PIGMENTED
LESION REMOVAL
BEFORE
AFTER
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Introduction:
A wide variety of conditions fall within the category of pigmented
lesions, from cafe au-lait marks that are often visible at
birth to liver or sun spots that appear with age as a result
of exposure to the sun.
Pigmented lesions are effectively the result of excess melanin
in the skin and for those that bear the light to mid-brown
marks, whatever size they may be, effective laser removal
has a dramatic effect on their self-confidence.
Theory:
Cells beneath the skin produce melanin naturally and in response
to factors such as prolonged exposure to sun resulting in
"tanned" skin. A pigmented lesion is caused when
the cells produce too much melanin in a localised region.
Like laser tattoo removal, the removal of a pigmented lesion
is based on the theory of selective photothermolysis. The
light emitted targets the particles of excess melanin heating
them rapidly until they fragment into smaller particles that
can then be removed by the body?s natural processes.
Basic treatment procedure:
The treatment is not painless but the skin can be anaesthetised
or cooled to minimise potential patient discomfort. Inflammation
and blanching of the area are the most common treatment end-points.
The skin should be cooled immediately after treatment and
a moisturising cream applied regularly as part of the prescribed
aftercare. The number of
PIGMENTED LESION REMOVAL FACT SHEET
Questions and Answers about Pigmentation Treatments
How does the system work?
The system consists of intense light that is emitted in a
series of short pulses. The wavelength of the light is specially
selected so that when it is directed into the skin, it is
predominantly absorbed by melanin contained within freckles
or lentigines (sometimes called sun spots or liver spots).
These pigmented lesions will absorb the light, which causes
them to heat up. The heat created damages the lesion while
causing minimal damage to the surrounding skin. Following
treatment, the damaged lesions turn darker and may crust.
Over the following weeks they will gradually flake away from
the skin leaving little trace of the original mark.
How is the treatment carried out?
It is necessary to apply a thin layer of gel to the skin
prior to treatment. This helps to cool the skin, as well as
ensuring optimal transmission of light from the applicator
to the skin.
A test patch should always be taken; the rectangular quartz
applicator is placed in contact with the skin surface over
the offending lesion. The light is pulsed through the quartz
and onto the skin. If the results of the test patch are satisfactory,
the applicator is then moved to the neighbouring area and
the process is repeated. During treatment you must wear protective
eye goggles.
Which patients can be treated?
Almost everyone can be treated, apart from very dark skinned
or tanned individuals. However, not all pigmented lesions
can be treated. Large, dark moles should not be treated, nor
should lesions covering a large part of the body. The pigmented
marks that respond the best are superficial lesions such as
those caused by sun damage (sun spots) and freckles.
Does it hurt?
As the light energy is absorbed by the skin, it heats it
up, and creates a sharp pinprick, burning sensation. Most
patients describe the discomfort as moderate and acceptable.
No anaesthesia is required.
What should I expect after the treatment?
Redness and a slight burning sensation are normal after treatment.
A cooling pack will be applied to the skin to ease these symptoms.
The lesions will darken after treatment and may appear more
obvious at first, but gradually the marks will 'flake' away.
It should be noted that continued sun exposure may result
in recurrence of the original mark and sunscreen should be
used to prevent this happening.
What are the side effects?
The visible light is completely safe so no special precautions
are needed apart from glasses for the brightness. The skin
of some patients becomes quite red immediately after treatment.
However, most patients experience no side effects and the
redness usually disappears within hours to a few days. Very
rarely hyperpigmentation, hypopigmentation or blistering may
occur.
How do I prepare for treatment?
Patients should avoid tanning and must not use any fake tan
6 weeks ahead of and during the entire treatment period to
avoid excessive discomfort from light absorption in the epidermis.
Immediately after the treatment, the skin is particularly
sensitive to UV light, and strong sunlight should be avoided
for 2-3 weeks.
How long does treatment take?
The length of each treatment will depend on the type and
size of lesion present, but a typical session will take in
the region of 15 to 30 minutes.
How many treatments are necessary?
The length and number of treatments will depend on the type
and size of pigmented mark present, but typically 1-5 treatments
will be needed. Treatments should take place approximately
every 4 to 6 weeks.
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