Pigmented Lesions

Pigmented Lesions

Deeper sited dermal pigmentation requires very short pulse width laser (generally Q-switched) which act in a photo-mechanical (photo acoustic) mode to shatter pigment which is then removed by macrophages or through scale crust transdermal elimination. All tattoos and dermal melanocytosis lesions such as naevus of Ota are treated in this way. Alternatively when pigment is at the dermo-epidermal junction it can be very effectively addressed through the 1927nm holmium laser (Fraxel Dual™) which acts at this level where pigment cells (water content) are the chromophore for this mid infrared emission spectrum. For more superficial photodamage comprising actinic lentigines, ephiledes and non-specific dyschromias intense pulsed light is ideal (hence the concept of photorejuvenation). The pulsed dye laser 595nm can also be effective in treating pigmentation so long as diascopic pressure is applied to reduce haemoglobin in the treatment field.

Melasma is often difficult to improve and may benefit most from multimodality treatments including the Fraxel 1550nm (Er:YAG) or 1565nm ResurFX™ which encourage transepidermal elimination of pigment in a non-ablative way through microthermal zones. Care must be taken on extra-facial sites (such as the neck) which are prone to marking and scarring. More pigmented phototypes (Fitzpatrick III and above) are at risk of adverse events from IPL and shorter wavelength lasers such as the KTP and should preferably be treated with longer wavelength ‘Q’ switched lasers. A good option for sun damaged skin (dyspigmentation) is superficial ablative fractional resurfacing with the ActiveFX™ technique which can eliminate abnormal epithelium of all sorts. Reduction of melanocytic activity through tyrosinase inhibitors such as hydroquinone can also be considered.

Melanocytic lesions

These must be part of a proper diagnostic process before being treated with any laser or light source. Different for benign pigmented lesions which resemble melanocytic lesions but these must also be diagnosed accurately – clinical experience/biopsy.

For more information about this condition, please contact the Solais team below...