Pigmented lesions: an annoying blemish

Pigmented lesions, and in particular age spots, are increasingly regarded by the persons affected as a cosmetic blemish. Age spots occur in 50% of women and 20% of men over the age of 50. As such signs of aging are increasingly being seen as annoying, the readiness to have these removed privately is also growing.
There are many different types of pigmented lesions, which differ from one another fundamentally in terms of their morphological and histological characteristics. For this reason, the evaluation of and possible therapy for pigmented lesions should always be reserved to doctors with specialist knowledge.
Benign pigmented lesions such as lentigo simplex, lentigo senilis (age and sun spots) and many other types of naevi may be treated with laser devices in various ways. Pico and Nano lasers emit short light pulses, which, thanks to their specific wavelength, are selectively absorbed by the skin pigment melanin. The laser treatment itself is uncomplicated and is conducted on an out-patient basis, with or without a local anesthetic.

Choosing the right wavelength: a decisive factor for the success of the treatment

The type of laser is a decisive factor when determining which color pigments may be treated particularly well and which colors do not respond as well to treatment.  Ruby lasers, which work in the near-infrared range, have proved themselves to be almost universally deployable in practice. As a result of the strong absorption of the ruby laser beam by the skin pigment melanin, these devices are particularly well-suited for the treatment of natural pigmented lesions. Patients generally tolerate the treatment without an anesthetic; a local anesthetic is only used in rare cases.
The wavelength of the Ruby or Nd:YAG laser light is specifically absorbed by the color pigments of the lesion. The energy is transferred and then fragments the colored particles from the connective tissue. The fragmented particles are then degraded epidermally and lymphatically. The irradiated area of skin appears whitish for between ten and twenty minutes immediately after treatment. A slight crust then forms, which will slough off after between one and two weeks.
Pigmented lesions may also be treated using ablative lasers. In this respect, it is necessary to differentiate between “cold ablation”, with the MCL31 Dermablate Erbium:YAG laser for instance, and vaporization with the QuadroStarPRO YELLOW.

What kind of pigmented lesions can be treated?

The Pico and Nano lasers from Asclepion can effectively and safely remove a large variety of pigmented lesions:
• Lentigines
• Ephelides
• Naevus of Ota/Ito
• Tattoo

How does the removal of pigments with lasers work?

The laser beam penetrates through the upper layer of the skin and is absorbed by the color of the pigments. As the high-energy laser pulses of these devices last only a few nanoseconds, they are absorbed by the pigment particles selectively without causing any coincident thermal damage to the surrounding tissue. The ink particles are fragmented by the laser irradiation and the broken-down ink are removed by the body’s own lymph system.

What is the course of treatment?

The distance holder of the laser handpiece is placed onto the skin. After the laser is activated via the foot switch, a light impulse is sent, which results in a gentle prickling sensation. The areas to be treated are then moved over with the handpiece of the laser. Immediately following the treatment, the treated area presents the so-called “popcorn effect”, appearing white and displaying blisters. Following the treatment, a redness of the skin, strong sensations of warmth or wheals may occur. After a few hours, the treated areas might darken and a small crust may form. This disappears within a few days. The next treatment, if necessary, can be carried out after six to eight weeks.

What needs to be considered following treatment?

Cool the treated skin for as long as it is comfortable for you. If crusts form, leave them alone. Protect treated areas from sunlight or intensive light (tanning salons) for at least six weeks – use suntan cream (SPF 20-50) if you stay outside longer. If skin changes occur that are not named above, contact your doctor immediately.

What complications may occur?

No medical treatment is completely risk-free. Normally, laser-treatment is very low-risk. Lightening of the skin or hyper-pigmentation may temporarily occur. In any case, all these effects are reversible and will disappear within a few weeks.

Asclepion Laser Technologies is working closely with physicians, clinics and universities to improve technologies to assess their effectiveness and safety as well as to improve its application. In clinical studies, scientific questions are answered in a controlled environment. This ensures the best possible results for both the users and patients.

Picosecond 532 nm Neodymium-Doped Yttrium Aluminium Garnet Laser for the Treatment of Solar Lentigines in Darker Skin Types: Safety and Efficacy.
Guss L, Goldman MP, Wu DC. Dermatol Surg. 2017 Mar;43(3):456-459. doi: 10.1097/DSS.0000000000000922.

 

Clinicopathologic efficacy of copper bromide plus/yellow laser (578 nm with 511 nm) for treatment of melasma in Asian patients.
Lee HI, Lim YY, Kim BJ, Kim MN, Min HJ, Hwang JH, Song KY. Dermatol Surg. 2010 Jun;36(6):885-93. doi: 10.1111/j.1524-4725.2010.01564.x. Epub 2010 May 7.

 

Split treatment of photodamaged skin with KTP 532 nm laser with 10 mm handpiece versus IPL: a cheek-to-cheek comparison.
Butler EG 2nd1, McClellan SD, Ross EV. Lasers Surg Med. 2006 Feb;38(2):124-8.

 

Treatment of lentigines with a diode laser at 808 nm
S McCoy; Laser, Skin & Vein Clinic, North Adelaide, South Australia

 

Non-ablative skin remodeling: an 8-month clinical and 3D in vivo profilometric study with an 810 nm diode laser.
Levy JL, Trelles M, Servant JJ, Agopian L. J Cosmet Laser Ther 2004;6:11-15

Professional therapy

With its extensive range of services, Asclepion sees itself as a competent partner for dermatologically and aesthetically oriented practices, institutes and clinics. Decide now for the treatment with the most advanced laser technology and discover a new world of professionalism and quality.

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