This is a starting framework, not a diagnosis. More than one technology may be suitable, and the plan can change after the skin's response is reviewed.
Concern
Potential options
Why
Extra caution
Freckles and sun spots
PicoSure, BBL or a selected Q-switched wavelength
These are often superficial melanin targets that may respond to photoacoustic disruption or filtered light.
Background melasma, tanning or reactive skin can alter the choice.
Brown pigment with redness
Sciton BBL or a staged light-and-laser plan
Filtered light can address selected brown and red photoageing patterns.
Heat-sensitive or darker skin needs conservative parameters.
Melasma-prone pigmentation
Skin preparation, topical care and selected low-energy laser pathways
Melasma is chronic and trigger-sensitive, so control is more realistic than permanent clearance.
Heat, inflammation, UV and aggressive treatment may cause recurrence.
Post-inflammatory pigmentation
Barrier repair first; a cautious 1064 nm or selected pico pathway may later be considered
The plan should reduce inflammation rather than add another uncontrolled injury.
Laser and BBL can worsen PIH when used too aggressively.
Tattoo colours
PicoSure, MaQX or QX MAX
Different wavelengths target different ink colours and depths.
Ink composition, density, layering and skin tone affect response.
Texture with pigment
Fractional pico, MaQX fractional modes or a separate resurfacing pathway
Collagen-focused treatment may be needed as well as pigment targeting.
Fractional treatment can add downtime and PIH risk.