Alopecia Areata
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PicoSure PRO
PicoSure PRO in London is the gold-standard picosecond laser for pigmentation, melasma, sun damage, and acne scarring. PicoSure PRO is the only FDA approved laser specifically indicated for the treatment of melasma. At Dr Ophelia's Harley Street clinic, PicoSure PRO is delivered within a full 360° dermatologist led approach to pigmentation that combines laser treatment with prescription skincare, oral therapies, and hormonal assessment where indicated because pigmentation, particularly in darker skin tones, demands far more than a laser session alone to achieve lasting, safe results.
As a Consultant Dermatologist of Indian heritage, Dr Ophelia understands firsthand the complexity of pigmentation in skin of colour: how it arises, how easily it can be worsened by the wrong treatment, and what it genuinely takes to treat it well. This includes the expertise to assess hormonal contributors such as HRT and the contraceptive pill, manage the underlying inflammatory skin conditions (like eczema, acne, and rarer dermatoses) that drive post-inflammatory hyperpigmentation, and deliver laser treatment at clinically appropriate energies under proper medical supervision. PicoSure PRO works by shattering pigment using ultra rapid pulses of energy without relying on heat, making it one of the most powerful and precise tools available for treating even the most challenging pigmentation conditions across all skin types.
What is PicoSure PRO?
- FDA approved for melasma
- No heat - shatters pigment
- Safe across all skin types
- Full 360° medical approach
PicoSure PRO is an advanced picosecond laser that delivers energy in pulses measured in trillionths of a second which is far faster than traditional nanosecond lasers. This ultra rapid delivery creates a photoacoustic, or pressure based, effect within the skin rather than a thermal one. Instead of burning pigment away with heat, PicoSure PRO shatters it into fine particles that the body can then clear naturally over time.
This distinction matters enormously in the treatment of pigmentation, and especially in skin of colour. Heat-based lasers carry a real risk of triggering post inflammatory hyperpigmentation worsening the very problem they are intended to treat. PicoSure PRO's non thermal mechanism of action makes it significantly safer across a wider range of skin types, and is the reason it has earned FDA approval specifically for melasma, one of the most difficult pigmentation conditions to treat effectively.
At Dr Ophelia's clinic, no laser is used in isolation. Every patient presenting with pigmentation receives a full clinical assessment that considers the underlying cause whether hormonal, UV-related, inflammatory, medication induced, or a combination alongside the full range of available treatments. This includes prescription topical agents, Dr Ophelia's own bespoke prescription pigmentation serums, oral tranexamic acid, Heliocare Fernblock photoprotection, careful management of any underlying inflammatory skin condition, and where relevant, assessment of hormonal contributors including HRT and hormonal contraception, with onward referral to specialist colleagues where needed. PicoSure PRO is the laser of choice within this comprehensive framework.
How Does PicoSure PRO Work?
PicoSure PRO uses picosecond technology to deliver laser energy at extraordinary speed. The photoacoustic effect this creates exerts a pressure based force on pigment granules within the skin, fragmenting them without the thermal injury that conventional lasers produce. The body's lymphatic system then gradually clears the shattered pigment particles, resulting in progressive lightening of pigmented lesions over a course of treatments.
For skin rejuvenation and acne scarring, PicoSure PRO can be used with a fractional Focus lens array which is a specialised attachment that concentrates laser energy into precise microbeams, stimulating collagen and elastin production in the dermis. This remodelling produces improvements in texture, pore size, scarring, and skin quality that develop progressively over weeks following each treatment.
For pigmentation around the eyes including dark circles with a melanin component Dr Ophelia's clinic uses intraocular eye shields during treatment. These sterile shields are placed directly over the eye itself, providing complete protection of the globe and allowing the laser to be used safely right to the orbital rim and across the delicate periorbital skin. Very few clinics in the UK offer this capability, and without it the area most commonly affected by periorbital pigmentation and dark circles cannot be properly treated.
At Dr Ophelia's clinic, treatment is delivered using clinically appropriate energy levels selected by a Consultant Dermatologist and not the conservative, low energy protocols that are standard practice at many laser and aesthetic clinics, where treatments are often performed by therapists with limited training. Higher, properly calibrated energies produce more meaningful clinical results per session, which is why patients treated in a medically led setting typically require fewer sessions to achieve the same outcome. At every visit, response is assessed objectively using VISIA imaging and medical photography, and energy parameters are adjusted accordingly - not applied by rote.
Benefits of PicoSure PRO
Patients choose PicoSure PRO at Dr Ophelia's clinic because it delivers meaningful, lasting improvement in pigmentation, clarity, and skin quality within a medically led framework that addresses cause as well as appearance. Key benefits include:
- The only FDA approved laser treatment specifically indicated for melasma
- Shatters pigment without heat, reducing the risk of post-inflammatory hyperpigmentation
- Strong topical anaesthetic (23% lidocaine with 7% tetracaine) applied for up to one hour before treatment, making the procedure highly comfortable; most other clinics offer no numbing at all
- Intraocular eye shields for periorbital treatment, allowing safe laser application to the full skin around the eyes - unavailable at most clinics
- Clinically appropriate energy levels selected by a Consultant Dermatologist, producing more effective results per session than the low energy protocols standard at non medical clinics
- Suitable for a wide range of skin types including skin of colour, following careful clinical assessment
- Effective for sunspots, lentigines, post inflammatory hyperpigmentation, melasma, and uneven skin tone
- Stimulates collagen and elastin for improved texture, pore refinement, and acne scarring
- Minimal downtime - most patients return to normal activities the same day
- Delivered within a full dermatologist-led 360° pigmentation plan addressing cause as well as appearance
- Hormonal contributors to pigmentation, including HRT and hormonal contraception, assessed and addressed where relevant
- Supported by Dr Ophelia's bespoke
prescription pigmentation serums, formulated specifically for use around
treatment - Oral tranexamic acid and Heliocare Fernblock prescribed where appropriate to reduce pigmentation recurrence
- Underlying inflammatory conditions including eczema and acne assessed
and managed as part of the plan - Objective progress monitoring with VISIA skin analysis and medical photography at every visit
Conditions PicoSure PRO Can Treat
PicoSure PRO can be used as a standalone treatment or as part of a comprehensive dermatologist-led pigmentation plan for a range of skin concerns, including:
- Melasma
- Post inflammatory hyperpigmentation
- Hormonally driven pigmentation
- Sun damage and solar lentigines
- Sunspots and age spots
- Dark circles (melanin component)
- Periorbital pigmentation
- Uneven skin tone and dullness
- Acne scarring and skin texture
- Enlarged pores
- Fine lines and early photoageing
- Tattoo removal
- General skin rejuvenation
Your consultation with Dr Ophelia will determine whether PicoSure PRO is the right first-line treatment for your pigmentation, whether it is best used alongside or sequenced with other clinic modalities such as VI Peel, Clear + Brilliant, IPL, or Fraxel laser, and what an appropriate and realistic treatment plan looks like for your skin type and concern.
What to Expect – Step by Step Treatment Process
Your PicoSure PRO treatment begins with a full dermatologist led consultation and skin assessment. For pigmentation and skin of colour, this stage is not a formality and it is the foundation on which a safe and effective treatment plan is built.
1. Consultation and Clinical Assessment
Dr Ophelia will assess your skin type, pigmentation pattern, medical history, current skincare routine, sun exposure history, hormonal history, and any underlying skin conditions. For melasma and post inflammatory hyperpigmentation in particular, understanding the drivers including whether hormonal factors such as HRT or the contraceptive pill may be contributing - is essential before any laser is used. VISIA skin analysis and medical photography provide an objective baseline of pigmentation, UV damage, redness, pore size, and texture, and are repeated at every subsequent visit to track progress with precision.
2. Pre Treatment Preparation
You will be advised to minimise direct sun exposure and to pause certain active skincare ingredients including retinoids, exfoliating acids, and strong brightening agents for a period before your appointment. Patients beginning Dr Ophelia's bespoke prescription pigmentation programme will receive specific guidance on how to use the Hyperpigmentation Day Serum, Hyperpigmentation Night Serum, and Hyperpigmentation Eye Night Serum in conjunction with their laser treatment schedule. SPF 50 is essential in the weeks before treatment.
3. Skin Cleansing
The treatment area is thoroughly cleansed to remove SPF, make up, oil, and surface impurities before anaesthetic is applied.
4. Topical Anaesthetic
A high strength topical anaesthetic (23% lidocaine combined with 7% tetracaine) is applied to the treatment area and left in place for up to one hour. This is a pharmaceutical grade numbing preparation significantly stronger than anything available over the counter, and it makes PicoSure PRO treatment highly comfortable for the vast majority of patients. Most laser and aesthetic clinics do not use any anaesthetic prior to PicoSure PRO. At Dr Ophelia's clinic, patient comfort is considered a clinical standard, not an optional extra.
5. Eye Protection
For treatments not involving the periorbital area, you will wear certified laser safety goggles throughout the session. For patients being treated around the eyes and for dark circles, intraocular eye shields are placed directly on the eye under topical anaesthetic drops, providing complete protection of the globe and allowing safe, precise treatment of the full periorbital zone including areas that cannot be safely reached with external goggles alone.
6. PicoSure PRO Treatment
The laser handpiece is passed over the treatment area using settings selected for your skin type, concern, and clinical assessment. With the topical anaesthetic in place, most patients find the procedure highly comfortable. Treatment time varies depending on the area and indication.
7. Cooling and Immediate Aftercare
Following treatment, the skin is cooled and calming products applied to reduce any temporary redness or warmth. You will receive full written aftercare instructions including SPF guidance, advice on Dr Ophelia's bespoke prescription serums, and details of what to expect in the days following treatment.
8. Dermatologist Review and Ongoing Treatment Planning
At every visit, the treatment plan is reviewed in full assessing clinical and objective photographic response to laser, adjusting the prescription skincare programme as needed, reviewing oral treatment where applicable, and planning the next phase. Energy parameters are recalibrated based on how the skin has responded, ensuring that each session delivers optimal clinical effect. This ongoing medical oversight, supported by VISIA imaging and standardised medical photography at every visit, is what distinguishes a dermatologist led pigmentation programme from a standalone laser or aesthetic clinic.
Results and Downtime
Immediately Mild redness, warmth, and a sensation similar to mild sunburn are common immediately after treatment. Pigmented lesions may appear temporarily darker which is a normal and expected part of the treatment process, not a sign of worsening.
24–48 hours Redness and warmth typically settle during this period. The skin may feel slightly sensitive. Make up can usually be worn after 24 hours if the skin is comfortable. Dr Ophelia's prescription pigmentation serums can be reintroduced as advised.
3–7 days The skin may feel slightly dry or have a finely rough texture as cellular renewal takes place. Gentle skincare and SPF 50 are essential. Active ingredients including retinoids and exfoliating acids should be avoided until advised.
1–2 weeks Improved skin clarity, brightness, and evenness become visible as the skin settles. Darker pigmented lesions may flake or fade. Many patients notice that their skin looks fresher, cleaner, and more even toned.
Course of Treatments Sustained improvement in pigmentation, acne scarring, and skin quality develops over a course of 3 to 6 treatments spaced 4 to 6 weeks apart. Because treatment at Dr Ophelia's clinic is delivered at clinically appropriate energies by a medically trained team, meaningful results are typically achieved in fewer sessions than patients have experienced at non medical laser clinics.
Long-Term Results With appropriate treatment, consistent sun protection, and Dr Ophelia's prescription skincare programme, improvements in pigmentation can be long-lasting. Melasma, by its nature, can recur with UV exposure or hormonal changes, and maintenance treatment alongside ongoing prescription skincare including Heliocare Fernblock for internal photoprotection is often recommended.
There is no significant downtime. Most patients return to normal activities the same day.
Pricing and Number of Sessions
The number of PicoSure PRO sessions required depends on the concern being treated, the skin type, the extent of pigmentation or scarring, and the treatment area. A single session can produce visible improvement, but a course of treatments produces the most meaningful and sustained results.
A typical course for pigmentation, melasma, or acne scarring involves 3 to 6 sessions spaced 4 to 6 weeks apart. Because treatment is delivered at clinically appropriate energies with objective assessment at every visit, many patients find they require fewer total sessions than they have needed at other clinics. Tattoo removal or deeper pigmentation may require additional sessions.
Dr Ophelia's bespoke prescription pigmentation serums the Hyperpigmentation Day Serum, Hyperpigmentation Night Serum, and Hyperpigmentation Eye Night Serum are available as part of a full treatment programme and are formulated to complement and extend the results of PicoSure PRO treatment. Oral tranexamic acid and Heliocare Fernblock are prescribed separately where clinically appropriate.
Full pricing is provided at consultation following a clinical assessment, as the appropriate treatment plan varies significantly between patients. Dr Ophelia's team will provide a clear, personalised cost breakdown before any treatment proceeds.
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Frequently asked questions
You are at the centre of a consultation with Dr. Ophelia Veraitch. From openly discussing your skin and hair concerns to having the opportunity to ask any questions, she will also delve into what products you currently use or have used in the past. Dr. Veraitch will need to understand how your condition affects you and the impact that it is having on your life.
Following this, you will receive a thorough examination and Dr. Veraitch will review any photos that you bring along to support the diagnosis. Clinical photographs may also be taken in order to assess your response to treatment.
In most cases, a diagnosis can be offered at this stage of the consultation and written details of the condition and proposed treatment options will be provided. This will enable you to consider all options at home before making a final decision as to which course of treatment you prefer. Dr. Veraitch will also prepare a personalised care plan for you to take away at the end of your consultation.
In some cases, further investigations, such as blood tests or a skin biopsy, might be required before a final diagnosis can be made. If necessary, these will be arranged either following your appointment or on a separate visit.
Following your appointment, Dr. Veraitch and her team are happy to answer any questions you might have, to ensure that you understand and have confidence in your treatment plan.
Only treatments supported by solid evidence will be recommended.
Dr. Ophelia Veraitch is highly experienced in Medical Dermatology and is able to diagnose and treat all skin and hair conditions including:
– Acne
– Rosacea
– Eczema
– Psoriasis
– Skin cancers
– Pigmentary disorders, including melasma and vitiligo
– Alopecia (androgenetic, alopecia areata, lichen planopilaris/ frontal fibrosis alopecia)
Dr. Ophelia Veraitch will recommend the best course of treatment based on her assessment of each individual patient. Services include:
– PRP/ PRF hair restoration
– Steroid injections
– VIPEEL chemical peels
– Skin boosters
– Wrinkle injections
– Dermal fillers
– Ellanse collagen stimulation
– Aqualyx fat dissolving
– Lanluma cellulite and body sculpting
– Fractional resurfacing laser
– Intense pulse light, Vascular lasers
– ND:YAG laser hair removal
– Steroid injections
– Skin Surgery
To book an appointment, visit our booking page and complete the form. Alternatively, you can contact the medical PA to Dr Ophelia by phone: +44 (20) 7022 9888 (available Monday - Friday 9am-5pm) or email: pa@drophelia.com.
Dr Ophelia is available for appointments in clinic on Tuesdays, Fridays and some Saturdays.
The price for an initial consultation with Dr. Ophelia Veraitch is £375 for a 30 minute standard medical dermatology consultation (e.g. acne, eczema, rosacea, pigmentation, mole checks, cosmetic concerns etc.). Hair patients can require more time, and therefore we book new hair patient consultations in for 45 minutes at a cost of £400. Follow up consultations are £225. Recommended treatments will be costed up and shared with the patient accordingly.
For More Information
Book a consultation with Dr. Ophelia, who will diagnose your condition and offer treatment options going forward, Click the link below to start the process.