▶ Previous Artlcle: Combination Treatment with Long-pulsed 755‧1064 Laser and Pico 1064‧532 Laser Ⅴ

 

Melasma requiring multi-faceted approach

Melasma is difficult to treat by using single method. That is because of its conditions: It looks black, but dermis is aging, and the basement membrane is broken, and blood vessels are increased, and mast cells are also increased. After all, dermis needs to be treated. Sunblock or moisturizing is also considered important to strengthen epidermal barrier function. It is necessary to peel off the melasma with the IPL or to stabilize the keratinocytes by applying the growth factor.

 

Personally, I perform the treatment of dermis by using the 1064nm Picosecond Laser MLA handpiece with 1064nm Long-pulsed Laser. These days, I try to lighten the skin tone even more quickly at the epidermis level, using the 755nm Picosecond Laser that has been made available newly. For the Picosecond Laser toning, I set the protocol to 7mm spot, 0.9~1.6J, 1,000~2,000shots. For the Long-pulsed Laser, I set the protocol to 10mm spot, 0.3ms, 7J 3,000shots. When the 1064nm MLA handpiece is used, I set the protocol to 10mm spot, 0.2~0.3J, 1,000shots. For the 532nm MLA handpiece, I set the protocol to 10mm, 0.1J, 500~800shots. Here, 755nm Picosecond Laser is sometimes used together.

 

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After using the MLA handpiece, growth factors or PDRN should be used to prevent side effects. That is because the erythema may occur immediately after the use of MLA handpiece. If Picosecond Laser toning and MLA handpiece are put in simple comparison, far better clinical effect can be expected from the MLA handpiece.

 

You may have your own reference points. Genesis is performed if you think about targeting the dermis intensively. Otherwise, if the epidermal pigment is considered mainly as freckle, you can stack it by raising the energy to 1.6J with 1064nm Picosecond Laser toning 7mm. In conventional Q-switched Nd:YAG Laser toning, hypopigmentation was frequent with heat. However, I have not experienced any hypopigmentation to date while using the Picosecond Laser over the last 3 years. I think that it is safe because the energy less than the half is used. You can stack only one area and then raise the energy as much as possible if a reaction is found. If you think that there is no reaction, you should move on to the dermis.

 

 

Summarized by Reporter Oh Je-Hyun