Pigment Problems

There are two basic colours of birthmarks – red and brown.  Brown marks are caused by an excess of melanin, the skin’s natural tanning pigment.  Exposure to the sun’s rays can alter the presence of melanin in the skin, leading to brown skin marks or blemishes.  Pigmented marks can appear at birth of sometimes later on into teenage years.

Café-au-lait patches are flat, light brown marks usually present at birth.  Naevus Spilus is very similar to café-au-lait mark but has multiple freckles within it.  Becker’s naevi are less common.  They first appear during adolescence as a spreading brown mark over one shoulder and the adjacent chest and upper back.  They spread for a few years and can develop coarse dark hairs.  They are more common in boys and tend to stop progressing in early 20’s.

Naevus of Ota is a deeper situated pigmented birthmark on the face, which can look blue, black or grey.  There may be a blue discolouration to the eye.  These birthmarks are much more common in Japanese patients.


The treatment of pigmented lesions is with The Appogee laser.  The last works by matching the colour of the laser light to the colour of the unwanted birthmark or blemish.  The laser energy is delivered in a serious of extremely brief pulses, which over a series of treatments, break down the pigment in the skin.    

As each laser pulse is extremely brief (lasting about one thousandth of a second) there is no build up of heat energy in the skin.  Through a technical process known as selective photothermolysis, the laser only interacts with the unwanted coloured skin – completely bypassing normal, unmarked and blemish free skin.  Such precision ensures that patients receive the safest possible laser treatment.

Most patients are happy to have treatment without the use of anaesthetic creams.  Patients often describe the treatment as a scratching feeling.  For those patients with sensitive skin, or undergoing treatment in sensitive areas, an anaesthetic cream can be used.

The duration of the individual treatment sessions will vary according to the size of the area treated, the type of birthmark or blemish and the type of laser used.  Treatment usually takes less than half an hour (and is often much quicker).

At each treatment causes the birthmark or blemish to fade and a number of separate treatment sessions are usually necessary to achieve the best results.


Although pigmented lesions generally respond well to the Appogee laser, the response in any individual can be unpredictable.  In some patients the birthmark may fail to respond to all and in others a good result may slowly revert back to the original appearance of the birthmark.  Commonly, laser treatment stimulates more pigment in the skin like an exaggerated tan – hyperpigmentation.  This always fades but may slow down treatment.  Occasionally, more pigment than desired is removed to leave a paler area – hypopigmentation.  These complications are minimised by performing a small test area first to assess the patient’s response.


Most patients will experience a positive, temporary reaction to the treatment, demonstrating laser therapy breaking down the unwanted pigment or colour in the skin.  This reaction can take the form of bruising, whitening or crusting of the treated area.  A few days after the treatment, this reaction will disappear, taking with it the colouring of the unwanted birthmark or blemish.

It is very important to avoid sun exposure in the treated area and we would advise that you use a sunblock on a daily basis.  Exposure to UVA light promotes hyperpigmentation in the treated area of some patients.  Please ask the Cosmetic Laser Clinic practitioner about avoiding hyperpigmentation in the treated area.