Laser Toning for Pigmentation

What's Unique About Laser Toning at Our Clinic?

• 1. We aim to deliver sufficient energy with over 2000 shots. Instead of quick treatments using low power and fewer shots, our clinic pursues a method of delicately applying over 2000 shots of energy to enhance effectiveness and reduce skin irritation.
• 2. The medical team individually adjusts the intensity according to the depth and type of pigmentation. This is because each type of pigmentation, such as melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and blemishes, has different depths and characteristics. Therefore, we approach melasma with a gentle method, ABNOM with more concentrated energy, and for complex cases, we apply intensity and treatment settings appropriate for the characteristics of each area.
• 3. During the treatment, we check and adjust your condition in real-time with you using a mirror. Instead of simply applying the laser and finishing, our medical team directly observes your skin's reaction during the procedure and, if necessary, changes the laser spot size, energy intensity, and even the handpiece. This is to ensure effective management through carefully planned, personalized treatments.
• 4. We use a Mark-Vu diagnostic device to precisely identify the location and depth of pigmentation. Instead of relying on guesswork, the Mark-Vu diagnostic device meticulously analyzes the type of pigmentation, its distribution within the skin, and its depth. These diagnostic results serve as important criteria for establishing a suitable treatment plan for each individual.
• 5. For complex pigmentation issues, we apply a multi-layered approach. For example, if melasma and ABNOM are present together, treating only one type of pigmentation aggressively could worsen the other. Our clinic uses a strategy that first focuses on stabilizing and calming the melasma, and then proceeds with more intensive management for ABNOM located in the dermal layer.

What are the characteristics of Laser Toning at Our Clinic?

Laser toning is a commonly used method for managing various pigmentary disorders. However, the treatment results can vary significantly depending on which equipment is used, how many shots are applied, and at what energy intensity.

Various types of pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) differ in their depth within the skin and their reaction patterns with surrounding tissues. For this reason, a delicate treatment plan that considers individual characteristics is crucial.

1. We provide sufficient energy with a minimum of 2,000 shots.

According to many research findings, stable and effective management is possible with low-fluence laser toning when applying between 1500 and 2500 shots.

Our clinic fundamentally provides sufficient energy with over 2,000 shots, and we develop treatment plans to achieve satisfactory improvement while minimizing unnecessary skin irritation.

Skin changes are not achieved by mere mechanical manipulation.

It is crucial to meticulously adjust the number of shots, laser output, irradiation speed, and spot size, taking into account the depth of pigmentation, distribution range, and individual skin sensitivity.

2. Medical team's customized toning adjustment according to the type of condition

1) Melasma Management

Melasma is one of the common pigmentary skin conditions that primarily appears on both sides of the face.

Since melanocytes, which produce melanin pigment, are excessively activated, strong stimulation can potentially worsen melasma.

Our clinic utilizes the Mark-Vu precise skin diagnostic device to clearly identify the distribution and depth of melasma. Based on this, we carefully begin treatment with a toning laser that uses short pulses of 5 nanoseconds (ns).

Our clinic's toning method focuses on reducing the risk of skin side effects by selectively destroying only the melanosomes within, without stimulating the melanocytes themselves.

During the treatment, the medical team checks with the patient in the mirror to adjust the energy intensity and focused treatment areas. To ensure no area is neglected, we precisely fine-tune even handpiece changes or detailed parameter settings if necessary.

Throughout all stages of the treatment, we monitor the skin condition with the patient by checking in the mirror.

2) ABNOM (Acquired Bilateral Nevus of Ota-like Macules) Management

ABNOM is a pigmentary disorder located in the dermal layer, similar to melasma. However, it tends to require a somewhat higher energy intensity compared to melasma.

If melasma and ABNOM appear concurrently, a delicate and gentle approach is required for melasma, while a more intensive approach is needed for ABNOM. The medical team's skilled experience is crucial for effectively applying such contrasting strategies.

Particularly, if high-intensity treatment is performed first without considering melasma, there is a possibility that existing melasma could worsen.

Our clinic establishes precise differentiation and personalized plans before treatment, adjusting energy intensity to reduce the likelihood of side effects while managing ABNOM simultaneously.

ABNOM treatment also involves precise differentiation through Mark-Vu diagnosis, followed by applying individual parameter settings based on the medical team's expertise. This includes meticulously adjusting the spot size, number of repeated irradiations, and laser output, considering the patient's skin characteristics.

3) Other Pigmentary Disorders

Pigmentations that show relatively quick responses, such as lentigines, freckles, and blemishes, are expected to improve with the application of appropriate wavelengths. However, if these pigmentations are accompanied by melasma or ABNOM, the treatment approach can become more complex.

In such cases, a delicate individualized strategy is required, including accurate diagnosis, mirror checks during each treatment, fine-tuning of laser output, and changing handpieces as needed. Through these processes, our clinic aims for customized melanin pigment management based on the medical team's judgment, going beyond merely universal laser toning.

Pico Toning vs. Laser Toning

Pico toning has the theoretical advantage of being able to break down pigments more finely by using very short laser pulses in picosecond units.

In contrast, general laser toning uses nanosecond units, delivering laser energy over a relatively longer duration.

Both toning methods can selectively target melanin pigment to brighten skin tone and are applicable for managing various pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to the difference in laser irradiation time, there is a view that pico toning may have a faster response speed in the initial 2-3 sessions. However, after 10 or more accumulated treatments, both methods can be expected to provide similar levels of skin tone improvement.

Laser toning has been consistently used for approximately 20 years and is regarded as a proven method. Especially for individuals with sensitive skin or conditions like melasma that are sensitive to irritation, it can be a more stable approach.

Due to pico toning's characteristic of delivering strong energy in a short period, temporary redness or a slight stinging sensation may occasionally be experienced after treatment.

From a clinical perspective, when comparing the two methods based on the same 1064nm wavelength, numerous studies report no significant differences in improvements in skin brightness, melasma lesion improvement, or melanin index reduction.

Consequently, how can one achieve similar effects to pico toning with laser toning?

It is important to repeat the treatment consistently more than 10 times for optimal results. Laser toning is a procedure where the results become more noticeable with accumulation.

The energy intensity should be delicately adjusted within the range of 1.0~2.0 J/cm², taking into account the individual's skin reaction.

For satisfactory results, a sufficient number of shots, at least 2000 or more, may be required.

It is recommended to maintain a treatment interval of 1-2 weeks. This is because if the interval becomes too long, the cumulative effect may decrease.

It is important to receive treatment from medical staff who can adjust the energy according to each individual's skin type and real-time response.

If the conditions mentioned above are met, similar results can be expected compared to pico toning, based on various research findings.

All this information is based on relevant research papers.

Key references include Medicina (Kaunas, 2022), Lasers in Medical Science (2021), and Journal of Cosmetic and Laser Therapy (2021).

What is Laser Toning?

Laser toning is a procedure that gradually breaks down pigments by delivering weak laser energy deep into the skin multiple times, thereby evening out the overall skin tone.

Unlike conventional treatments that directly burn pigments with strong energy, this procedure repeatedly provides subtle stimulation to the skin, gently breaking down melanin and promoting the skin's natural regeneration.

It can be applied to various pigmentary disorders such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) without causing significant irritation to the skin. It is currently one of the popular pigment improvement treatments.

1. Type of Laser Used: Q-switched Nd:YAG

The equipment generally used for laser toning is the Q-switched Nd:YAG laser.

The 1064nm wavelength of this laser reaches the upper dermal layer where melanin pigments are concentrated. Its characteristic is that it can selectively destroy pigments without damaging the skin surface.

It can help preserve the skin barrier while focusing on pigment removal, making it a viable option for individuals with sensitive or thin skin.

2. 'Tone-Up' Method with Repeated Low-Energy Pulses

While past pigment treatments involved using strong lasers to remove pigments in one go, laser toning differs by repeatedly irradiating low-energy light multiple times.

This approach reduces the burden of skin tissue damage while gradually breaking down melanin particles. These fragmented melanin particles are then absorbed by the body's immune system (macrophages) and naturally removed.

Through this process, you can expect your skin tone to gradually become more even and clearer.

3. Destruction of Melanocyte Dendrites (Processes) and Melanin Removal

Beyond simply breaking down pigments, laser toning can also be expected to play a role in regulating the melanin production pathway itself.

The core of this mechanism lies in the destruction of melanocyte dendrites (processes).

Dendrites (processes) act as pathways that transport mature melanosomes (melanin carriers) produced by melanocytes to the epidermis, the skin's surface.

When the laser damages these processes, melanosomes cannot be delivered to the epidermis. Therefore, it can help prevent the formation of new pigments on the skin surface.

Furthermore, it can directly break down melanin pigments already accumulated within melanocytes, which can help improve existing hyperpigmentation.

This action is primarily observed in lasers with short pulse durations, measured in nanoseconds or picoseconds.

In other words, it is one of the important mechanisms seen in treatments like laser toning or pico toning.

Three Key Principles of Laser Toning

The three core treatment principles by which laser toning works are as follows:

Laser toning can be described as a treatment that goes beyond simply eliminating existing pigments, comprehensively managing the entire process of melanin production and migration.

1. Breakdown and Removal of Existing Pigment Particles

For pigmentary disorders other than melasma, such as freckles or ABNOM (Acquired Bilateral Nevus of Ota-like Macules), improvement can be seen by adjusting the intensity to remove melanin.

However, melasma can react sensitively to skin irritation, so careful adjustment by medical staff is essential. Caution is advised, as improper treatment could potentially activate melanocytes further.

2. Regulation of Melanosome Transport through Dendrite (Dendritic Process) Destruction

By hindering the movement of melanosomes produced by melanocytes to the epidermis, it can help prevent the occurrence of new hyperpigmentation.

3. Direct Breakdown of Melanin Accumulated within Melanocytes

Laser energy directly breaks down the melanin pigment within melanocytes, reducing the density of melanin in the skin and helping to improve overall skin tone.

Expected Effects of Laser Toning

• 1. You can expect a tone-up effect that brightens and evens out skin tone. The laser's subtle stimulation gently breaks down melanin, which can help dull skin gradually become clearer.
• By selectively destroying melanosomes without stimulating melanocytes, sensitive melasma and pigmentation can be gently alleviated.
• We approach ABNOM (Acquired Bilateral Nevus of Ota-like Macules), which is located in a deeper layer than melasma, with individually tailored intensity. You can expect safer improvement even for dermal pigmentation.
• By managing the dendritic sheath, known as the pathway for pigment, we reduce the ascent of melanin to the epidermis. This can help suppress pigment regeneration and reduce the burden of recurrence.
• The stimulation delivered by the laser to the skin induces collagen production and aids skin regeneration. As a result, you can expect the secondary benefits of refined skin texture and improved fine lines.
• By irradiating multiple times with low energy, skin irritation is reduced. This allows even sensitive skin types to approach the treatment with less burden.

Recommended for Laser Toning

• Those concerned about dull and uneven skin tone
• Those who repeatedly experience or have worsening pigmentary lesions such as melasma, blemishes, and freckles
• Those concerned about deep dermal pigmentation such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• Those with thin or sensitive skin who are cautious about pigment treatment
• Those also considering the benefits of fine line and skin texture improvement
• Those who want to reduce skin irritation while consistently expecting changes in their skin condition

Laser Toning Treatment Process

• STEP 1. Mark-Vu Precision Skin Diagnosis: A process of precisely identifying the depth and scope of pigmentation that is difficult to ascertain with the naked eye.
• STEP 2. 1:1 Direct Consultation with the Director and Establishment of a Customized Treatment Plan
• STEP 3. Parameter Setting and Laser Toning Treatment Tailored to Individual Skin Condition (Final confirmation with the Director using a mirror before treatment)
• STEP 4. Checking Condition and Reviewing Focused Improvement Areas via Mirror During Treatment
• STEP 5. Mirror Confirmation After Treatment Completion and Guidance on Future Progress

A Sincere Message from the Director

I am well aware that many people have struggled for a long time with pigmentation problems like melasma or ABNOM.

You likely also have significant concerns such as, 'Can it truly improve?' or 'Will the pigmentation actually get darker?'

Therefore, in pigment treatment, we strive to go beyond merely mechanical procedures.

We make it a crucial principle to meticulously examine our patients' skin and precisely treat only the necessary areas with the required amount.

An individual approach is needed depending on the depth of the pigmentation and skin sensitivity.

Laser toning is performed through a system suitable for each individual, based on careful diagnosis. We will always do our best to ensure our patients experience positive changes.

Precautions After Treatment

• • You may wash your face and apply makeup on the day of treatment. Please pay particular attention to sun protection.
• • Your skin may be temporarily irritated after treatment, so adequate soothing and moisturizing care is recommended.
• • Mild swelling or redness may occur after treatment and usually subsides naturally. If it persists for several days, please contact the clinic for advice.