I do you 755 as well for pigmented lesions
if you had Beckers Naevus (Birthmark) that was biopsied and determine safe to be
removed I would use it there
I might use in a cafe lait birthmark I might use it for Just for some pigmented
areas of PIH even would be applicable
where it would be a use of it
So before we get started
make sure that the skin is clean I usually have
my patients cleanse their face first and wash their whole face with
a mild soap and then I also wipe off the skin have any
residual oils and residue with an alcohol wipe
and then be sure that the skin is totally dry before we start the laser
treatment
For pigment
I typically recommend using a pretty low pulse with because pigment is very
superficial
and then because Deri in here is
roughly a fitzpatrick type two skin-type
I'm going to use an energy level or fluence
that is towards the higher end of the recommended settings in the manual
because she's pretty fair skinned
and fair-skinned people can actually tolerate the laser
more so then skin of color
and so I can use a bit of a higher
setting for the fluence or for the energy. So we're gonna get started
And I'm gonna have you put on these safety goggles.
I'm gonna start on your left cheek so turn to your right just a little bit
I'm gonna adjust the goggle just a little bit over here.
Here we go
So what I'm doing is actually treating the entire surface area of
the face you can spot treat brown spots
or hyperpigmentation but I have found
in my experience that it just works better to treat the entire face
and then you actually end up getting areas where he didn't even know pigment
was there
to come out.
Now if you can turn to right a little bit. So the clinical endpoint that
you want to look for when treating brown spots is a slight darkening of the brown
spots that may or may not be seen for a few minutes
after the treatment but that's the end point that we're looking for and that shows
that it's actually working.
So Darien how does your skin feel right now? It feels
warm, a little hot, like a sun burn. okay okay
for a long time well that's normal saw your face is gonna feel like a mild
sunburn
for probably up to a couple hours or a few hours two to three hours lets say and then it
should go away and that's totally normal
if it's uncomfortable you can certainly take some Tylenol
or some ibuprofen and for the discomfort
and the brown spots have gotten darker
which is also normal and they may continue to get a little bit darker
until this evening and that's normal they actually get worse before they get
better
and then you can see a bit of a coffee ground appearance
like little dark spots and that's normal as well and over about the next week or
so
those dark spots just slough off. You can use your regular skin care regimen so
you can use
your normal face wash your normal face lotions and moisturizers
and definitely I recommends an SPF daily moisturizer on your face for sun
protection.
All right you have any questions? No I think you covered all of them.
Ok Great!