pico laser depends on the mode, which is why forum answers contradict each other. Low-energy toning across the face usually leaves redness and warmth that settle within hours, and most people go about their day. Spot treatment of a discrete sun spot or freckle darkens the mark, which forms a fine crust and flakes away on its own over days, so the spot is more visible before it is less visible. Fractional mode, used for texture, leaves pinpoint redness, mild swelling and a rough feel while the skin renews, and takes longer to settle than the other two.

None of these is a fixed number of days, because the energy used, the area and your skin all change it; the written aftercare for the mode used tells you what to expect. What matters more than the days is what you do with them: no picking crusts, no actives until the surface has settled, and daily broad-spectrum sunscreen. The guide to pico laser downtime and side effects describes each mode in words, since comparison photographs are not permitted in Singapore healthcare advertising.

How many visits do people need before they see anything?

There is no number that applies to everyone, and a count given before the pigment has been examined is a guess. A single sun spot treated in spot mode is a different task from diffuse tone across both cheeks treated by low-energy toning, and both are different from melasma, which is managed rather than cleared. The pigment type, its depth, the wavelength and mode chosen, the skin's reaction to the first treatment and sun exposure between visits all change how a plan unfolds.

What is fixed is the method: the pigment is identified first, with a dermatoscope where needed, the response to each treatment is read before the next is planned, and toning is not run on an open-ended schedule because frequent repeated toning of the same area has been linked to pale, mottled spots. Packages sold as a fixed number of visits assume an answer the skin has not yet given. The main pico laser page explains how the plan is staged and what determines the fee.

Is pico laser safe for Chinese, Malay or Indian skin, or will I end up with white patches?

Pico laser is used routinely in Fitzpatrick III to V skin, which covers most patients in Singapore, and the two risks the question names are real and have different causes. Darkening is post-inflammatory hyperpigmentation, driven by too much heat, too short an interval or sun on treated skin. Pale or white patches are hypopigmentation, and in the pico laser literature they are linked to frequent repeated low-energy toning of the same area over long periods; the melanocytes are suppressed rather than the pigment fragmented.

Both are managed by how the laser is used rather than by which laser it is. Wavelength is chosen for the pigment and the skin: 1064 nm penetrates further and is absorbed less by epidermal melanin, which makes it the more conservative choice in darker skin, while 532 nm is strongly absorbed and kept for discrete superficial spots. Fluence, spot size and passes are set for the skin in front of the doctor, a test spot is used where the reaction is uncertain, and toning is stopped rather than continued indefinitely. A picosecond pulse spreads less heat than a nanosecond one, which is the mechanistic case for it in this population; it is not a promise about a particular face.

Is PicoSure worth paying more for than other pico lasers?

PicoSure is one brand of picosecond laser, with a 755 nm alexandrite wavelength and its own fractional handpiece, and it is the name forum threads compare most often. Other picosecond platforms use different wavelengths: the DEKA TORO that Dr Sin Yong uses for the T2 Frax Radiance protocol has a 785 nm picosecond emission alongside 532 nm and 1064 nm nanosecond emissions. The physics of a picosecond pulse is shared; what differs is the wavelengths available, the spot sizes, the fractional optics and the clearance.

A higher fee for a particular brand buys that brand's consumables and clearance, not a different biology, and the pigment problem decides which wavelength is useful more than the brand does. The comparison of PicoSure with other pico lasers sets the platforms side by side without ranking them. The more useful question for any clinic is which wavelength and mode will be used for your pigment, at what settings, and who sets them.

Why is pico laser so cheap at some clinics and expensive at others?

A low fee usually describes a different treatment: a quick low-energy toning pass across the face on a preset, with no diagnosis of what the pigment is, performed by whoever is free. A higher fee usually describes a doctor identifying the pigment first, with a dermatoscope where needed, choosing the wavelength and mode for it, treating a defined area at settings chosen for the skin, and reviewing the response before anything further is planned. Both are called pico laser.

Singapore's rules restrict price advertising by clinics, so this site publishes no figures, and a number given before assessment would not describe your skin. What moves the fee is the area treated, what the assessment finds the pigment to be, whether one wavelength or several are used, whether fractional mode is added for texture, and how the plan is staged. A written, itemised quote follows the consultation, and the how we quote page explains what it contains and why a lower figure elsewhere may describe a different device, plan or person.

Does pico laser help with acne scars and pores?

Pico laser in fractional mode prompts remodelling around texture, which is a narrower job than the phrase scar removal suggests. A diffractive optic creates small zones of tissue breakdown beneath an intact surface, and the skin remodels around them; that can soften fine texture and the appearance of pores, though nothing shrinks a pore itself and response varies between people. It does not rebuild the wall of a boxcar scar, release a tethered rolling scar or reach the floor of an ice pick tract.

Those scars need other steps: subcision for tethers, TCA CROSS for narrow tracts, fractional CO2 or RF microneedling for walls and texture, matched to the scar type. Where acne has left flat brown marks rather than dents, those are post-inflammatory pigmentation, and low-energy toning once the acne is controlled is a reasonable question for the pico laser. Telling a dent from a mark is the first step, and it is done by stretching the skin and looking, not by choosing a device.

Can I do pico toning regularly like a facial?

Pico toning is a medical treatment with a cumulative dose, not a facial, and running it on a fixed frequent schedule is how pale, mottled patches happen. Low-energy toning across the whole face places a small amount of energy into every melanocyte on every visit; repeated often enough over the same area, that can suppress pigment cells unevenly and leave spots paler than the surrounding skin, which are harder to correct than the original pigment was.

The sensible pattern is a plan with a defined aim, a review of the response after each treatment, and a stopping point. Where the aim is to maintain tone over time, the interval is set by how the skin is holding rather than by a membership calendar, and sun protection does more of the maintaining than the laser does.

Is pico laser the same as laser toning or a carbon laser facial?

Laser toning describes a technique, low-energy passes across the face to even out tone, and it can be done with a nanosecond Q-switched 1064 nm laser or with a picosecond laser; pico is a pulse duration, not a technique. The laser toning page explains how the 1064 nm Nd:YAG is used here and for which pigment. A carbon laser facial is different again: a layer of carbon lotion is applied and a Q-switched laser is passed over it, so the energy is spent on the carbon at the surface, giving a brief brightening and some effect on oil but not treating pigment at depth. It is offered by other clinics and is not a treatment described on this site.

The names overlap because marketing uses them loosely. What distinguishes treatments is the wavelength, the pulse duration, the energy, the mode and the diagnosis they are aimed at. A forum thread comparing prices across the three is usually comparing three different treatments for three different problems, which is why the answers never agree.