What to expect from picosecond laser treatment for cafe-au-lait spots

Cafe-au-lait spots are flat, light-brown patches caused by increased pigment. A picosecond laser sends energy in extremely brief pulses to break up pigment while limiting heat spread around the target. During treatment, you may feel snapping, warmth, or prickling. The clinician may use cooling and eye protection, and the chosen settings depend on the spot, its location, and your skin tone.

The treated area can look red or swollen and may become temporarily darker, lighter, or speckled before the pigment fades. Colour change can be unpredictable, especially in recently tanned or darker skin. The spot may need assessment after healing before any further session is considered, and some spots can recur or respond incompletely.

Tell the clinician about tanning, medicines, cold sores, scarring history, pigment changes after injuries, and any change in the spot. Avoid tanning before treatment and follow the clinic's pause instructions for irritating products. Afterward, keep the area clean, do not scratch or pick, and use the recommended dressing or moisturiser.

Protect the area from sunlight with clothing and the sunscreen recommended for your skin once the clinician says it is suitable. Heat, friction, and exfoliation may worsen irritation while the surface is recovering. Take a clear photograph after treatment if useful for comparison, but have any changing or unusual spot examined rather than treating it by appearance alone.

Contact the clinic if pain or swelling is worsening, blisters are extensive, the area becomes increasingly hot, or you see pus or spreading redness. Seek urgent help for facial swelling affecting breathing or vision. Arrange a review for a spot that changes shape, develops irregular colour, bleeds, crusts, or fails to heal, because laser treatment should not delay assessment of a changing pigmented lesion.

Ask whether the spot has been examined closely before laser treatment, what colour changes are expected for your skin tone, how to protect the area from sunlight, and when the result should be reviewed. Ask how recurrence or incomplete fading would be managed.