Pigmentation concerns are common in Asia – but not all treatments are created equal. For those with darker skin tones, lasers can either help or harm. Here’s the difference.
“My pigmentation got worse after laser. Is this normal?”
That was the worry gnawing at Ms Gayathri, a young woman in her 30s who had just undergone laser treatment for acne-related pigmentation. Instead of lightening, the treated spots had deepened in colour. For many Asians with melanin-rich skin, lasers can sometimes do more harm than good.
Pigmentation is one of the most common skin concerns in Asia – ranging from freckles and sunspots to more stubborn conditions like melasma. Laser treatments are often marketed as a quick fix. But, for Asians with varying skin tones, the situation isn’t always so straightforward.
While lasers can effectively lighten sunspots and melasma, they also carry some risks of making the pigmentation worse, particularly on those with darker skin.
So what exactly makes laser therapy more risky for certain skin types?
Understanding Fitzpatrick Skin Types
The Fitzpatrick skin types (FST) scale is used to classify the skin tone and its response to ultraviolet (UV) radiation. The scale ranges from Type I to VI, with lower types burning more easily and higher types tanning more readily.
| Fitzpatrick Skin Type Classification | Description |
| I | Skin always burns and never tans. Sensitive to UV exposure. |
| II | Skin burns easily but tans minimally. |
| III | Skin burns moderately and tans gradually to light brown. |
| IV | Skin burns minimally and always tans well to moderately brown. |
| V | Skin rarely burns and tans rapidly to dark. |
| VI | Skin never burns. Deeply pigmented and the least sensitive to UV exposure. |
Why Does Darker Skin Respond to Lasers Differently?
Asian skin generally contains more melanocytes (cells that produce melanin, a natural pigment to give the skin its colour). More melanin means darker skin which is more reactive to heat, making them more susceptible to skin pigmentation issues.
Laser treatments work by emitting controlled bursts of light and heat energy to break down the excess pigment. However, in melanin-rich skin, this can trigger inflammation, leading to post-inflammatory hyperpigmentation (PIH) – where the treated area becomes even darker than before.
“Patients with darker skin (Fitzpatrick skin types IV to VI) are more hesitant with laser treatments due to the fear of burns, scarring, or post-inflammatory hyperpigmentation (PIH).” says Dr Preethi Jeyabal from Eagle Aesthetics & Surgery. “These complications are typically the results of wrong laser choice or poorly calibrated settings.”
Common Laser Risks in Darker Skin
Dr Preethi further elaborates:
“Darker skin contains a higher baseline of melanin in the epidermis. Hence, excess energy from lasers may inadvertently target melanin production. This raises the risk of PIH, hypopigmentation, and surface burns, if not handled with the right wavelength and pulse duration.”
Here’s what each of these mean:
Post-Inflammatory Hyperpigmentation (PIH) or Worsening Melasma
PIH occurs when the skin produces excess melanin following irritation, burns or injury. New dark patches often appear on the treatment sites.
PIH is especially common in Asian skin due to its higher melanin activity. Some heat-based treatments can also worsen melasma.
Hypopigmentation
Hypopigmentation may develop after laser treatments as heat may damage the pigment-producing cells, leading to a drop in melanin levels. Additionally, hypopigmentation may result from the formation of new collagen during the skin’s natural healing process after laser therapy.
Burns, Scarring or Texture Changes
Although uncommon, scarring or changes in skin texture are possible if laser settings are inappropriate. The risk of scarring is particularly higher, particularly with ablative resurfacing lasers. Scarring may result from burns, poor wound healing, or skin infections after treatment.
Which Lasers Are Safe for Darker Skin?
Certain lasers carry higher risks of complications on melanin-rich skin. These include:
- Short-wavelength devices (532 nm)
- Fully ablative CO₂ lasers
Dr Preethi recommends safer alternatives:
- Longer wavelength lasers (e.g., Nd;YAG 1064 nm) – longer wavelength that penetrates deeper and bypasses the pigment-rich epidermis
- Fractional non-ablative lasers (e.g., 1550 nm erbium-glass) – lower risk of overheating the skin surface
Alternatives to Laser Treatment
If you have a history of PIH or are cautious about lasers, there are other treatment options:
- Topical depigmenting agents (e.g., hydroquinone, azelaic acid, tranexamic acid, retinoids)
- Mild chemical peels (e.g., mandelic acid)
- Microneedling or radiofrequency microneedling
These treatment modalities act on pigmentation pathways or promote skin remodelling without directly targeting the melanin.
Self-Care Tips Before and After Laser Treatment
Proper skin care before and after treatment is essential to get the best results and reduce risks of complications.
| Before Treatment | After Treatment |
| Avoid sun exposure | Use strict photoprotection (e.g., SPF 50+, physical barriers such as wearing a cap and using an umbrella in outdoors) |
| Stop using irritants such as topical retinols, AHA/BHAs or exfoliants 3-5 days before treatment. | Use gentle cleansers and moisturisers. Avoid picking or exfoliation. |
| Disclose to your dermatologists any history of PIH or keloids. | Seek advice from dermatologists early for early topical treatment if PIH develops. |
💡 Pro tip: For those with skin type Fitzpatrick IV-VI, always request a test patch before proceeding with full-face laser.
TLDR: Can Lasers Worsen Pigmentation in Darker Skin?
The answer is yes – if done inappropriately.
It is not about avoiding lasers altogether, but finding the right approach. With careful selection and conservative settings, darker skin types can still benefit from laser safely. Speak with a doctor with experience in treating diverse skin types to find out what is the most appropriate option for you.
P.S: Find out more about your skin type and your most appropriate treatment at our Aesthetics Page
References
- The Mystery of Freckles: How Do You Get It. Medical Channel Asia. Updated: 27 June 2023. https://medicalchannelasia.com/the-mystery-of-freckles-how-do-you-get-it/
- What Are the Fitzpatrick Skin Types? Healthline. Updated: 30 August 2022. https://www.healthline.com/health/beauty-skin-care/fitzpatrick-skin-types#About-the-Fitzpatrick-skin-types
- What is Post-Inflammatory Hyperpigmentation? WebMD. Updated: 21 February 2024. https://www.webmd.com/skin-problems-and-treatments/what-is-post-inflammatory-hyperpigmentation
- https://eagleeyeaesthetics.com.sg/doctors/dr-preethi-jeyabal/
- Hypopigmentation. Cleveland Clinic. Updated: 27 June 2022. https://my.clevelandclinic.org/health/symptoms/23363-hypopigmentation
- Laser Complications. National Library of Medicine. Updated: 28 August 2023. https://www.ncbi.nlm.nih.gov/books/NBK532248/
- Can You Actually Restore and Stimulate Collagen Production? Medical Channel Asia. Updated: 12 August 2025. https://medicalchannelasia.com/can-you-actually-restore-and-stimulate-collagen-production/
