Laser against pigmentation

Why do pigment spots appear

Dermatologists began to actively use the laser against pigmentation relatively recently, but this method almost immediately proved itself on the positive side due to excellent results. Particularly acute is the problem of excessive pigmentation on the face, and therefore this is where laser technologies are so important, because able to combine high efficacy and painlessness. Brown spots appear due to the excess pigment melanin, which is reproduced by special cells of the dermis – melanocytes. As a rule, dermatologists subdivide pigment spots into two types: primary (age-related formations, moles, freckles, etc.) and secondary (post-infectious and post-inflammatory). Violation of the production of melanin depends on many factors, which include hormonal imbalance, genetic predisposition, lack of vitamins, etc.

What types of pigment spots can be removed with a laser

When removing pigment spots by laser, especially on the face, you should first determine the type of pigmentation and make the correct diagnosis. The following types of benign pigmented lesions respond most effectively to laser treatment: lentiginosis, freckles, Oto and Ito nevi, coffee-colored milk stains (PCM). The use of laser exposure to other types of pigmentation – melasma, non-cellular nevus, malignant lentigo, etc. it is recommended only to experienced doctors because of the significant variability in the response of the skin to laser exposure.

The principle of laser action against pigmentation. The types of lasers used to remove pigment spots

When removing pigment spots using laser radiation, the main chromophore is accumulations of melanin pigments. In this case, in contrast to the laser hair removal procedure, where the chromophore is also melanin, in laser treatment of pigmentation, laser radiation focuses on the particles of melanin contained in melanocytes, keratinocytes or skin macrophages. The size of the individual melanin particles to which the laser radiation is directed, in this case, is very small, therefore, the duration of the laser pulses should also be very short and for safe and effective pigmentation removal should not exceed 8-10ns.

Thus, analyzing the concept of the thermal relaxation time of a target under laser irradiation, it can be concluded that Q-switched lasers are most suitable. In addition to temporal characteristics, the wavelength of the laser module radiation is also of great importance. Given the absorption spectrum of melanin and the depth of penetration of laser radiation into the skin, ruby ​​Q-switched lasers are most suitable for laser removal of pigmentation. A number of dermatologists indicate that good results are also achieved with a KTP neodymium laser with Q-switch, but only for fair skin and pigmentation with a small depth of bedding (PCCM), otherwise the risk of micro-scars increases significantly.

The technique of removing pigment spots of lasers and the main contraindications for the procedure

When laser treatment of pigmentation, it is very important to observe a certain sequence of actions that must be maintained with the correct removal of pigment spots:

1. Anesthesia. Most patients tolerate short-term discomfort during laser removal of pigmentation, which can be compared with sharp, burning tingling sensations. For particularly sensitive areas of the skin, especially when removing pigmentation on the face, you should use cold air blowing or apply anesthetic creams for 40-50 min before the procedure.
2. Eye protection.Because Q-switched lasers are used to remove pigment spots, then
   eye protection, especially when removing age spots on the face, is especially relevant. LasMedTech experts recommend the use of safety glasses with a degree of protection of at least OD6 + for the wavelength at which the laser module generate during the procedure.
3. Determination of treatment parameters using test spots. At the beginning of the procedure, it is recommended that even experienced doctors begin treatment with low energy densities (J / cm2), while it is recommended that the first test laser flashes be performed on less visible areas of the skin. The correct skin reaction during laser removal of pigmentation is considered to be whitening of the skin in the treatment area.
4. Correct handpiece placement during the procedure. The attending physician must keep the handpiece at the correct distance from the skin (usually determined by the limiter of the laser module) and strictly perpendicular. Direction of laser radiation to the skin at an angle leads to additional scattering and a decrease in absorption efficiency, and incorrect remote positioning of the laser nozzle from the skin can lead to a change in the density of energy delivered to the skin, which significantly reduces the effectiveness of laser pigmentation treatment.
5. Postoperative period. Immediately after the procedure, a non-drying gauze dressing should be applied to the treatment area. This area should be moist to prevent crusting. Complete healing of the treatment area occurs within 8-12 days.
6. Additional treatment sessions. Additional treatment sessions are recommended after 5-7 weeks, depending on the skin phototype. With a second treatment of pigmentation, you can slightly increase the energy density to completely remove pigmentation.

It should be remembered that only full compliance with these actions and the use of professional medical laser equipment guarantees safe and effective removal of pigmentation and the avoidance of scars and burns.