Honestly, I used to think all pigment lasers were pretty much the same too

These days, as the weather gets chilly

the clinic starts filling up with people saying, "The tan I got in summer won't fade,"

and it gets busy.

"I searched online and there are so many kinds of lasers

I don't know which one I should get,"

I heard that from seven different people just last week.

Today I'll walk you through the reason step by step.

So what exactly is different?

Pigment lasers are a general term for devices that selectively

destroy only melanin pigment.

But within the single term "pigment laser,"

toning, Spectra, pico, ruby, Q-switched...

all of these are included.

This is where many people get confused,

because even if the names look different, in the end

wavelength (nm) and pulse mode are what it comes down to.

The rest is just a difference in equipment brands.

Why do some people see less of an effect?

The key point of this article

The pigment laser most often asked about by people in their 20s and 30s around Seoul and Hongdae,

is easier to choose once you understand the depth differences by wavelength.

The pigment laser most often asked about by people in their 20s and 30s around Seoul and Hongdae,


the depth differences by wavelength


make selection much easier.

This was a 28-year-old woman who came from Hongdae last month.

She had received toning 10 times at another dermatology clinic,

but came in saying, "I think my melasma actually got darker."

After examining her, it turned out not to be melasma but

ADM (acquired dermal melanocytosis).

The tricky thing is that

it looks virtually identical to melasma on the surface.

But here's the important part.

Melasma is located in the epidermis to the superficial dermis (around 0.3 mm),

while ADM extends down to the mid-dermis (over 1 mm).

A 1064 nm wavelength penetrates 4–5 mm into the skin,

while a 532 nm wavelength reaches only about 1 mm.

That difference completely changes the result.

She had only been receiving repeated toning with the 532 nm type,

so it wasn't even reaching the deeper pigment.

At our clinic, with a 1064 nm pico + ruby combination,

we did three sessions,

and when she came in last week, even she was surprised.

Director Wi Young-jin's key takeaway


Pigment treatment is determined by "where it is."


Even if it looks like the same brown spot,


the device changes depending on whether it's in the epidermis or the dermis.


So diagnosis comes first, and the laser comes second.

This is how I classify them in the clinic

It varies by case,

but this is the way I usually break it down and explain it.

But this isn't always a good thing.

Especially with melasma, if you hit it too aggressively with a laser,

it can actually cause rebound hyperpigmentation.

So in the first consultation,

"Let's examine it with a Wood's lamp first and then decide."

That's how I usually say it.

However, for freckles or blemishes like

these clearly defined epidermal pigments,

they tend to fade clearly in just one or two sessions,

so they're the best choice in terms of value.

The three questions I get most often in the clinic

Q1. If you get it near Seoul, aren't the results all about the same?

A. Honestly,

diagnosis matters much more than the device.

Even if the same pico device is used,

if the type of pigment is misjudged,

the power and wavelength settings can end up completely off.

At the first visit,

I always check a Wood's lamp and dermoscopy together.

Q2. How many sessions do I need, and how much does it cost?

A. It depends on the type.

Epidermal blemishes often clear in 1–2 sessions,

while melasma usually needs at least 5 sessions.

The cost varies depending on the area, size, and device,

so the per-session range can be quite wide,

and the exact amount is best discussed during consultation.

Q3. I've heard people say they got darker after laser treatment?

A. That's called post-inflammatory hyperpigmentation (PIH).

It happens especially often in melasma patients.

If the power is set too high,

or the intervals are too short, it can occur.

That's why I deliberately prefer a low-output, gentle, repeated

approach.

It takes a bit longer, but it's safer.

I'll continue with a deeper discussion in the next post. This was Wi Young-jin.