(light instrumental music)
- In this video I'm going to be talking about
pigmentation laser treatment.
This video will include information
on the treatment of sunspots, freckles, and birth marks.
So, how does laser treat pigmentation?
Pigmentation is due to a concentration of melanin
or skin pigment in a particular area of the skin.
Now, this can be caused from a number of reasons,
the most common in Australia is the sun,
however, pigmentation can also be congenital,
such as a birth mark...
or hormonal, such as in melasma.
The lasers which we use to treat these problems
include the Ruby laser, the RevLite or MedLite laser,
and the Gemini laser, and these lasers basically
are attracted to pigment in the skin.
Now, areas which have more pigment in the skin,
for example a sunspot or a freckle,
will pick up this laser energy at a greater level
than that of normal skin which is usually
fairer than the freckle.
In the ideal situation, you have pigmentation
which is very dark that you wanna treat,
and the skin is very fair.
However, you don't always have the ideal situation,
and sometimes pigmentation occurs on olive
or darker skin types, and in these situations
we have alternate strategies which I'll discuss.
In essence, these lasers are specifically targeted
to the pigmentation problem,
and leave normal skin relatively intact, or alone.
The difference between laser treatment for pigmentation,
and say a treatment like liquid nitrogen for pigmentation,
is that laser treatment is very specific.
Liquid nitrogen basically goes in and destroys
any tissue right in front of it,
laser only picks up the pigmentation from the skin,
and it doesn't pick up normal skin which is paler.
So what should you expect for your first consultation?
The doctor will take you through your medical history,
and see if there's any reasons
why you can't have the treatment at this time,
for example if you're on a particular medication
like Roaccutane which precludes you
from having laser treatment.
Your doctor will also perform a examination,
and this may involve looking at your skin
under a Wood's lamp, which is a purple colored light,
or black colored light, like you see at nightclubs,
and this can determine the depth of the pigmentation,
or the type of pigmentation it is.
You also have an assessment of your skin type,
now this may involve asking you some questions
as to how easily you tan,
or what's your natural hair color,
and what's your natural eye color.
The darker your skin, the more difficult it is
to treat your pigmentation with laser,
and there will be a point where the pigmentation
in your normal skin is too dark
to actually have laser treatment.
In other words, the laser won't be able to differentiate
between your freckle or sunspot, and your normal skin.
So what should you expect during your treatment?
If you're a fair skin person with sunspots for example,
it may be a simple matter of just going ahead
with the laser treatment, and not requiring
any particular skin preparation.
For those who olive skins or darker skins,
and in particular Asian skins,
you may require a degree of preparation before
undergoing laser treatment.
This is to help reduce the rate of complication
or problems, as darker skins or olive skins
will tend to pick up the laser energy
more readily than fairer skins.
Often your doctor in these situations
will advise that you go on a lightening serum
like Kligman's lotion for a period of one to two months
prior to your laser treatment.
Also, for olive or darker skin types,
a test patch may be indicated to see what the effect
of the laser is prior to treating the whole area.
A reduction in the laser settings may also be required
in those with olive or darker skin types,
and post treatment care may involve the application of
a topical steroid to help reduce
inflammation after treatment,
and this will help reduce the chance
of postinflammatory hyperpigmentation,
which is darkening of the skin after laser treatment.
The laser treatment in this case
can be a little bit uncomfortable,
it often feels like a hot prickly sensation.
The face can be treated in its entirety,
as in, you treat every part of the face,
and you might do this in someone with widespread freckles,
or you can treat spots, for example,
in those who have just a couple of sunspots here or there.
Numbing cream can also be applied prior to treatment,
especially if you're having a large area treated,
and this will help reduce any discomfort
associated with the procedure.
Cooling is also a very important part of the procedure,
and by this I mean cooling the top layers of the skin
with either a Zimmer cooler,
which is a machine which blows cold air
across the top of the skin,
or through in built cooling in the hand piece.
But it helps to reduce any discomfort,
as well as reduces the side effects from treatment.
After treatment there's usually a degree
of redness to the treated areas,
as well as a degree of swelling, which will be proportionate
to the intensity of the treatment.
Depending on the laser used,
the pigmentation may appear immediately whitened,
and usually this lasts for 20 minutes,
and after that the pigmentation appears darker
and remains this way for the next week until it scabs off.
Other than feeling a little bit sun-burnt
in the area treated, there's no real pain
or discomfort after the treatment.
Over the next week, you expect all the spots to darken
and scab up, and then fall off after about 7 to 10 days.
During this time it's important to look after your skin,
and it's important to put some cream on it
like Bepanthen cream, which is actually nappy rash cream,
or some other rich moisturizer.
It's important to stay out of the sun,
and wear sun screen as well for at least two weeks.
As for all laser treatments,
there are a risk and benefit to each treatment,
we'll be able to help you assess your potential risk
for any complications prior to having your procedure.
Firstly, it's possible to get a patchy result
if the laser hasn't covered all the areas to be treated,
and in these cases we need to actually re-treat
and go over the area once again
to help even out the treatment.
Hypopigmentation or loss of pigment
to the point where an area of skin becomes lighter
than the normal surrounding skin,
is a possible complication of laser treatment,
in most cases this returns after about a month,
but can also take about a year to return.
In severe cases this may be a permanent problem.
Hyperpigmentation or increased pigmentation
in the treatment area is also another complication,
this is a very annoying complication
which can last for six to 12 months,
and requires the use of lightening serums
to help reduce its presence.
It often occurs in olive or darker skin types,
so we have to take particular care
in the treatment of these patients.
Scarring is an extremely rare complication,
and something we never see at this clinic
with pigmentation treatments.
Finally, infection with either a bacteria
or the cold sore virus, herpes simplex,
is another possibility after laser treatment.
Again, this is very unusual,
and if this occurs we usually treat it as soon as possible,
and there's no consequence on the skin.
So in summary, pigmentation can be treated effectively
with laser, and this can help to improve your skin tone,
it can help reduce your need to wear makeup,
and brighten the skin up.
(light instrumental music)