Top 4 Reasons Why Some Laser Pigmentation Removal Treatments Don’t Work

In recent years, lasers have become a favourite tool in several aesthetic treatments. More and more patients turn to laser treatments to remedy their skin flaws. The most common treatment availed are laser treatments that promise to erase unwanted pigmentation on the facial skin.

Yet, despite repeated procedures, there are patients who would come to my clinic for a consultation regarding the stubborn discolouration on the skin— the question I most commonly face is, “why does my skin pigmentation still exist?”

There are several factors that can contribute to substandard treatment. Read on to find out more about what you could do to avoid these mistakes.

1. Improper Laser Settings

Lasers come in different types and each type has a different setting. The settings also differ depending on the kind of skin flaw that needs to be treated. When a laser device isn’t calibrated to the right setting before implementation, the chances of a successful treatment is going to be low.

A lot of “laser specialist” clinics have popped up everywhere across the island, many of them offering dirt cheap prices for pigmentation removal treatments. On first glance, I can see why someone would be so enticed.

Treatments that cost cheap ($70 to $90 per session) use lasers that are set on low intensity. After a session, the patient will again be asked to come back to the clinic to complete the same procedure several times in order to achieve optimal results. In reality, when you add up the cost of the recommended rounds of “cheap” treatment, the total sum is equal to getting a proper laser treatment or even more.

Aside from this, patients should be wary of the risks and side effects that can be caused by repeated laser treatments, even when done at low intensity. Studies done on lasers have uncovered that it can cause hypopigmentation (white spots) when the interval between treatments is short. This is a common side effect noted on patients that were treated using Q-switched Nd:Yag laser. The effect of hypopigmentation is very difficult to reverse; I've seen some patients whose skin was damaged permanently.

Ideally, pigmentation removal treatments should be done only once a month. Be careful!

2. Wrong Laser Type Used for the Treatment

skin treatment

As mentioned earlier, there are various lasers used for pigmentation removal treatment. I am usually asked what laser I use to treat my patients. The answer to that is I use not just one laser, but multiple lasers.

In reality, I use two types of laser to treat pigmentation. These are the Picosecond/Pico Lasers and Q-switched Nd:Yag laser. Some doctors use a single laser as they are more familiar with how this equipment works. However, I’ve found that a combination of lasers for pigmentation removal usually gets the best results.

Both Pico laser and Q-switched lasers have their own specialization. I find that Q-switched lasers are best to erase mild pigmentation. For skin pigmentation that is complicated and harder to banish, Picosecond lasers are more effective.

Let’s take a closer look at how Picosecond and Q-Switched Nd:Yag lasers work to see why neither can work effectively in removing skin pigmentation when used alone.

Picosecond Laser works with the use of short pulse durations that is less than 1 nanosecond. It destroys pigments selectively and leaves the surrounding healthy tissues undamaged. It is best used in treating melasma, naevus of Ota, minocycline-induced pigmentation among others.

Q-Switched Nd:Yag Laser works by releasing a wavelength of light that is charged with high energy. When focused on a certain skin condition, this energy charged light discharges heat that breaks down dead cells. Nd:Yag lasers can be used on solar lentigines, freckles, Hori naevus and others.

In the same way, another important aspect as using the correct laser for pigmentation removal is the appropriate skill set of the doctor administering the procedure. Highly experienced doctors usually get their training abroad.

3. Incorrect Aftercare Following a Pigmentation Removal Procedure

Once the anaesthetic procedure is completed, doctors do not skip on giving aftercare instructions. Number one on this list is ensuring that the skin is protected from the harsh UV-rays of the sun at all times. The skin is generally susceptible to external factors after treatment, making the risks of developing side effects high. The skin should be treated with utmost care most especially following laser procedures. In addition to this, doctors usually prescribe gentle skin cleansers and advice to keep the skin moisturised at all times.

4. Choose the Right Doctor for Your Pigmentation Removal Treatment

Choose the Right Doctor

Doctors are vital in achieving a successful pigmentation removal treatment. With the rise of clinics offering mini-treatments (e.g. cheap, but repetitive treatments), one can never be too sure if the persons who perform the procedure are aptly trained in handling lasers. Remember that lasers are powerful tools and mishandling them on the skin could lead to devastating results.

When searching for a doctor to do your pigmentation removal treatment, be sure to do extensive research. The internet is a good place to start. Most clinics have their own websites. The websites usually post the procedures offered by the clinic, the equipment available for various treatments, and even doctor credentials. Ensure that the doctor and clinic that you choose to provide for the care that your skin needs show a genuine concern for their patients. A doctor that listens well to and is after the best interest of their patients is your best bet to a reaching a successful pigmentation removal.

Next, read about the experiences of other bloggers. A lot of bloggers do not shy away from sharing their experiences about the different kinds of treatments that they have undergone. Their inputs can help you gauge which clinic or doctor to go for. Although, do check the blog review thoroughly as some posts may be sponsored by medical clinics.

Lastly, inquire about the kind of equipment that a clinic uses for treating pigmentation, especially the lasers that are available. Bear in mind that not all lasers can address pigmentation efficiently. To be more specific, look for clinics that have both Pico and Q-switched Nd:Yag lasers in their arsenal of aesthetic equipment.


Unflattering skin pigmentation can be removed. If you have started laser treatments and have not been seeing any improvement on your skin condition, I hope this article was able to help you point out the reason why there seem to be no changes happening on your skin. As final advice, heed on these three tips when venturing out for the appropriate pigmentation removal treatment for your skin:

  • Do not be fooled by cheap treatments. These treatments are substandard and use lasers that are set in lower settings that can worsen your skin’s current state. On top of this, when these kinds of treatments are done repeatedly, expect the cost to be the same or be more than the laser treatments that are done properly.
  • Choose a doctor and a clinic that has the right credentials as well as equipment. The outcome of your treatment will highly depend on the skill of your doctor. Be sure to only go for the doctor with the right qualifications to avoid substandard procedures. Likewise, check if the clinic has both a Q-switched Nd:Yag and Picosecond lasers.
  • Religiously follow your prescribed aftercare. When the doctor advises to put on sunscreen, do it. This is not for your doctor’s benefit, but yours. Be kind to your skin and stay away from unneeded sun exposure.