Treatment of pigmented lesions depends on the principle of selective photothermolysis; the proper wavelength is applied, and the light energy is absorbed by the chromophore and converted to heat which breaks up pigment. Surrounding tissue remains undamaged. In many cases numerous sessions are required to maximize results.

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To successfully treat pigmented lesions one must carefully apply energy to break up pigment or blood but spare surrounding tissue. This can be more or less difficult depending on each patient’s individual characteristics such as skin color. Practitioners can account for these characteristics by adjusting treatment parameters such as fluence, pulse width, and repetition rate to maximize delivery of energy (for better results) and minimize patient discomfort. Many devices are limited in their utility because the different parameters cannot be adjusted independently (if at all). Understandably, treatment of darker skin is more challenging due to the higher concentration of melanin in the skin as a competing chromophore; in those cases treatment may be too painful or cause burning.