Laser Pigmentation Treatment in Northern Cyprus

Before beginning any pigmentation treatment, it is essential to identify the lesion type accurately. At our clinic, differentiation is made using a Wood's lamp, dermoscopy and, where necessary, biopsy. The lesion type directly determines the treatment response.

• Sun spots / age spots (solar lentigo, lentigo senilis): Well-defined, epidermal, dark lesions that develop from years of sun exposure. This group responds best to laser. Picosecond 532 nm or Q-switched Nd:YAG 532/1064 nm typically achieves 70–90% improvement in two to three sessions. Most commonly seen on the face, backs of hands, décolletage and shoulders.
• Ephelides (freckles): Small lesions with a genetic basis that appear in youth and darken with sun exposure. They respond to laser, but the recurrence rate is high — they may partially return within one to two years in patients who are not diligent about sun protection. For most patients, the conversation includes an acknowledgement that freckles are often an aesthetic identity and that complete removal is not a realistic expectation.
• Post-inflammatory hyperpigmentation (PIH): Dark marks left by acne, eczema, burns or waxing. Mostly epidermal, though dermal forms exist. Treatment requires a combined approach, not laser alone: first addressing the underlying inflammation (e.g. isotretinoin or topical retinoids if acne is active), followed by low-dose picosecond or chemical peel. Aggressive laser can flare PIH and paradoxically leave a darker mark.
• Melasma: Brown-grey darkening, typically symmetrical, appearing across the cheeks, forehead and upper lip. It is a chronic condition with hormonal triggers (pregnancy, the combined oral contraceptive pill, thyroid dysfunction) and a genetic basis, exacerbated by sun exposure. Laser alone does not resolve melasma and frequently triggers a flare. The gold standard is multimodal: strict sun protection + triple cream (hydroquinone / tretinoin / corticosteroid) + low-dose picosecond toning where appropriate + oral tranexamic acid. Patients at Nis Clinic with suspected melasma are first directed to the comprehensive protocol on our medical aesthetic pigmentation treatment page; laser forms only one element of that programme, at low dose.
• Café au lait, Becker's naevus, melanosis (naevus of Ota / Ito): Congenital or early-onset dermal pigmented lesions. This group requires individual assessment; picosecond produces excellent results in some cases, while in others dermatology referral and biopsy are appropriate. The definitive decision is made per patient at consultation.
• Actinic keratosis, seborrhoeic keratosis: These fall outside the scope of laser pigmentation treatment; they are pre-malignant or tumour-type lesions and require dermatological and pathological assessment. Cosmetic laser is not applied to these lesions at our clinic; the patient is referred to the appropriate specialist.

There are four principal platforms used in pigmentation treatment. Each has a different affinity for melanin; which is used depends on the clinician's decision, based on skin type and lesion depth.

• Picosecond laser (PicoWay, PicoSure-type platforms — 1064 nm + 532 nm + 785 nm): The gold standard for pigmentation treatment. Pulse width is at the picosecond level (10⁻¹² seconds); this means energy is distributed within the tissue as mechanical shock rather than heat. Melanin is selectively disrupted while surrounding tissue is spared. 1064 nm targets deep pigment, 532 nm superficial pigment, and 785 nm intermediate depth. It is the only laser platform considered safe for use in Fitzpatrick IV–VI skin types. It supports a broad range of indications including sun spots, PIH, melasma toning and tattoo removal.
• Q-switched Nd:YAG 1064 nm + KTP 532 nm: The previous generation of technology, operating at nanosecond pulse widths. It remains an effective and safe platform. In particular, 1064 nm is safe in Fitzpatrick V–VI patients and effective for deep dermal pigment (naevus of Ota, Becker's naevus). The 532 nm wavelength is suitable for superficial lentigo but is not used on darker skin.
• Alexandrite laser 755 nm: Effective for sun spots and freckles owing to its high melanin affinity, but safe only in Fitzpatrick I–III. In Fitzpatrick IV–VI skin, the epidermal melanin absorbs significant energy, creating a high risk of burns, blistering and permanent hypo- or hyperpigmentation. At Nis Clinic, the Alexandrite platform is used primarily for laser hair removal; for pigmentation treatment it carries limited indications — only superficial lentigo in fair-skinned patients. Applying Alexandrite to darker skin is a clinical error.
• IPL (Intense Pulsed Light): A broad-spectrum light source rather than a single wavelength — technically not a laser. It is suitable for broad-area scanning in superficial sun spots, photoageing and generalised redness. It is insufficient for deep dermal lesions and requires care in darker skin types, though it is less hazardous than Alexandrite in this context. It does not achieve the monochromatic targeting of a true laser, and patients should be made aware of this clearly.

At Nis Clinic, the primary platforms for pigmentation treatment are picosecond and Q-switched Nd:YAG; Alexandrite or IPL may be considered in Fitzpatrick I–III patients with superficial lesions. Device selection is determined by the patient, not predetermined. We are transparent about this distinction.

Laser pigmentation treatment in patients with darker skin (Fitzpatrick V–VI — genetically high photoprotection, pronounced tanning) is carried out under a more cautious protocol. These patients have a higher concentration of epidermal melanin, which means some of the laser energy is absorbed by the epidermis before reaching the lesion. This increases the risk that an incorrectly chosen device or energy level will leave burns, blistering, permanent hypopigmentation or paradoxical PIH.

Our protocol principles:

• First choice: picosecond 1064 nm at low energy or Q-switched Nd:YAG 1064 nm. Both wavelengths spare epidermal melanin to a greater degree.
• Alexandrite 755 nm and IPL are contraindicated in this skin type (very limited use by a highly experienced practitioner at very low dose is conceivable for superficial lentigines only — it is not the clinical standard and is not our preference).
• Test patch required — a small area is treated at low dose 24–48 hours before the main session, or at the start of the same session, and the skin's response is observed over 24 hours.
• Preparation (prep) period of 4–6 weeks — before the session the patient uses a topical melanogenesis suppressant such as hydroquinone 4% or tretinoin 0.025–0.05% daily. This significantly reduces the risk of post-session PIH.
• Session intervals are extended — from the standard 4–6 weeks to 6–8 weeks, giving the skin additional time to recover.
• Close post-session monitoring — we remain in contact within the first 48–72 hours; any concerning change is assessed by the clinician on the same day.

Aggressive treatment in darker skin carries far greater risk than the same energy level applied in fair skin. For Fitzpatrick V–VI patients, our approach is longer protocol, lower dose. Safety first — not promises of quick results.

The initial consultation takes place at our clinic or online (WhatsApp / Zoom). We assess the following:

• Lesion type differentiation: We examine the lesion under a Wood's lamp. Epidermal pigment intensifies under the Wood's lamp; dermal pigment fades — this distinction is critical for predicting the treatment response. Suspicious lesions (asymmetry, colour heterogeneity, history of growth, itching) are referred to dermatology and pathology. We never overlook the possibility of melanoma.
• Fitzpatrick skin type: Classification on a scale of I to VI — this determines which device, which energy level and which session interval we use.
• Hormonal and medication review: Pregnancy, breastfeeding, the combined oral contraceptive pill, thyroid medication, isotretinoin (Roaccutane), tretinoin / retinol, photosensitising antibiotics (doxycycline) — all affect the process.
• Sun history: Has the patient been in strong sun in the last 30 days? Is there active tanning? Are holidays planned? Sessions are not performed on tanned skin and are deferred by at least four weeks.
• Expectation discussion: A 70–90% improvement is realistic for sun spots, but recurrence occurs with sun exposure. Laser is not a standalone solution for melasma; complete removal is not a realistic outcome for freckles.

At the consultation, the proposed laser platform, estimated number of sessions and indicative price range are shared with the patient. There is no pressure — the patient goes home, reflects and decides.

For Fitzpatrick III–VI patients in particular, we apply a prep period of 4–6 weeks before the session. During this time the patient uses, daily:

• SPF 50+ sunscreen — mineral filter (zinc oxide / titanium dioxide) preferred.
• Tretinoin 0.025–0.05% or retinol in the evenings — accelerates epidermal turnover and reduces PIH risk. Discontinued 5–7 days before the session.
• Hydroquinone 2–4% (where suitable) — suppresses melanogenesis. Used under clinical oversight, intermittently; routine in Fitzpatrick V–VI.
• Azelaic acid 15–20% or arbutin — an alternative when hydroquinone is contraindicated.
• Strict sun avoidance — beach, swimming pool and tanning are not permitted.
• Medication cessation: if isotretinoin has been used in the last six months, the session is not performed; retinoids are stopped 5–7 days in advance; photosensitising antibiotics must be discontinued at least two weeks beforehand.

A session carried out without prep produces inferior results: PIH risk rises and pigment is cleared unevenly. We discuss this 4–6-week period from the very first appointment, because the safety and outcome gains it delivers are well worth the wait.

A laser pigmentation treatment session proceeds as follows:

1. Skin cleansing: The area is freed from any make-up, lotion or fragrance residue and gently wiped with alcohol.
2. Photography: Pre-session photographs are taken at a standardised angle and lighting. A baseline is required for outcome comparison.
3. Topical anaesthetic (optional): For sensitive areas or patients with a low pain threshold, EMLA or lidocaine cream is applied 20–30 minutes before. Most sessions proceed without anaesthetic.
4. Protective eyewear: Both patient and practitioner wear laser safety goggles to protect the retina.
5. Cooling system: Integrated or external contact cooling is used with picosecond and Nd:YAG devices to reduce pain and thermal injury.
6. Pulses: Pulses are delivered to the lesion area at the correct wavelength and dose. Each pulse produces a sensation described as a "sharp, brief sting" or "elastic band snap". Picosecond sessions are generally perceived as less painful because the energy is mechanical rather than thermal. A session lasts 10–30 minutes depending on lesion size.
7. Post-session: The area shows mild redness, slight swelling and a grey-white "frosting" on the targeted lesion (a sign that the pigment has been disrupted). A cooling gel and mineral-filter cream are applied.

First 7–10 days after the session:

• Mild crusting may develop over the lesion; it is left to shed naturally and is never picked off. Picking significantly increases the risk of PIH.
• Hot water, saunas, steam rooms, the sea and swimming pools are prohibited for 48–72 hours; strenuous exercise, heavy sweating and alcohol-based tonics for 48 hours.
• Strict sun avoidance and daily SPF 50+ mineral filter.
• Make-up may be applied the following day after picosecond; waiting 48–72 hours is safer after Nd:YAG.

Number of sessions: Varies by lesion type:

• Sun / age spots: 2–4 sessions, 4–6 weeks apart. Most patients see results in 2–3 sessions.
• Freckles: 2–3 sessions; annual maintenance for recurrence is discussed.
• PIH: 3–6 sessions, combined with peeling and topical treatments.
• Melasma: Not laser alone — within a multimodal programme — low-dose picosecond toning 4–8 sessions + triple cream + oral tranexamic acid + strict sun protection. This protocol is managed through the medical aesthetic pigmentation treatment page.
• Naevus of Ota, café au lait, Becker's naevus: 4–8 sessions, sometimes more; planned on a case-by-case basis.

Session intervals: 4–6 weeks as standard; 6–8 weeks in Fitzpatrick V–VI patients. Shortening the interval does not improve results and increases PIH risk.

Sun avoidance after laser pigmentation treatment is not optional — it is a clinical requirement. Northern Cyprus (TRNC) has a high UV index year-round; even patients who visit primarily for a holiday will undermine their treatment — and risk PIH and recurrence — if they go to the beach to tan.

Our rule set:

• Strict sun avoidance for 30 days after each session — no beach, no pool, no prolonged outdoor activity. Shade, a wide-brimmed hat, sunglasses and protective clothing.
• Daily SPF 50+ sunscreen for a minimum of 6 months — mineral filter (zinc oxide / titanium dioxide) preferred; chemical filters may irritate sensitive skin. Reapplied every 2–3 hours.
• Indoor UVA is also active — car windows transmit UVA. Patients who drive for extended periods apply daily SPF to the backs of their hands and face.
• Bronzers, self-tanners and tanning sprays are stopped at least 4 weeks before treatment and are not recommended for at least 30 days afterwards — they stimulate pigment production.
• If you have a holiday planned — schedule the laser session at least 4–6 weeks before your trip, not immediately before departure. Sessions following sun exposure on holiday are deferred. We are explicit with patients about this: wanting laser immediately on returning from a sunny holiday is not clinically appropriate.

Over the long term, sun protection determines the lifetime recurrence risk of pigmentation. Laser can clear existing pigment, but the sun will create new lesions. If the patient has not genuinely internalised this, the outcome will not last — we repeat this conversation at the start of every session.

• Patients with sun / age spots, Fitzpatrick I–IV: Superficial epidermal pigment, well-defined lesions. Significant improvement in 2–3 sessions with picosecond or Q-switched Nd:YAG 532/1064 nm. Most commonly treated on the backs of hands, face, décolletage and shoulders.
• Dark marks following PIH (post-acne, post-waxing): Underlying inflammation under control, lesion stable. Low-dose picosecond combined with topical treatment.
• Fitzpatrick V–VI patients (sun spots or deep pigment): Picosecond 1064 nm or Q-switched Nd:YAG 1064 nm can be applied safely. With a prep period and low-energy protocol.
• Naevus of Ota, Becker's naevus, deep dermal pigment: Good response with picosecond or Q-switched Nd:YAG. A higher number of sessions is required, but durable results are achievable.
• Patients who can commit to long-term SPF and prep discipline: In a patient who does not maintain sun protection, laser results cannot be sustained; this is assessed as part of candidacy.
• Melasma patients — within a multimodal programme only: Laser is one element of the programme, not a standalone treatment. For the protocol, patients are directed to the medical aesthetic pigmentation treatment page.

In the following circumstances, laser pigmentation treatment is not performed, is deferred or requires a specialist protocol:

• Pregnancy and breastfeeding: Direct harm from laser light to the foetus or infant has not been established, but safety data during this period are insufficient. Hormonal changes may themselves worsen pigmentation (melasma gravidarum); the session is deferred. Treatment can begin once the menstrual cycle has stabilised after the end of breastfeeding.
• Isotretinoin (Roaccutane) within the last 6 months: Treatment is not performed during active use or for six months after completion. The skin barrier is compromised, and the risk of scarring and PIH is elevated.
• Active herpes simplex infection: Patients with peri-oral lesions begin antiviral prophylaxis (valaciclovir or aciclovir) 1–3 days before the session; if an active cold sore is present, the session is deferred.
• History of keloid formation: If there is a known tendency to form hypertrophic or keloid scars, a test patch is required; laser may not be appropriate in some cases.
• Active tanning or sunburn: A minimum wait of four weeks is required. Laser on tanned skin is both ineffective and carries a high risk of burns and PIH.
• Active acne, eczema or skin infection: Deferred until resolved.
• Vitiligo, active psoriasis: Laser is not appropriate or requires specialist assessment.
• Melasma (laser as sole treatment): Directed to a multimodal programme; laser alone is generally ineffective and may be provocative.
• Suspicious lesion (asymmetry, colour heterogeneity, growth history, itching): Cosmetic laser is not applied; the patient is referred to dermatology and pathology. We never overlook the risk of melanoma.
• Photosensitising medications: Doxycycline, sulphonamides, certain NSAIDs, St John's Wort — these must have been discontinued at least two weeks before the session.
• Uncontrolled diabetes, immunosuppression, connective tissue diseases: Healing is delayed; assessment by the relevant specialist is required first.
• Tattooed area: Tattoo ink absorbs laser energy and can cause burns. A safety margin is maintained around the tattoo.

Saying "this is not right for you at this stage" or "laser alone will not be enough — we will put together a programme together" is not a commercial loss; it is clinical responsibility. Protecting the patient from marketing that promises quick fixes also protects the outcome.

• Transient redness and mild swelling: Settles within a few hours to 24 hours.
• Mild crusting: Sheds naturally within 7–10 days; do not pick it off.
• Transient hyperpigmentation (PIH): More common in Fitzpatrick IV–VI. Most cases resolve within 2–6 months with topical treatment; thorough prep and sun protection markedly reduce the risk.
• Hypopigmentation: A lighter area of healing around the treated lesion. Rare, but may be permanent — risk is higher in Fitzpatrick V–VI patients treated at higher energy levels. This is why we prefer a low-dose protocol.
• Minor blistering or superficial burn: Rare; minimised by a low-dose protocol and contact cooling.
• Paradoxical darkening (melasma): The wrong device or a high dose can flare melasma — a conservative multimodal approach is essential for this reason.
• Recurrence: Pigment reforms with sun exposure. New lesions may appear within one to two years in patients who relax their sun protection. This is "new pigmentation has developed", not "the laser did not work".

Should a side effect occur, same-day clinician assessment is arranged, and topical treatment with close follow-up begins immediately.

• Sun and age spots: A 70–90% improvement in two to three sessions is typical. Complete removal is not achievable in every case; an 80–90% reduction is the satisfaction threshold.
• Freckles: Partial reduction; partial recurrence within one to two years is common in patients who do not maintain sun protection. Complete removal is not a realistic target.
• PIH: Significant improvement in 3–6 sessions; the outcome is durable if the underlying cause (e.g. acne) is controlled.
• Melasma: The realistic goal with a multimodal programme is keeping it under control; the word "removal" is clinically inappropriate for melasma.
• Naevus of Ota, Becker's naevus: Multiple sessions are required; a good outcome is achievable, though complete removal may not be.

Be cautious of clinics that promise "it will be done in two sessions" from the outset — the number of sessions varies with lesion type and individual skin; every patient is planned individually.

The Nis Clinic laser infrastructure includes picosecond (1064 / 532 / 785 nm), Q-switched Nd:YAG (1064 / 532 nm) and Alexandrite Candela GentleLase Pro platforms together. This gives us the flexibility to select the appropriate wavelength for each patient and each lesion type: picosecond 1064 nm for Fitzpatrick V–VI patients; picosecond 532 nm or Alexandrite for superficial lentigo in Fitzpatrick I–III patients; IPL for broad-area photoageing.

Clinics that claim to treat everything with a single device typically have only an Alexandrite or IPL — neither of which is safe in darker skin or capable of reaching deep pigment. We are transparent about this limitation. For device context, see our Nis Clinic Laser Clinic page.

Laser pigmentation treatment may appear to be a cosmetic procedure, but it always sits alongside the need for medical differential diagnosis. Distinguishing a lesion from melanoma, a dysplastic naevus or seborrhoeic keratosis requires clinician assessment. A melanoma treated with cosmetic laser could cost the patient their life.

At Nis Clinic the process is as follows: at the consultation, Op. Dr. İbrahim Meyzin or the clinical team assesses each lesion with dermoscopy and a Wood's lamp; any suspicious lesion is referred to dermatology and pathology, and laser is not applied until biopsy results are received; treatment is carried out by a certified laser practitioner in accordance with the clinic protocol, with energy parameters recorded session by session in the patient's file; if a complication arises, same-day clinician assessment and topical treatment are provided; photographic comparison is performed before each session to document progress.

For Op. Dr. İbrahim Meyzin's clinical background, see the Op. Dr. İbrahim Meyzin profile page. Skin safety is a precondition for starting every session.

The price of laser pigmentation treatment varies by area, lesion type, device used and number of sessions. At Nis Clinic we quote pricing per session; we do not operate on a per-pulse or "whatever it comes to" basis.

2026 current per-session price ranges (per session, € EUR):

Pricing is determined within the range based on lesion density, area size and the laser platform used (picosecond or Q-switched Nd:YAG). Upfront payment discounts are applied for typical 2–6-session package protocols.

All sessions include consultation, pre-session photography, cooling, post-session topical care advice and complication follow-up; there are no hidden charges. International patients planning a Northern Cyprus holiday combined with laser treatment will find further options on our medical tourism packages page; you can reach us via our contact page or booking form.

For other treatments within our laser clinic: see our sister pages laser hair removal and laser thread vein treatment. For multimodal pigmentation treatment (melasma, resistant PIH, combined topical / peeling protocols), our medical aesthetic pigmentation treatment page sets out our comprehensive approach. Chemical peel support can be found on the chemical peel page, and for home-care reinforcement, our dermaroller / microneedling page is also relevant.