Pico toning uses a pico laser, which fires extremely short pulses measured in picoseconds (trillionths of a second). The laser is passed evenly over the whole face at low energy, and pigment in the skin is broken down a little at a time. It does not erase spots in one visit. It is one of several ways to treat pigment, and melasma in particular needs ongoing care of the skin barrier and daily habits alongside it. Below is a real before and after case from Kondae PPEUM Clinic in Seoul, an honest look at what that photo does and does not show, and the answers our medical director, Dr. Park Hwonham, gives patients in consultation.
Pico toning at a glance
- Good fit: blurry-edged melasma spread across both cheeks, cheekbones or forehead, or a wish for a more even overall tone
- Sessions: in studies, usually 4–5 sessions about 4 weeks apart made up one course
- Downtime: redness for a few minutes to an hour or two; the common 1064 nm toning does not cause scabs, so daily life can continue the same day
- Limits: melasma is a chronic condition that often returns, and typical melasma sometimes needs another treatment before toning
- Not for every spot: freckles and lentigines are usually treated with a spot laser aimed at each spot
Laser Toning Before and After: A Freckle Case (Toning + Spot Laser)
This patient was treated at Kondae PPEUM Clinic in Seoul. The portfolio record names the treatment “Dual Toning + Spot Laser”: toning across the skin plus a spot laser aimed at individual brown spots. The record does not list the device, wavelength, settings, number of sessions or the time between the two photos, so we describe only what is visible. One point needs to be clear from the start: this is not a melasma case. The pigment in the photo is scattered, freckle-type spots, and the result should not be read as melasma clearing.
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Case: Scattered freckle-type spots on the cheek (female)
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- Before: many small, light-brown dots are scattered across the cheek below the eye, spreading toward the cheekbone and the side of the nose. Each dot has its own edge, the pattern freckles usually show, rather than one wide, blurry patch.
- After: the dots on the cheek are no longer clearly visible in this photo, and the cheek looks more even in color. No redness or scabbing is visible.
- Keep in mind: the after photo shows more shine on the cheek and a slightly different head angle, which can make faint spots harder to see, and the result reflects toning and spot laser combined.
Why this case used two lasers. Different brown pigments respond to different approaches. Freckles and lentigines (sun spots) are usually treated with a pigment laser aimed at each spot. Melasma is usually treated with several sessions of low-energy toning together with medication and sun protection. Real faces often have a mix, so a plan can pair toning for the overall tone with a spot laser for distinct dots. The spot laser was part of this result, so it does not show what toning alone would do. It also tells you nothing about melasma, which behaves differently and tends to come back. For a broader look at pigment options, see our guide to pigmentation treatment in Korea.
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DR.BAQUO’s Answers on Pico Toning
These are the answers Dr. Park Hwonham, Medical Director of Kondae PPEUM Clinic and a surgeon trained at Seoul National University Hospital, gave in October 2026 to the questions patients ask most often about pico toning.
Does pico toning actually work? What changes?
“Clinical studies and real-world treatment have shown that pigment can be lightened when a laser of a specific wavelength, set to appropriate values, is applied repeatedly to melanin spots on the face or body. That way of firing the laser was defined as toning. As these devices developed and the pulse was shortened to picoseconds, toning became possible with lower risk. After several sessions, spots can lighten noticeably and the skin tone becomes brighter and clearer, and that is what we call pico toning. In practice, the goal and the course depend completely on the pigment pattern. Some patients improve clearly and are very satisfied, while others say they are not sure. That is why a thorough consultation about what you want is necessary.”
How many sessions, and how far apart?
“In studies, four to five sessions about four weeks apart usually made up one course, and many people start to notice a change around the second or third session. In practice, I adjust the interval and the number of sessions according to the depth of the pigment and how the skin reacts. After the first course, maintenance continues depending on the condition. Cases vary a great deal. When toning is truly needed, I recommend the number of sessions that fits. When it is not essential and the goal is general skin care, we talk it through and decide when you want it. If the skin is very sensitive, or frequent make-up and irritation are expected, I explain the precautions, and sometimes I do not recommend it.”
Will my melasma go away completely? Can it come back?
“Pico toning can be used for many pigment conditions to clear the tone and lighten pigment, but it is right to think of it as one of several treatments for pigment. Melasma, lentigines and age spots are approached differently depending on their cause and condition. Managing your environment to reduce aggravating factors and treating the current symptoms have to happen together. Typical melasma in particular sometimes needs a treatment that comes before toning, with toning used afterwards for management. If this treatment and care do not continue well, the pigment can come back or get darker. Above all, typical melasma requires understanding the skin barrier and an effort to change your environment. Explaining this and helping patients change their daily habits is not easy, so in most cases melasma is difficult to treat.”
How do I know if it’s melasma, freckles or sun spots?
“Melasma usually looks like blurry-edged brown patches spread over both cheeks, the cheekbones or the forehead hairline. Freckles are small scattered dots. Lentigines and age spots are brown patches with fairly clear edges, either flat or slightly raised. Nevus of Ota and ABNOM, acquired bilateral nevus of Ota-like macules, are bluish or grayish-brown spots that show through from deeper in the skin. In reality, several pigments are often mixed, so it is best to see a doctor in person and get a recommendation. I think a diagnosis name is only a reference the medical team uses to decide treatment, and it doesn’t mean much more than that. Most cases are mixed, and the same diagnosis can be treated differently depending on the situation, so focusing only on the label easily leads to misunderstanding. Results tend to be better when you leave the professional judgment to the medical team.”
What are the side effects? Can it cause white spots or make pigment darker?
“The common reactions are temporary redness and warmth. Rarely, blotchy white spots of hypopigmentation are reported. They happen when pigment cells are destroyed or become less active, so once they appear they are not easy to improve. That is why sessions that are too frequent or too close together need caution. If the skin overreacts and temporary inflammation develops, post-inflammatory hyperpigmentation can appear, but most of it improves well when you follow the aftercare. It is important to adjust energy and interval to the skin’s response and to pause treatment if anything looks wrong. If possible, it is better to be treated steadily at one place where your progress is followed. Every situation is so different that it’s hard to sum up in a word, but when a problem appears, what matters most is the doctor and the patient working together and doing their best.”
Does it hurt? Will I get scabs?
“It feels like a light snap of a rubber band with some warmth, so we usually do it without numbing cream. Numbing cream can constrict blood vessels, make the skin swell or cause an allergy to the cream, which leaves the skin sensitive and in a state where the laser is harder to do, so I recommend avoiding it where possible. Redness right after treatment may last from a few minutes to an hour or two, and the commonly used 1064 nm toning laser does not cause scabs. Other methods or lasers of other wavelengths can also be combined for a synergistic effect. Toning is a light, maintenance-level laser treatment, so unless you do something very irritating to the skin, you can go about daily life from the same day.”
Can creams, pills or sunscreen get rid of melasma?
“Sunscreen is very important for skin health and protects the skin from the environment in which melasma can form. But melasma that has already appeared needs several approaches, and there is no easy way, so the fastest route is to talk with a doctor and stay with the treatment. I use oral medication for a short period, about three to six months, when actively treating severe melasma in people without underlying conditions. I don’t recommend topical ointments, because in melasma patients they make things worse far more often than not.”
Pico toning vs laser toning, PicoSure and PicoPlus: what’s the difference?
“You can think of laser toning and pico toning as being divided by whether the laser fires in nanoseconds or picoseconds. PicoSure and PicoPlus are names of laser devices used for pico toning. There are so many devices, and how a device is used matters far more than the device itself, so the right wavelength and energy for the situation and the treating doctor’s adjustments have a bigger effect on the result. Which one is right depends on the situation, so we decide through a consultation.”
Why do pico toning prices differ between clinics?
“Even for one session of pico toning, the price depends on which device is used, whether it covers the whole face or part of it, whether spot removal or soothing care is included, and how many sessions are in the package. Compare clinics on those same conditions. Toning means watching your progress over several sessions before and after each treatment, so I recommend finding an experienced doctor somewhere convenient for you to visit.”
What Is a Pico Laser? How Pico Toning Works
- Targeting: laser light is absorbed by melanin pigment in the skin. Toning passes evenly over the whole face several times at low energy, nudging the pigment a little at a time while limiting irritation to the surrounding skin.
- Breaking it up: a picosecond laser fires far shorter pulses than a conventional Q-switched laser, which works in nanoseconds (billionths of a second). Before heat can spread, the pressure from the pulse breaks pigment into finer pieces, and less heat reaches the surrounding tissue.
- Clearing: the fragmented pigment is pushed out through the skin or cleared by the body over several weeks. This is why the change builds from session to session.
| Pico toning | Laser toning | |
|---|---|---|
| Laser | Picosecond laser | Nanosecond Q-switched laser |
| Pulse length | Trillionths of a second | Billionths of a second |
| How pigment is broken up | Mainly pressure rather than heat | Heat and pressure |
In a split-face study of 12 Asian melasma patients treated four times, one month apart, the side treated with a 755 nm picosecond laser lightened faster than the 1064 nm Q-switched side from the second session, and was still lighter at three months. It was a very small study, so it points in a direction rather than settling the question. Our longer guide to pico laser in Korea covers more background.
Pico Laser Treatment: How Many Sessions, and When You See Change
- First course (in studies): 4–5 sessions about 4 weeks apart
- When change is noticed: many people notice a difference in tone and in the edges of melasma around the second or third session
- Afterwards: maintenance based on the pigment, the season and how your skin responds
In a randomized split-face study, 30 melasma patients received low-energy 1064 nm picosecond laser five times, four weeks apart. Their melasma scores (MASI) were lower than at the start at one, three and six months, with no serious adverse events. Yet at six months, 6 of 30 patients had darkened again on the standard pico toning side. A finished course is not the end of care.
Before
After 4–5 sessionsBooking sessions too close together adds up cumulative energy, which is linked to reactions such as white spots. Adjusting the interval to your skin's response matters as much as the number of sessions. If your skin is very sensitive, or you expect a stretch of heavy make-up and irritation, it may be wiser to wait. We look at the question of frequent toning and skin thinning in laser toning for the face.
Why Melasma Keeps Coming Back
Melasma does not have a single cause. Several triggers stack on top of skin that is genetically prone to it.
| Factor | Examples |
|---|---|
| UV and light | Sunlight, light coming through windows |
| Hormones | Pregnancy, birth control pills, changes in female hormones |
| Irritation and inflammation | Contact dermatitis, harsh treatments, frequent rubbing |
| Constitution | Melasma in the family |
For this reason melasma is classed as a long-lasting, frequently recurring chronic condition. No current treatment removes it for good in one go. The core of treatment is control and prevention: sun protection combined with topical medication, oral medication and procedures as needed. Even after pico toning lightens melasma, strong sun or a hormonal change can darken it again. Habits that sensitize the skin, such as scrubbing when you wash, frequent exfoliation and harsh products, can undo progress or make it worse. Dr. Park explains more in melasma treatment in Korea.
Melasma, Freckles or Sun Spots: Which Laser Fits?
| Pigment | What it looks like | Common approach |
|---|---|---|
| Melasma | Blurry-edged brown patches on both cheeks, cheekbones or forehead | Several sessions of low-energy toning + medication and sun protection |
| Freckles | Small brown dots scattered over the nose and cheeks, darker in summer | Pigment laser aimed at each spot |
| Lentigines (sun spots), age spots | Brown patches with fairly clear edges, flat or slightly raised | Pigment laser aimed at each spot |
| Nevus of Ota, ABNOM | Bluish or grayish-brown spots around the eyes or cheekbones, showing from deeper in the skin | Lasers for deep pigment, spaced months apart |
In a Korean split-face study of 20 patients with lentigines, a 532 nm picosecond laser lightened spots more than a 532 nm Q-switched laser, with post-inflammatory hyperpigmentation in 5% versus 30%. In a randomized trial of 56 patients with nevus of Ota, a picosecond alexandrite laser lightened lesions more with fewer sessions (an average of 5.26 versus 5.87, 12 weeks apart), with less hypopigmentation (21% versus 47%) and less hyperpigmentation (26% versus 34%) than a Q-switched alexandrite laser. These results apply to those pigment types. They should not be read as melasma results.
Most faces have a mix of pigments, which is exactly what the case above shows: freckle-type dots handled with a spot laser on top of toning. Rather than relying on a label, have the pigment checked in person and decide with the doctor how to combine toning and a spot laser.
Side Effects: White Spots and Rebound
| Reaction | What it looks like | What studies report |
|---|---|---|
| Hypopigmentation (white spots) | Blotchy lighter patches | Linked to higher cumulative energy with laser toning; 0.38% of 796 patients treated with picosecond laser |
| Post-inflammatory hyperpigmentation | Brown that gets darker after irritation | Can follow aggressive treatment, more common in darker skin |
| Recurrence (rebound) | Lightened melasma darkens again | Reported within months after treatment |
A review of 42 studies on low-fluence Q-switched laser toning found it generally effective and safe. Some patients, however, developed blotchy hypopigmentation that lasted, which was associated with higher cumulative energy, and aggressive treatment could darken pigment instead of lightening it. In a review of 796 melasma patients (3,096 picosecond sessions), hypopigmentation occurred in only 0.38% (3 people). It still happened despite low energy and 4–12 week intervals, and color barely returned over six months of follow-up.
If you notice white patches or darker pigment, tell the clinic that treated you and discuss pausing the next session. Tell us beforehand if you are pregnant or breastfeeding, have inflammation, acne or dermatitis in the area, have recently tanned, have had pigment darken after a laser before, or take medication that can cause photosensitivity.
Pain, Scabs and Make-up After Pico Toning
| Reaction | Usual duration |
|---|---|
| Redness, warmth | A few minutes to an hour or two |
| Mild dryness or tightness | A few days |
| Scabs | Not with the common 1064 nm toning; possible on spots treated with a spot laser |
| Daily life, make-up | From the same day, as long as you avoid anything very irritating |
After treatment, sun protection and moisturizing matter most. If a spot-laser scab forms, let it fall off by itself, because picking it can leave pigmentation behind.
Sunscreen, Creams and Tranexamic Acid
| Method | Role | Good to know |
|---|---|---|
| Sunscreen | Blocks the main trigger that darkens melasma | Apply daily; reapply when outdoors for long |
| Oral tranexamic acid | Reduces signals that drive pigment production | Dr. Park uses it short term (about 3–6 months) for severe melasma in people without underlying conditions. Mention any history of blood clots, birth control pills or smoking. |
| Lightening ointments, topicals | Reduce pigment production in studies | Dr. Park does not recommend them for melasma, as they often irritate and worsen it; if used at all, only as prescribed after a consultation |
A meta-analysis of 22 randomized trials (1,280 patients) found that tranexamic acid lowered melasma scores whether taken by mouth, applied to the skin or injected, with the largest reduction for the oral form. Reported side effects included stomach upset, skin irritation and menstrual irregularities. A meta-analysis of 9 studies combining laser with topical tranexamic acid also found that the combination significantly lowered melasma scores.
Expectations for laser alone should be realistic. A 2026 meta-analysis of five randomized trials (139 patients) on the 755 nm picosecond laser found greater improvement with a triple-combination lightening cream, and more post-inflammatory hyperpigmentation with the laser than with the cream. The evidence was rated low. In everyday practice, though, Dr. Park sees topical ointments worsen melasma often enough that he decides case by case in consultation.
Pico Toning vs Laser Toning vs PicoSure vs PicoPlus
| Name | What it is | Notes |
|---|---|---|
| Pico toning | Toning with a picosecond laser | Very short pulses break pigment into finer pieces |
| Laser toning | Toning with a nanosecond Q-switched laser | Long-established, with many studies |
| PicoSure | Name of a picosecond laser device | Best known for its 755 nm wavelength |
| PicoPlus | Name of a picosecond laser device | Uses several wavelengths, such as 1064 nm and 532 nm |
Even among picosecond lasers, the wavelength, energy and firing method decide which pigment responds. The case photo above is recorded only as "Dual Toning + Spot Laser", so it should not be read as a result from any particular device brand. For how toning results usually look over time, see toning laser before and after.
Pico Laser Korea: Treatment at Kondae PPEUM Clinic
Kondae PPEUM Clinic is directly connected to Konkuk Univ. Station Exit 1 in Seoul. A pico laser plan here starts with a look at your pigment: whether it is melasma, freckles, lentigines or a mix. Then comes a decision on whether toning is needed, whether a spot laser should be added, and how the interval should be adjusted to your skin. Because toning works over several sessions and depends on how your skin reacts, Dr. Park recommends being followed at one clinic you can visit steadily. If you are coming from abroad for a short stay, discuss in advance what can realistically be done within your trip. Our first-time Korean clinic guide covers booking and practical details.
Pico Laser Prices in Seoul: What a Pico Laser Treatment Price Includes
Standing prices at Kondae PPEUM Clinic (event prices are not listed here):
| Option | Price |
|---|---|
| First-Visit Special: Pico Toning, 1 session (first-visit price) | KRW 9,900 |
| Pico Toning, 1 session | KRW 59,000 |
| Spot Laser | KRW 150,000 |
| Pico Toning + LED + Hydrating Mask (3 sessions) | KRW 250,000 |
| Pico Toning + Genesis + Modeling Pack (5 sessions) | KRW 390,000 |
| Pico Toning + LED (10 sessions) | KRW 350,000 |
| Pico Toning + Genesis + Rejuran Tone-Up Booster 2CC (Iontophoresis) + LED + Modeling (10 sessions) | KRW 990,000 |
Pico toning events in Korea
Kondae PPEUM Clinic regularly updates its events and packages, including first-visit prices and bundles with other treatments. The prices above are standing prices. For the latest Pico toning event prices and conditions, check the packages page.
See current events →The first-visit price applies to a first visit only. Prices may change. When comparing clinics, line up four things: which device is used (picosecond or nanosecond), whole face or a partial area, whether spot removal or soothing care is included, and how many sessions are in a package, along with its interval and validity terms. A case like the one above, with distinct freckle-type spots, may also involve a spot laser, which is priced separately.
FAQ — Pico Laser Before and After
Q: Does one pico laser session make a difference?
A: Some people feel their tone looks clearer after one session, but melasma usually lightens more clearly over several sessions in a row. Studies typically used 4–5 sessions about four weeks apart, and many people notice change around the second or third.
Q: Does the before and after photo above show melasma results?
A: No. It shows scattered freckle-type spots treated with toning plus a spot laser. Melasma is a chronic condition that behaves differently and often returns, so this photo should not be used to predict melasma results.
Q: Is a Korean pico laser treatment different from one at home?
A: Our sources do not compare countries. What they and Dr. Park stress is the same everywhere: matching the wavelength and energy to your pigment, the doctor's adjustments, sensible intervals, and steady follow-up at one place. Those matter more than the device name or the location.
Q: Can I get pico toning in summer?
A: Yes, but melasma darkens more easily in sunny seasons. Careful sun protection is important all year, and especially during a course.
Q: Can I wear make-up right after?
A: Toning is a light, maintenance-level laser, so daily life can continue the same day as long as you avoid anything very irritating. Once the redness settles, use gentle products, and keep up sunscreen and moisturizer.
Q: Why do some reviews say pico toning didn't work?
A: The goal and the course depend on the type and pattern of pigment. Pigment that suits toning can change a lot. Typical melasma may need another treatment first, and change is hard to see if daily habits stay the same. Agree on your goal in consultation first.
Q: Can I have it while pregnant or breastfeeding?
A: Melasma darkens easily during pregnancy because of hormones, and some oral medications and ointments may not be usable. Tell us before any treatment if you are pregnant or breastfeeding.
Related Before & After Cases and Guides
- Laser Treatment for Pores Before and After: What Seoul Patients Actually See
- Toning Laser Before and After: What Your Skin Can Realistically Expect
- Pigmentation Treatment Korea: Clear Skin in One Seoul Trip
- Fraxel Laser Pores Korea: The Medical Science Behind Seoul's Most Advanced Pore Treatment
- Melasma Treatment Seoul: Why Korean Doctors Get Results When Others Don't
- Before & After gallery (members)
Sources
- Espósito ACC et al. Update on Melasma — Part I. Pathogenesis. Dermatol Ther (Heidelb), 2022. PubMed 35904706
- Cassiano DP et al. Update on Melasma — Part II. Treatment. Dermatol Ther (Heidelb), 2022. PubMed 35906506
- Lee MC et al. A split-face study — comparison of picosecond alexandrite laser and Q-switched Nd:YAG laser in the treatment of melasma in Asians. Lasers Med Sci, 2018. PubMed 29732522
- Wu X et al. Efficacy and safety of low-fluence 1064 nm picosecond laser with/without micro-lens arrays for melasma treatment — a randomized, split-face controlled study. Lasers Med Sci, 2025. PubMed 41003821
- Lee YS et al. The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma — A Systematic Review. Medicina (Kaunas), 2022. PubMed 35888655
Show 7 more sources
- Hang X, Lim DS. Hypopigmentation Following Picosecond Laser Treatment for Melasma — A Case Series. Lasers Surg Med, 2025. PubMed 41243347
- Chua KR et al. Assessing the Safety and Efficacy of Picosecond Alexandrite Lasers in the Management of Melasma — A Systematic Review and Meta-Analysis of Randomised Control Trials. Australas J Dermatol, 2026. PubMed 41589005
- Calacattawi R et al. Tranexamic acid as a therapeutic option for melasma management — meta-analysis and systematic review of randomized controlled trials. J Dermatolog Treat, 2024. PubMed 38843906
- Khan QA et al. Effectiveness of laser and topical tranexamic acid combination therapy in melasma — an updated systematic review and meta-analysis of randomized controlled trials. Lasers Med Sci, 2023. PubMed 37326860
- Kim JY et al. A Split-Face, Single-Blinded, Randomized Controlled Comparison of 532 nm Picosecond Nd:YAG Laser versus 532 nm Q-Switched Nd:YAG Laser in the Treatment of Solar Lentigines. Ann Dermatol, 2020. PubMed 33911703
- Ge Y et al. Comparison of a picosecond alexandrite laser versus a Q-switched alexandrite laser for the treatment of nevus of Ota — a randomized, split-lesion, controlled trial. J Am Acad Dermatol, 2020. PubMed 30885760
- Ridha Z et al. Laser and Light-Based Therapies for Treating Melasma — An In-Depth Review. Dermatol Surg, 2026. PubMed 41020517
Photos are real patients of Kondae PPEUM Clinic shown with eyes blurred. Results vary between individuals and one case does not predict another. Doctor's answers: Dr. Park Hwonham, Medical Director, Kondae PPEUM Clinic (DR.BAQUO), October 2026.
DR.BAQUO | Hanlim Tower 2F, 229 Achasan-ro, Gwangjin-gu, Seoul | Konkuk University Station Exit 1 (Line 2) | Google Maps | LINE: @364kbfyj | global.drbaquo.com
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Kondae PPEUM Clinic
Dr. Park Hwonham (DR.BAQUO), Medical Director
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- Hanlim Tower 2F, 229 Achasan-ro, Gwangjin-gu, Seoul
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- Line 2 Konkuk Univ. Station Exit 1 (directly connected)
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- Mon–Fri 10:00–20:30 · Sat 10:00–16:30 (KST)
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