Even though some may suggest the treatment interval to be 2 to 3 times per month or even 1 to 2 sessions per week, 1-month intervals for recovery after laser treatment are safe to prevent hyper or hypopigmentation.
The complications
Although it was thought to be very safe initially, the repeated whole face laser treatments with multiple passes may cause some serious complications. Through the years, it was found that if patients received more than five sessions of the treatment or were treated with very short intervals, it would increase the incidence of complications, like depigmented white spots on the skin, or poikiloderma-like uneven pigmentation.
This situation was especially found in patients with melasma. It was speculated that repeated laser treatments after short periods of recovery time, such as 1-week intervals, may reduce or exhaust hyperactive melanocytes, and increase the risk of spotty hypopigmentation difficult to recover.
The 1-month treatment interval was optimal for skin recovery. Therefore, for patients with liver spots, it is still in debate whether laser toning is a good treatment option. In fact, most dermatologists in Taiwan tend to be conservative now. The safest treatment interval should also be 1 month or even longer to avoid this complication.
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If the complication does occur, the best way is to stop further laser treatment or to reduce energy of this procedure. Some dermatologists in Taiwan proposed using the topical hydroquinone bleaching agent or oral tranexamic acid (transamin) to correct this poikiloderma-like complication. However, the patient must be very patient, because this treatment usually takes more than one to two years continuously before significant improvement is noted.
Other complications, like worsening of acne or contact dermatitis to laser beams, can be seen occasionally. If these complications occur, treatment should be suspended.
-To be continued
