Pigmented Lesions

 

What is Photo Rejuvenation?

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Photo rejuvenation involves the treatment of surface skin irregularities such a fine lines, enlarged pores and benign pigmented and vascular lesions by using a light based system such as a laser.  At Territory Laser Clinic we use the Candela GentleMax Pro medical grade laser.  We were the first clinic in the Northern Territory to own and operate Candela medical grade lasers and Dermal Therapists Holly Copping is a Syneron Candela Laser Certified Practitioners.



Treating pigmented lesions

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Laser is indicated for the treatment of the following benign lesions:

• Freckles

• Solar Lentigines (Age Spots)

• Mottled Hyperpigmentation

• Seborrheic Keratosis

• Melasma (Chloasma)

• Common Pigmented Birthmarks

 

How does laser treat pigmentation?

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Through the process of selective photothermolysis of melanosomes.  The melanin within the pigmented lesion absorbs the light energy. Heat then destroys the melanin containing keratinocytes and potentially the melanosomes within the melanocytes itself.

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After laser (1 minute to 48 hours later), the melanin undergoes a chemical change and turns darker (referred to as micro-crusting).  The cells that contain this darker melanin travel towards the stratum corneum (outermost layer of the epidermis) and then slough off.  This takes about 5-7 days on the face and 14-21 days on other areas.  



When treating pigmented lesions you need a contrast in colour between the lesion and the surrounding skin.  With lighter skins, there is more contrast between the skin and the lesion so a higher fluence (energy) can usually be used and better results can be achieved.  With darker skin types there is less contrast between the skin and the lesion so lower fluences must be used and modest results are generally achieved over a greater number of sessions.



How many sessions will I need?



The number of sessions a patient needs to obtain optimal results will depend on:

1. Skin type

2. Depth of pigmentation

3. Fluence (energy)

 

On average, most patients need at least 3 treatments.



How often do I have to have treatments?

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Due to quicker healing time on the face, laser photo rejuvenation should be performed at 4 week intervals and 6 week intervals on the body. However if residual micro-crusting is present, the treatment should be delayed until it is totally resolved.



How do I maintain the results?



Unfortunately pigmentation can return if the patient does not practice sun protection and wear an SPF 50+ daily.  A melanin inhibiting cosmeceutical will also help to maintain results such as Aspect's Pigment Punch.  Despite that the patient has been doing all things instructed, it is still possible for the skin to re-pigment.  In this case maintenance sessions may be required.

 

Click here to see before and after photos.

  

​Collagenesis (new collagen growth) using laser​​

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Collagenesis is a favourable side effect of laser.  New collagen growth post laser involves a complex process of chemical changes, though to simplify, thermal injury results in an increase of fibroblast activity and angiogenesis.  The textural changes noticed may include a reduction in pore size, fine lines and skin roughness, as well as skin tightening and reduced flushing.  For collagenesis to become apparent, at least 2 sessions are required.  



What is the treatment process?

 

As with all dermal therapies, the consultation is essential to provide a desirable outcome for both patient and therapist.  During a consultation the therapist should assess skin type and skin condition being treated, and refer to doctor if further assessment is required. It is also important to discuss contraindications, discuss how treatment works, estimate the number of treatment sessions, discuss side effects of treatment and potential complications, advise the costs, a consent form must be signed and then any test patches can be performed.  



During a consultation, the therapist will also ask a number of questions to determine a candidates suitability for treatment.  It is important to postpone a treatment when a candidate presents with recent unprotected sun exposure, tanned skin, fake tan, known photosensitising reaction, and open lesions and cuts. Other factors affecting treatment outcome will need to be taken into consideration.  These include post treatment sun exposure, medications such as the oral contraceptive pill, topical steroid use, and hormonal changes such as pregnancy. Lastly, the therapist needs to inform the patient how to look after their skin post treatment.