Pigmentation & Tattoo Removal

For sun spots, freckles, post-inflammatory hyperpigmentation (PIH), and unwanted tattoo ink — with a medical-first approach designed for pigment-prone skin.

Pigmentation and tattoos may appear as simple surface marks, but successful removal requires understanding of cause, depth (epidermal vs dermal) and inflammatory triggers. The wrong approach — especially aggressive laser use — can lead to worsening pigmentation (PIH) or immediate relapse. As a clinic focused on both skin cancer medicine and aesthetics, every treatment begins with an accurate medical diagnosis to confirm your pigmentation is benign and suitable for laser before we begin. ^(1–4)

What we treat

Pigmentation

• Solar lentigines (sun spots, age spots) ^(5,6)
• Freckles (ephelides)
• Post-inflammatory hyperpigmentation (PIH) ^(2,7,9)
• Selected birthmarks and dermal pigment patterns (case-dependent)

Tattoo ink

• Professional and amateur tattoos
• Black and darker inks — typically the most responsive ⁽⁸⁾
• Selected coloured inks — variable response depending on pigment chemistry ⁽⁸⁾

Specialised care for melanin-rich skin

Patients with olive, brown or deep skin tones require a different level of precision. Because the risk of post-inflammatory hyperpigmentation (PIH) is significantly higher in these skin types, we manage these cases through our dedicated Skin of Colour Clinic →.

Here, the focus is on pre-conditioning the skin with medical topicals for 4–6 weeks before treatment — so the laser is safe and effective without causing secondary darkening. Conservative parameters and longer intervals between sessions are also part of the safer pathway.

The 3-step pathway (the medical difference)

Step 1 — Medical assessment and pigment typing

Before any laser treatment, we perform a clinical assessment to determine:

• Diagnosis: is this benign pigmentation, or a lesion requiring a different medical path?
• Depth: is the pigment epidermal, dermal, or mixed?
• Risk profile: what is your “PIH risk”? Critical for patients with melanin-rich skin or a history of scarring ^(2,7)
• Drivers: are UV exposure, hormones (melasma) or medications driving the pigment? ^(2–4)

Step 2 — Medical-grade Q-switched Nd:YAG laser

The Q-switched (nanosecond) laser delivers high-energy pulses designed to fragment pigment or ink into microscopic particles, allowing your body’s immune system to clear them naturally. ^(6,8)

Why Q-switched (nanosecond) vs picosecond? While “pico” lasers are marketed heavily for speed, Q-switched nanosecond technology remains a gold standard for safety in high-risk pigmentation.

• Controlled thermal profile — Q-switched lasers provide a predictable thermal interaction with skin. In complex pigmentation, the ultra-fast delivery of picosecond lasers can create photo-acoustic shockwaves that may inadvertently trigger inflammation and PIH in sensitive or pigment-prone skin.
• Stability — we prioritise the stability of surrounding tissue. Using specific low-fluence Q-switched protocols we can clear pigment effectively while keeping the skin “quiet” and avoiding the aggressive inflammatory response that leads to relapse. ⁽⁸⁾

Step 3 — Stabilisation and protecting your result

Laser is only one part of the solution. To prevent the pigment from returning, we focus on stabilising the melanocytes (pigment-producing cells). ^(2–4,7)

• Prescription therapy — where appropriate, medical-grade topicals to suppress excess pigment production and reduce inflammation.
• Evidence-based actives — vitamin B3 (niacinamide) for modulation, azelaic acid for anti-inflammatory support, and barrier repair to stop the “reaction spirals” that lead to new spots. ^(9,10)
• Dermal therapist integration — consistent, gentle care with a therapist ensures your skin remains stable between and after laser sessions.

Tattoo removal (realistic expectations)

Tattoo removal is a medical journey. Most tattoos require multiple sessions to allow for immune clearance of fragmented ink. While we aim for complete removal, we also specialise in “fading” tattoos to a level where high-quality cover-up art is possible. ⁽⁸⁾

• Typical timeline: 5–10+ sessions for professional ink.
• Spacing: intervals are intentional — your body needs time to clear the ink safely.
• Ink type: darker inks generally respond more predictably than bright blues or greens. ⁽⁸⁾

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References

1. Passeron T, et al. Melasma. RACGP. 2021.
2. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010.
3. Arora P, et al. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. Lasers Med Sci. 2012.
4. Grimes PE. Melasma: etiologic and therapeutic considerations. Arch Dermatol. 1995.
5. Mardani G, et al. Treatment of solar lentigines: a systematic review of available therapies. J Cosmet Dermatol. 2025.
6. Kim JS, et al. Objective evaluation of the effect of Q-switched Nd:YAG laser on solar lentigines. Ann Dermatol. 2015.
7. Kang DH, et al. Postoperative risk assessment of post-inflammatory hyperpigmentation after 532-nm Q-switched Nd:YAG treatment for solar lentigines. J Cosmet Dermatol. 2024.
8. Ross EV, et al. Comparison of responses of tattoos to picosecond and nanosecond Q-switched lasers. Arch Dermatol. 1998.
9. Chaowattanapanit S, et al. Postinflammatory hyperpigmentation: a comprehensive overview. J Am Acad Dermatol. 2017.
10. Auffret N, et al. Acne-induced post-inflammatory hyperpigmentation: treatment approaches including azelaic acid evidence. Acta Derm Venereol. 2025.