Company insight
Laser treatment of freckles and melasma
Treating common benign pigmented lesions like freckles and sunspots can be difficult, but even more complex and difficult conditions like melasma can be effectively treated with a high- performance Q-switched laser system such as Fotona’s StarWalker MaQX.
I
t is widely recognised in the medical community that Q-switched lasers are the ideal tools for removing benign pigmented lesions. Multi-wavelength, Q-switched laser systems with frequency-doubled KTP are uniquely able to produce very short pulses of intense light that are selectively absorbed by treatment-specific pigments in a lesion. As you will see from the following examples, two or more wavelengths are often better than one. Superficial lesions can usually be treated most effectively with the 532nm wavelength, while the 1,064nm wavelength can be used to target deeper lesions and is also safer for darker skin.
A highly effective three-step, dual- wavelength freckle treatment Freckles are a purely aesthetic condition with a very high treatment demand. They are light to dark brown macules that affect photo-exposed skin; they may also form part of a syndrome or specific clinical picture that requires a specialised evaluation before treatment. They usually start at about 2mm or less, but in time can increase in quantity, size and even colour intensity. Traditional treatments such as chemical peels, intense pulsed light and various laser sources have shown only limited effectiveness. Very impressive results have been obtained using a new dual-wavelength treatment modality developed by Drs Sebastián and
Julio Cesar Velez
Ocampo from Colombia. The treatment is based on a unique three-step protocol using two synergistic laser wavelengths and two different pulse
durations available in the Fotona StarWalker Q-switched laser. The following case was treated in three
Before and after the three-step, dual-wavelength freckle treatment.
sessions, performed once every three weeks. The end result pictures were taken ten months after the final treatment. Before and after treatment, patients must protect their skin with adequate photo-protection.
A new protocol for long-term results in treating melasma
For melasma, a complex condition that has proven to be exceptionally challenging to treat, Drs Velez Ocampo have developed a multifactorial approach that has proven to be effective at not only treating the symptoms but also addressing the underlying vascular cause of melasma.
This protocol offers a new therapeutic modality in melasma in all patients and it is especially safe for patients with phototype III and IV. The first step applies Q-switched Nd:YAG with MaQX1 mode, which delivers a subcellular
Before and after 12 months with six treatment sessions for melasma. 54
photoacoustic effect oriented to the destruction of melanosomes and fragmentation of dermal melanin. The applied fluence depends on the degree of pigmentation and the patient’s phototype; the higher the pigmentation, the lower the fluence. The
second step uses short, low-fluence FRAC3 pulses to reduce the production of cytokines and control inflammation as well as vascular endothelial growth factors (VEGF). The third step requires the use of a fractional Q-switched handpiece for stimulating the exchange of keratinocytes and initiating non-thermal rejuvenation of the tissue. An additional fourth step is applied when vascular lesions are visible.
The before and after pictures show a typical case with nine months follow up on a patient that received six sessions of laser treatment with no hydroquinone or tranexamic acid. Post-op care requires cooling and epithelising cream immediately after the treatment. Erythema should be expected to last between two and five days, and patients should avoid sun exposure and use sunscreen starting the day after treatment. The StarWalker MaQX from Fotona with its high-energy, single-pulse Q-switched technology allows larger spot sizes to remain effective by avoiding the scattering effect of laser light inside the skin tissue. With high-energy single pulses, more and deeper-lying pigments can be targeted and removed. Combined with its multi- modal, multi-wavelength characteristics, StarWalker is an ideal solution for treating pigmentation disorders. ●
www.fotona.com Practical Patient Care /
www.practical-patient-care.com
© Drs Velez
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