Pigment is not one problem, and not one laser
Freckles, sun spots, melasma and dermal pigment look related in the mirror and are not related under it. They sit at different depths, behave differently under laser energy, and one of them punishes aggressive treatment.
Pigment treatment starts with identifying the type and the depth. Superficial pigment such as freckles and sun spots generally responds well to picosecond laser toning. Melasma is mixed-depth, unstable, and can worsen with excessive energy — it is managed conservatively over time rather than removed. Dermal pigment such as ABNOM requires deeper wavelengths and more sessions.
Matching the pigment to the approach
| Type | Depth | Approach at DIESTA |
|---|---|---|
| Freckles, small sun spots | Epidermal | Pico toning, PicoPlus |
| Seborrheic keratosis (raised) | Epidermal, raised | CO2 laser; if flat, toning may be combined |
| Melasma | Mixed epidermal and dermal | Pico toning, Excel V+ — conservative energy, extended course |
| Pigment with a red component | Vascular and pigmented together | Excel V+ |
| ABNOM, dermal pigment | Dermal | PicoPlus, Pico-K, dual toning |
| Moles and defined lesions | Lesion | CO2, Heukja-zium |
The same visible type is treated with different device combinations depending on depth, colour and skin condition. No pigment treatment is described here as a cure or complete removal, and the number of sessions varies between individuals.
Melasma deserves its own paragraph
Melasma is the pigment condition most often made worse by treatment, and it is worth understanding why before you sit down in front of a laser. It is not simply pigment sitting in the skin — it involves pigment-producing cells that are, in effect, over-reactive. Heat and inflammation are among the things that provoke them. A laser powerful enough to clear a sun spot in one session can, on melasma, provoke the exact process you are trying to suppress and leave the area darker than it started.
This is why melasma is approached with lower energy across more sessions, why sun protection afterwards is not optional advice, and why anyone promising to remove your melasma in a fixed number of visits is describing an outcome that cannot be guaranteed. Melasma is managed — often well, often to the point where it stops being the thing you see first — but it recurs with sun, hormonal change and heat, and honest treatment planning says so in advance.
If you have been treated aggressively elsewhere and the pigment came back darker, that history is important; bring it to the consultation.
Devices at each location
The pigment lineup differs between the two clinics.
| Device | Characteristic | Location |
|---|---|---|
| Pico toning (PicoSure) | 755nm picosecond; Zoom Pass and Zoom Spot focused modes | Gwanggyo |
| Excel V+ | Vascular and pigment laser with Cool View and Genesis modes; treats redness, melasma, vessels and sun spots | Gwanggyo |
| PicoPlus | 450 picosecond pulse | Gwanggyo |
| CO2 · Heukja-zium | Moles, milia, skin tags, defined lesions | Gwanggyo |
| Dual toning · Pico-K | True 300 picosecond pulse | Cheonho |
| Brighton | Nanosecond, uniform beam profile | Cheonho |
| GV laser | 532nm, German-manufactured | Cheonho |
Why aftercare decides the result
Pigment treatment is the category where what you do afterwards changes the outcome most. Treated skin is inflamed, and inflamed skin exposed to strong sun can develop post-inflammatory hyperpigmentation — a darkening that takes months to fade and can leave you visibly worse off than before treatment.
This creates a specific problem for visitors: a pigment laser and a beach itinerary are incompatible. If your trip includes significant sun exposure, treat pigment at the end of the trip rather than the beginning, or defer it. Raise your travel plans at consultation, because this is the single most common reason a technically successful treatment produces a disappointing result.
Immediately after treatment, pigment often looks darker before it clears — treated pigment rises and forms fine crusts before flaking away. This is expected and not a sign of failure. Do not pick at it.
Frequently asked questions
No treatment can honestly promise that. Melasma involves over-reactive pigment-producing cells and is influenced by sun, heat and hormonal change, which means it recurs. It can be managed — often to the point where it is no longer the first thing you notice — but it is managed rather than cured, and treatment is deliberately conservative because excessive energy can provoke it. A clinic guaranteeing complete removal in a set number of sessions is promising something outside anyone's control.
In the first days after treatment, yes — this is usually the expected sequence. Treated pigment rises toward the surface and forms fine crusts before flaking away, so the area can look more defined before it clears. Do not pick at the crusts. What is not expected is a diffuse darkening appearing weeks later across the treated area; that can indicate post-inflammatory hyperpigmentation, often triggered by sun exposure, and should be assessed.
Pigment treatment is generally a course rather than a single visit, and the number depends on the type, depth and how your skin responds — dermal pigment such as ABNOM takes considerably more sessions than superficial freckles. Melasma is treated conservatively across more sessions precisely because pushing energy is counterproductive. An honest estimate comes after examination, and any estimate should be framed as a plan that gets reassessed as your skin responds.
Freckles are superficial, well-defined, generally stable, and respond predictably to picosecond laser toning. Melasma is mixed in depth, has indistinct borders, fluctuates with sun and hormonal change, and reacts badly to aggressive energy. They are frequently confused by patients — and treating melasma as though it were freckles is the most common way pigment treatment goes wrong. This is one of the main reasons the consultation matters before any laser is chosen.
It depends on the rest of your itinerary. Sun exposure after pigment treatment risks post-inflammatory hyperpigmentation, which takes months to fade. If your trip includes beaches or long days outdoors, treat at the end of the trip rather than the start, or defer it entirely. Recently tanned or sunburned skin may also be turned down for treatment on the day, because pigment already in the skin absorbs energy meant for the target.
No, and this distinction is medical rather than cosmetic. Defined lesions are treated differently from diffuse pigment — typically with a CO2 laser rather than toning. More importantly, any pigmented lesion that has changed in size, shape, colour or border, or that bleeds or itches, needs to be examined by a physician before any cosmetic removal is considered. Removing such a lesion with a laser without assessing it first is not a cosmetic decision.