Pigmentation is the most requested skin concern in most clinics, and the most frequently mistreated. The reason is that brown marks on skin are not one condition. They have different causes, sit at different depths, and respond to entirely different treatments.
Two of the options are Cool Laser and IPL. They work differently, and choosing between them properly means knowing what kind of pigmentation you have.
Not all pigmentation is the same
Before comparing treatments, it is worth separating the main types, because the answer changes with each.
Sun damage produces flat brown patches on exposed skin, typically the face, chest, shoulders and hands. Pigment usually sits in the upper layers, and it generally responds well.
Post-inflammatory hyperpigmentation is the mark left after a spot, a burn, a rash or a treatment. Depth varies with skin tone and how severe the inflammation was, and the underlying cause has to be controlled or new marks keep appearing.
Melasma is the difficult one. It is hormonally influenced, sits deeper, appears symmetrically across the face, and is prone to returning. It is managed rather than cured, and aggressive treatment frequently makes it worse.
Freckles are genetic, darken with sun exposure and are not a disorder.
How Cool Laser addresses pigmentation
By resurfacing. It removes the outermost layer using cold ablation rather than heat, taking pigmented cells with it and prompting the skin to renew, so the improvement comes through turnover rather than by targeting pigment specifically.
That approach suits pigment sitting in the upper layers, which covers most sun damage and a good deal of superficial post-inflammatory marking. Because it works by removing and renewing rather than by heating, the risk of provoking further pigmentation is lower than with heat-heavy alternatives, which matters in skin prone to that response.
How IPL addresses pigmentation
Differently, and the difference is fundamental. IPL is not a resurfacing treatment. It emits broad-spectrum light, absorbed by pigment, which heats and breaks it up so the body can clear it. The surface is left intact.
That makes it efficient on discrete brown spots with clear edges, particularly on lighter skin where there is good contrast between the mark and the surrounding skin. It also treats redness and visible vessels, which resurfacing does not.
The practical differences
What each targets
IPL targets pigment specifically. Cool Laser treats the whole surface. So IPL suits defined spots, and resurfacing suits diffuse, generalised discolouration where there is no individual mark to aim at.
Skin tone
This matters more here than in almost any other treatment decision. IPL relies on contrast between the pigment and the surrounding skin, and in richer skin tones that contrast narrows, which changes both what it can achieve and how it is used. Approach and device selection are decided at consultation and confirmed by patch test.
Downtime
IPL typically produces redness for a few hours and darkening of the treated spots, which then flake off over a week or so. Cool Laser produces redness for a day or two with light flaking afterwards. Neither is a week off work.
What else they do
Cool Laser improves texture, fine lines and overall skin quality alongside pigment, because it resurfaces everything it passes over. IPL does not improve texture, but it does treat redness and vessels, which resurfacing leaves untouched.
Which suits which problem?
Discrete sun spots on lighter skin. IPL is efficient at exactly this.
Diffuse sun damage with rough texture. Resurfacing, since two problems are being addressed at once.
Post-inflammatory marks. Often resurfacing, particularly where the pigment is superficial, and with the underlying cause treated in parallel.
Melasma. Cautiously, and rarely with heat-based treatment as the first move. This is the one where doing too much makes things worse, and it needs a plan rather than a treatment.
Pigmentation with visible redness. Often both, addressing different components.
The part that is not about the device
No pigmentation treatment holds without sun protection. Ultraviolet exposure is what stimulates pigment production, and treating pigmentation while continuing to expose the skin means paying repeatedly for the same result.
Daily broad-spectrum protection is not an add-on sold at the end of the appointment. It is the difference between a result that lasts and one that returns within a season.
The same applies to cause. Treating post-inflammatory marks while acne is still active means new marks arriving as old ones clear.
Why assessment matters more here
Pigmentation is the area where treating the wrong thing does the most damage. Aggressive treatment of melasma can worsen it. Heat-based treatment in skin prone to pigmenting can provoke the response you are trying to resolve. Resurfacing a face where the pigment sits deeper than the treatment reaches produces disappointment at best.
Establishing which type you have, how deep it sits and how your skin responds is what a consultation and patch test are for, and it is not a judgement to make from photographs on a screen.
How long before it improves?
Pigment responds over months rather than weeks, whichever route is taken, and courses are spaced accordingly. Photographs taken at the start in consistent light are worth more than memory, because gradual fading is genuinely hard to perceive day to day.
Some pigmentation, melasma in particular, is managed on an ongoing basis rather than resolved once. That is not a failure of treatment; it is the nature of the condition.
Getting it assessed
Pulse Light Clinic is CQC-registered and doctor-and-nurse-led, and has been treating skin in London since 2001. You can read more about our approach to pigmentation.
Book a consultation to have your pigmentation assessed before starting any treatment.
