The picosecond lasers, Q-Switched Nd: YAG and Alexandrite
are pigment lasers developed to remove black, red and other colours of tattoo
pigment, certain brown growths and birthmarks from the skin. Picosecond lasers are
a new generation of pigment lasers that treat superficial pigmentation such as freckles
and lentigines; deeper pigmentation such as Hori’s and Ota Naevus as well as
green, sky blue and black tattoos. These lasers operate in the ultrashort picosecond
domain and complement other lasers and light devices (e.g. Q-switched Nd:YAG laser,
intense pulsed light device) in the treatment of pigmented lesions.
Repeated laser treatments are often necessary depending on the
indication. The tattoo or pigmentation will be treated at intervals of two months
or longer until either the pigment is removed or further improvement is deemed
Solar lentigo (sun spot) on the cheek
Nevus of Ota (pigmented birthmark) on the cheek
Number of treatment sessions required
The number of treatment sessions generally required are as
Nature of pigmentation
Naevus of Ota
1 - 3
2 - 3
3 - 5
4 - 6
7 - 10
7 - 10
7 - 10
The above information serves only as a general guide. There is no guarantee
that the pigmentation/ tattoo will be totally removed at the end of the treatment
Colour of tattoo and response to treatment
Response to treatment
With the Q – Switched Alexandrite Laser
What happens during Pigment Laser Treatment
Treatment of the pigmented skin lesions is usually done in
stages under topical anaesthesia, which is often applied for about 1 hour
before the procedure.
Your doctor will precisely target the pigmented lesion to be removed
with the laser. When the laser hits the skin, you may feel a pricking pain, somewhat
like a rubber band snapping on the skin. The pain is usually bearable and
short-lived. An icepack can be used to minimise the pain immediately after the
What happens after Pigment Laser Treatment?
Pigment laser treatment often causes mild damage to the superficial
layer of the skin (epidermis). This appears as redness and swelling soon after
the laser procedure and lasts for several hours.
You may experience some burning discomfort for several hours after the
laser treatment. Pain and discomfort can be relieved by taking painkillers (e.g.
2 tablets of paracetamol) and by using an ice- pack.
The laser wound should be cleansed gently with sterile normal saline solution.
Prescribed antibiotic ointment should then be applied to the treated areas
twice daily for 5-7 days or until the surface wound is totally healed.
Showers are permitted but gently pat the area dry and avoid further
injury to the healing skin.
Over the next 5-7 days, superficial scabs which form over the treated
areas will fall off by themselves. It is important not to pick at the scabs as
this may result in infection and scarring.
If the laser is used to treat a deeper pigmentation using a deeper
penetrating laser wavelength, superficial pin-point bleeding on the surface of the
skin may result instead of superficial scabs. This will take 3-5 days to heal.
not rub, scratch or pick at the treated area.
Do not apply make-up and avoid swimming and contact sports until the
scabs disappears (usually 5-7 days).
If the treated area shows signs of infection (tenderness, redness,
swelling or pus), consult your doctor or nurse-in-charge, Laser Suites, National
Skin Centre for further advice and management.
Over the next 3-6 months, avoid direct exposure to the sun and use a
broad spectrum sunscreen daily to reduce the risk or severity of post-laser hyperpigmentation.
Is it safe?
When performed by a trained dermatologist, pigment laser treatment is a very safe procedure with minimal risk of permanent scarring. In most people, the treated area loses its pigment (hypopigmentation) and becomes lighter in colour than the surrounding skin temporarily. The skin colour usually returns to normal over the next 2-4 weeks.
Increased pigmentation (hyperpigmentation) may occur after the lasered skin has healed (post-inflammatory hyperpigmentation). It is usually seen 2-4 weeks after the laser treatment and is often made worse if skin is exposed to the sun. This post-laser reaction is temporary but may take 4-6 months to gradually fade. Your doctor may prescribe a skin lightening cream to help clear this post-laser pigmentation faster.
Scarring is a very rare occurrence from pigment laser treatment. It may
result from skin infections following the laser treatment. Textural changes with
hypopigmentation may appear after laser tattoo removal. This is usually
transient but may rarely be permanent. It is important for patients to report
to their doctor immediately if there is prolonged pain, redness, tenderness and
oozing of the laser-treated skin. To minimise the chances of scarring, it is
important that you follow the post-laser skincare instructions carefully.
Persistence of tattoo or pigment
Some tattoo ink or pigment is located too deep in the skin
to be removed completely in spite of repeated treatments. Vague spots of colour
may remain after treatment. There may be some ink colours that change colour or
darken in response to the laser and others that simply will not respond to this
laser. It may not be possible to completely remove all tattoo and skin
pigmentations with this laser. If this situation arises, there may be other treatment