Picosecond laser for melasma: what to know

Melasma causes patches of uneven brown or grey-brown colour, often on the face. It can sit at different depths and may be influenced by light, heat, hormones and irritation. A laser pulse can break up pigment, but inflammation after treatment may trigger darker or more noticeable patches in some skin. The aim is controlled improvement, not a promise that the condition will stay away. Your clinician may recommend a broader plan rather than laser alone.

Have the patches examined before treatment so they are not confused with another condition. Mention pregnancy, hormone treatment, recent tanning, previous reactions and products that sting. Use the prescribed pigment-care routine consistently and protect the face from daylight with sunscreen, shade and a hat. After a session, cleanse gently, avoid heat and friction, and wait for your clinician’s advice before restarting exfoliants or retinoids.

Contact the clinic for worsening burning, spreading redness, blisters, pus or a rapidly darkening area. Urgent assessment is needed for facial swelling that affects breathing or vision, or for severe pain with skin breakdown.

How confident are you that this is melasma, what could trigger rebound darkening, and what non-laser options should I use? How will you adjust treatment for my skin tone and monitor the patches?