Pigment deep in the dermis does not respond well to topical agents. Resurfacing procedures such as chemical peels and liquid nitrogen can be helpful but recurrences often happen too quickly for patient satisfaction. As a result, intense pulsed light devices (IPL) and laser treatments have far outpaced these other procedures. While IPLs and laser treatments may significantly help rid skin of brown discolorations the treatments are expensive, the results are not consistent, and problems can occasionally occur. Of course, without strict use of a sunscreen with UVA-protecting ingredients the discolorations almost always come back. Moreover, laser treatments of this kind have been a problem for those with darker skin tones, though new research indicates that specific lasers now pose only rare incidences of unwanted side effects.
After taking all of the pros and cons into consideration, it’s clear that when laser and light treatments do work they can make a marked difference in the appearance of the face, arms, hands, and chest, which are the areas of the body most prone to hyperpigmentation. The results can be startling, and completely eliminate any appearance of the problem. (Source: Journal of the American Academy of Dermatology, May 2008, pages 719-737.)
laser
LASER (light amplification by stimulated emission of radiation) light is emitted in a single, high-intensity beam of coherent energy. This light source is absorbed by water, hemoglobin, and melanin in the skin. The absorption of this energy destroys the melanin and prevents its regrowth. The wavelength of the particular type of laser dictates the depth of laser penetration and the amount of melanin that can be targeted.
Based on the absorption spectrum of melanin, the Q-switched ruby laser (694 nm) and the Q-switched Nd:Yag laser (1064 nm) are the lasers of choice for the treatment of brown discolorations. In a randomized controlled trial of 27 patients with solar lentigines on the back of the hand, the best treatment was with the Q-switched Nd:Yag laser compared with a krypton laser, 532-nm diode pumped laser, or liquid nitrogen. (Source: Lasers in Surgery and Medicine, February 2006, pages 94-97.)
The Q-switched ruby laser treatment is a safe procedure for the treatment of solar len – tigines even in dark-skinned individuals. In addition to concentrating on melanin content alone, considering other factors in the patient’s background is required for minimizing side effects, especially postinflammatory hyperpigmentation in darker skin. (Source: Dermatologic Surgery, November 2008, pages 1465-1468.) Never go for a laser treatment without a discussion of pros and cons with the physician.
Adverse effects from laser treatment include discomfort, redness, mild swelling, and postinflammatory hyperpigmentation. Patients should always have a test spot performed before a full treatment.