Living with unwanted skin pigmentation affects more than your appearance — it affects your confidence. Sun damage, age spots, dark circles, and conditions like melasma, Nevus of Ota, and Hori’s Macules are all common, but notoriously difficult to treat effectively. At Dr MediSpa in Knightsbridge and Marylebone London, and Loughton Essex, we select only the most advanced, evidence-backed technologies for skin rejuvenation. PicoSure Pro® is the gold standard for laser pigmentation — the first picosecond laser with FDA clearance for the three most challenging facial pigmentation conditions, supported by over 83 peer-reviewed studies. It is available at our Marylebone London Clinic.
PicoSure Pro® is a picosecond pulse laser that emits lig20 – 45 minutewht pulses in trillionths of a second, making it highly distinctive. Unlike traditional lasers that mainly rely on heat to break down pigment, PicoSure Pro® uses the photoacoustic effect to produce pressure waves that shatter pigment particles without causing thermal damage, thereby reducing side effects in the surrounding skin.
The laser specifically targets melanin — the pigment responsible for dark patches — rather than water in the tissue. This precise method results in cleaner outcomes, fewer side effects, and better results across all skin types, including darker Fitzpatrick types (III–VI), where pigmentation issues are more common and harder to treat safely.
This process, known as Laser-Induced Optical Breakdown (LIOB), also activates the body’s natural repair mechanisms, increasing collagen and elastin production. As a result, PicoSure Pro® not only treats pigmentation but also improves overall skin quality.
Sun damage and age spots
Years of UV exposure increase melanin production, forming brown spots, freckles, and uneven skin tone that can age your appearance. PicoSure Pro®’s 755nm wavelength targets melanin precisely, breaking it down without damaging surrounding tissue — ensuring quick recovery and a low risk of discolouration. Improvements in the appearance of sun damage can often be seen after just one or two sessions.
Dark under-eye circles
Persistent dark circles that don’t improve with rest or eye creams are often linked to pigmentation, particularly in those with olive, South Asian, East Asian, Middle Eastern, or African skin, where excess melanin causes periorbital hyperpigmentation. PicoSure Pro® offers precise treatment with fewer side effects than traditional lasers, making it a safe, non-surgical option. During your consultation, we will assess whether your dark circles are primarily pigmentary, vascular, or structural, and determine the best treatment approach.
Melasma
Melasma is a challenging chronic skin condition characterised by irregular grey-brown patches, commonly on the forehead, cheeks, chin, and upper lip. It can be triggered by sun exposure, hormones, pregnancy, and contraceptive use. While topical treatments may help control it, complete clearance is rare.
PicoSure Pro® is the first FDA-cleared picosecond laser specifically for melasma pigmentation. Clinical trials showed a 28–39% improvement on the MASI scale after treatment, with effects lasting at least a year. In comparative studies, PicoSure Pro® outperformed the Q-Switched Alexandrite laser in both clearance efficacy and side-effect profile.
Nevus of Ota
Nevus of Ota is a form of dermal melanocytosis characterised by melanin-producing cells residing deep in the dermis, causing a bluish-brown or slate-grey discolouration around the cheeks, forehead, nose, and eyes. It is most common among individuals of Asian and African descent and affects women at a ratio of 5:1.
Because the pigment is embedded deep within the skin, surface treatments are ineffective. PicoSure Pro® is the only FDA-cleared picosecond laser for Nevus of Ota. In the largest clinical study conducted (56 participants, up to 6 treatments), all patients achieved at least 75% clearance, with 53% reaching 95–100% clearance.
Hori’s Macules
Hori’s Macules (ABNOM) is a pigmentation disorder that develops as bilateral facial patches in middle-aged individuals, mainly affecting Asian and Eurasian patients. It closely resembles Nevus of Ota but is usually more widespread.
FDA-cleared PicoSure Pro® effectively treats Hori’s Macules. Clinical evidence shows that after two sessions, most patients see at least 60% clearance, and after three, over 90%. In a large patient satisfaction survey, 93.4% reported being satisfied or very satisfied six months post-treatment.
Book a free consultation at Dr MediSpa in London or Essex. Our clinicians will assess your pigmentation in person and recommend the most effective treatment plan for your skin type and condition — with no obligation to proceed.
Absolutely — and this is one of PicoSure Pro®’s key advantages. Pigmentation conditions like melasma, Nevus of Ota, and Hori’s Macules are more frequently seen in individuals with medium to dark skin tones (Fitzpatrick types III–VI). Traditional heat-based lasers carry a much higher risk of post-inflammatory hyperpigmentation (PIH) in these skin types, which can worsen pigmentation rather than improve it.
PicoSure Pro®’s photoacoustic technique causes considerably less thermal damage, and its 755nm wavelength is optimised to target melanin without generating the heat that may lead to PIH. In published comparative studies, PIH rates with PicoSure Pro® were significantly lower than with Q-Switched alternatives.
PicoSure Pro® is considered very safe and effective across all skin types, but it isn’t suitable for everyone. Treatment may not be appropriate if you:
• Are pregnant or breastfeeding
• Have an active skin infection or open wound in the treatment area
• Are currently taking isotretinoin (Roaccutane) or have done so within the past six months
• Have a history of keloid scarring
• Have recently had significant sun exposure or a tan in the area to be treated
This isn’t an exhaustive list, which is why we always begin with a free consultation at one of our clinics in London or Essex. During this appointment, we’ll assess your skin in person, review your medical history, and give you an honest picture of what PicoSure Pro® can realistically achieve for your specific condition.
A topical numbing cream is applied around 30 to 45 minutes before your session begins. During treatment, your practitioner will pass the PicoSure Pro® handpiece over the designated area to deliver precise pulses of laser energy. Most sessions last between 20 and 45 minutes, depending on the size of the area and the condition being treated.
Every treatment is fully personalised. Your practitioner will select the appropriate wavelength (532nm, 755nm, or 1064nm), energy level, and spot size based on your skin type and the condition being treated — nothing is set to a default. Detailed aftercare guidance will be provided after each session.
Most patients find PicoSure Pro® very tolerable. The sensation is usually described as a mild snapping or light pinching against the skin — similar to a rubber band flicked at close range. To maximise comfort, we apply a topical numbing cream around 30 to 45 minutes before your session. Immediately after treatment, the skin may feel like a mild sunburn, but this typically settles within a few hours. Compared to traditional lasers, the photoacoustic mechanism causes significantly less heat-related discomfort.
The number of sessions depends on your specific condition and how your skin responds. As a general guide:
• Hyperpigmentation and sun damage: 2–4 sessions at four-week intervals
• Dark circles with pigmentation: 3–5 sessions
• Melasma: 3–5 sessions at four-week intervals
• Nevus of Ota: 2–6 sessions at 4–12-week intervals
• Hori’s Macules: 2–4 sessions at 3–6-month intervals
Improvements continue in the weeks following each session as your skin’s natural healing processes take effect. We’ll be honest with you during consultation about what’s realistic for your particular condition.
One of PicoSure Pro®’s main benefits is its minimal downtime. Immediately after treatment, the skin might look slightly red or swollen — this is normal and typically subsides within a few hours. You may notice the treated area darkening slightly before it lightens; this is part of the pigmentation-lifting process and is entirely expected. Most patients can comfortably return to their usual activities on the same day.
Sun protection is crucial throughout your treatment course. We provide detailed aftercare advice after each session, tailored to your skin and the specific protocol used.
Early improvements can often be observed within one to two weeks of the initial session, as the shattered melanin particles are naturally absorbed and eliminated by the body. Full results develop gradually — you’ll most likely see your best outcome within four to six weeks after each session, with overall skin quality continuing to improve as collagen and elastin production increases.
Optimal final results are generally evaluated three to six months after your final treatment. PicoSure Pro® is not a one-session cure, but it is the most clinically proven method to achieve meaningful, lasting clearance.
PicoSure Pro® is the most clinically proven picosecond laser for facial pigmentation — and it’s available at Dr MediSpa in Marylebone. Your first step is a free, no-obligation consultation with one of our specialist clinicians.
