Three sessions is the usual answer, but the more useful question is what changes between them. Here is what a course looks like week by week, and what moves your own number.
Three sessions, four to six weeks apart. That is the usual shape of a pigmentation course at Dr Joney De Souza Skin & Laser. It is the honest answer to the question most people arrive with.
It is also the least interesting thing we can tell you. A session count on its own says nothing about what you will actually see, or when, or why the gap between appointments is the length it is. Those are the parts worth understanding, because they are what makes a course feel like progress rather than waiting.
So here is the fuller picture. PicoSure Pro is a 755nm picosecond laser, meaning each pulse lasts around a trillionth of a second and breaks pigment apart by pressure rather than heat. The fragments then leave through your lymphatic system over the following weeks, which is the single most important thing to grasp about timing.
Your skin does most of the work between appointments, not during them. The laser breaks the pigment up. Your own circulation carries it away. That is why the gap matters as much as the session, and why arriving early does not speed anything up.
Most patients notice something within days of the first session, and it is usually brightness rather than the disappearance of individual marks. Skin looks fresher and a little clearer. Some marks may darken briefly before they lift, which is the pigment fragmenting and is a sign the laser has done its job.
By two to four weeks after that first session the fuller change has developed. This is why we assess results four weeks on rather than on the day, and why the photographs we take in consistent light matter so much. Memory is unreliable about skin, and a phone snap in different lighting is worse.
The second session is where most people become confident it is working. Overall tone has evened out, and the marks that remain are easier to see as individual targets rather than a general haze. Settings are usually adjusted at this point based on how your skin responded to the first.
Between the second and third session is where the clearest change typically arrives. Discrete marks such as sun spots and age spots are often gone rather than faded. Each one is a defined deposit of pigment rather than a general tendency. Post-acne marks lift in the same way.
After the third session your result keeps developing for another two to four weeks before it settles. Only then is it worth deciding whether a fourth session would add anything, and for a good proportion of patients it would not.
Averages are useful for planning and useless for prediction. Several things push a course shorter or longer, and your practitioner reads all of them at your assessment.
Tattoo removal runs on a different timeline entirely, usually four to eight sessions spaced six to eight weeks apart. It is assessed separately on our PicoSure tattoo removal page.
Sessions start from £320 for a focal area such as the eye or mouth area, with a full face from £475 and a course of three from £1,282. Because you pay by session there is no block to buy upfront, so if your skin clears faster than expected you simply stop sooner. The full breakdown sits on the PicoSure treatment page.
A surprising amount of your result sits in your hands between appointments, and none of it costs anything.
Keep to the spacing your practitioner sets, because that gap is when your body clears the fragmented pigment. Wear SPF 50 daily throughout the course and afterwards, since ultraviolet light both deepens existing pigment and creates new marks. Pause active vitamin A products such as retinol for about a week before each session. And treat untanned skin only, because a tan gives the laser competing targets.
Your sessions are carried out by Roma Sumskiene, our Advanced Skin and Laser Specialist, who is Level 4 qualified and has run hundreds of PicoSure sessions. Dr Joney De Souza provides the clinical oversight. The settings chosen for your skin are a medical decision rather than a default. Your skin is reviewed at every visit and the plan adjusts with it.
Everything starts with a consultation and a patch test, which is where your actual number comes from. Book a consultation at our Marylebone clinic, or look at current prices first.
A number pulled from an article is a starting point. The one that matters comes from someone looking at your skin in good light, and you leave your consultation at our Marylebone clinic with it, along with a patch test already done.
Questions our Marylebone team hears most about course length and what to expect along the way.
A course of three sessions spaced four to six weeks apart is the usual plan for pigmentation, with the clearest change often arriving between the second and third. Your own number depends on what you are treating, how deep the pigment sits, your skin type and how quickly your body clears the fragments. Your practitioner confirms it at your assessment.
Yes, and most patients see something within days, though it is usually overall brightness rather than individual marks vanishing. A single session gives a genuine lift and some people are happy to stop there. A course simply takes it further, because each session works on pigment the previous one could not reach.
Because that gap is when the work actually happens. The laser breaks the pigment into fragments and your lymphatic system carries them away over the following weeks. Treating again too soon means working on a job that is only half finished. The waiting is part of the treatment rather than a delay.
Four weeks after a session, not on the day. The immediate effect is brightening, and the fuller change develops across the following two to four weeks as the fragmented pigment clears. We photograph your skin in consistent light at each visit so progress is judged properly rather than from memory.
Yes, and it is a good sign. Some pigment darkens briefly as it fragments before it lifts and clears. It settles within days. Your practitioner will tell you what to expect for the specific marks being treated so nothing comes as a surprise.
It needs a different approach more than a longer one. Melasma responds to heat as well as to light, so it is treated at gentler settings and more patiently. It is hormonally driven rather than purely sun driven. Many patients then keep it settled with a single maintenance session once or twice a year.
Four things, and all of them are free. Keep to the spacing, wear SPF 50 every day, pause retinol for about a week before each session, and treat untanned skin only. Patients who do those consistently tend to clear faster, because they are not undoing progress between appointments.
No. You pay per session, so nothing is bought in advance and there is no unused block to reclaim if you stop early. That also means if your skin clears faster than expected you simply have fewer sessions. Your practitioner will say so rather than complete a course for the sake of it.
Tattoo work runs on its own timeline, typically four to eight sessions spaced six to eight weeks apart, with ink density, layering, depth and the age of the piece all moving that number. It is assessed and priced separately from pigmentation, and the detail sits on our PicoSure tattoo removal page.
For discrete marks such as sun spots and age spots, often not, because a cleared deposit of pigment tends to stay cleared. What creates new marks is future sun exposure, which is why daily SPF protects the money you have already spent. Melasma is the exception and usually benefits from occasional maintenance.
