[Customized for my skin] Laser Toning

The Uniqueness of Our Korean Medicine Clinic's Laser Toning

• At our Korean medicine clinic, we use sufficient energy of over 2000 shots during laser toning. We do not rush treatments with low output or a small number of shots. Our focus is on precisely delivering energy to enhance treatment effectiveness and minimize skin irritation.
• Pigmentation requires different treatment intensities depending on its type and depth. Various pigmentary disorders such as melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and blemishes are located in different skin layers and have unique characteristics. At our Korean medicine clinic, the director personally considers the depth and type of pigmentation, applying delicate treatment for melasma, the necessary energy for ABNOM, and different intensities and settings for each area in complex cases.
• We do not believe that laser treatment simply ends with energy delivery. During the procedure, our director personally checks your skin's reaction with you in a mirror. If necessary, we adjust the spot size, laser intensity, or even the type of handpiece in real-time. Through these precise, customized treatments, we strive to help each patient improve their pigmentation in a way that is suitable for them.
• Pigment diagnosis is the first step towards accurate treatment. We do not rely solely on visual diagnosis; instead, we utilize a Mark-Vu diagnostic device to precisely analyze the type, distribution, and depth of pigmentation within the skin. Based on these diagnostic results, we establish and proceed with a suitable treatment plan for each individual.
• When multiple types of pigmentation, such as melasma and ABNOM, appear together, treating only one aggressively can actually worsen the pigmentation. A multi-layered approach is crucial for such complex pigmentation. At our Korean medicine clinic, we first focus on stably calming melasma, and then proceed with an appropriate intensity for ABNOM located in the dermal layer.

What are the characteristics of Korean Medicine Clinic Laser Toning?

Laser toning is a treatment used to improve various pigmentary disorders. However, the expected results can vary depending on several factors, such as the equipment used, the number of shots delivered, and the treatment intensity.

Pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) differ in their depth within the skin and tissue response. Therefore, a precise treatment plan tailored to the characteristics of each condition is crucial.

1. Sufficient Energy Delivery of Over 2,000 Shots

According to various research findings, low-output laser toning can be performed relatively stably and effectively within the range of approximately 1500 to 2500 shots.

At our Korean medicine clinic, we provide a minimum of 2,000 shots during treatment, planning for sufficient energy delivery for pigment improvement without causing excessive skin irritation.

Skin changes are difficult to achieve by simply operating a laser device.

It is crucial to delicately adjust various factors such as the number of shots, output intensity, irradiation speed, and spot size, tailored to the depth and distribution of pigmentation, as well as the individual's skin sensitivity.

2. Customized Laser Toning Adjustment for Each Condition

1) Melasma

Melasma is one of the pigmentary disorders that primarily appears on both sides of the face and spreads widely.

Since melanocytes that produce melanin pigment are overly activated, unnecessary irritation can potentially worsen melasma.

At our Korean medicine clinic, we use a Mark-Vu precision skin diagnostic device to accurately identify the extent and depth of melasma within the skin. Based on this information, we perform treatments with a toning laser that uses short pulses of 5 nanoseconds.

Our clinic's toning method is designed to selectively destroy only melanosomes, where melanin pigments are clustered within the cells, without stimulating the melanocytes themselves. This helps reduce skin irritation and the risk of side effects.

Even during the procedure, our director checks the skin's reaction with the patient in a mirror and adjusts the laser intensity and areas requiring focus. To ensure no areas are missed, the handpiece may be changed or parameter settings delicately modified as needed.

We meticulously check the patient's skin condition with them in a mirror throughout the entire treatment process: before, during, and after the procedure.

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

ABNOM, like melasma, is a pigmentary disorder located in the dermal layer of the skin. However, it may require higher energy laser irradiation compared to melasma.

In complex cases where melasma and ABNOM appear together, melasma requires a gentle approach, while ABNOM needs more aggressive energy. Applying such contrasting treatment strategies simultaneously requires skilled treatment expertise.

Specifically, if strong treatment for ABNOM is performed without sufficiently stabilizing melasma, there is a possibility that melasma could worsen.

At our Korean medicine clinic, we provide a thorough pigmentation diagnosis and a tailored treatment plan before the procedure. This allows us to customize the laser intensity to reduce the burden of side effects while still achieving improvement in ABNOM.

ABNOM treatment is also precisely diagnosed using Mark-Vu, after which customized parameters are set according to the director's judgment. Various treatment elements such as spot size, laser repetition rate, and output are meticulously adjusted to match the patient's skin type.

3) Other Pigmentary Disorders

Pigments that respond relatively quickly to lasers, such as lentigines, freckles, and blemishes, are generally easy to improve with the appropriate wavelength. However, if these pigments appear alongside melasma or ABNOM, treatment requires even greater caution.

For such complex pigmentary disorders, accurate diagnosis is crucial, along with checking the skin's reaction with a mirror during each session, and implementing delicate customized strategies such as output adjustment and laser handpiece changes. At our Korean medicine clinic, we do not simply adhere to the name 'laser toning'; instead, we provide melanin pigmentation treatments optimized for each individual based on the director's diagnosis and experience.

Comparison of Pico Toning and Laser Toning

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

In contrast, conventional laser toning operates in nanosecond (ns) units, delivering laser energy for a relatively longer duration compared to pico toning.

Both toning methods can be used to selectively destroy melanin pigments, clarify skin tone, and improve various pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to differences in laser irradiation time, pico toning may show a relatively faster response during the initial 2-3 sessions. However, after 10 or more consistent treatments, both methods can be expected to achieve similar levels of skin tone improvement.

Laser toning is a method that has been validated through nearly 20 years of diverse clinical experience. Especially for sensitive skin or conditions like melasma that react sensitively to external stimuli, it can be a relatively stable treatment option.

Pico toning has the characteristic of delivering high energy intensively within a short time, which may occasionally result in temporary redness or a stinging sensation.

Many clinical studies comparing pico toning and laser toning based on a 1064nm wavelength report no significant differences in improving skin brightness, reducing melasma severity, or lowering melanin index.

So, what should be considered to expect effects comparable to pico toning with laser toning?

For optimal cumulative results, it's recommended to consistently undergo 10 or more treatment sessions.

The energy intensity is carefully adjusted within the range of 1.0~2.0 J/cm², tailored to your individual skin reaction.

To achieve sufficient results, it is recommended to apply at least 2,000 shots per session.

Maintaining a treatment interval of 1 to 2 weeks is recommended. If the interval is too long, the cumulative effect may diminish.

It is crucial to receive treatment from medical professionals who can create and adjust a customized treatment plan, considering your skin type and real-time reactions during the procedure.

When these conditions are met, various research findings suggest that similar results can be expected compared to Picotoning.

All of the above information has been compiled based on research papers.

References include Medicina (Kaunas, 2022), Lasers in Medical Science (2021), Journal of Cosmetic and Laser Therapy (2021), among others.

What is Laser Toning?

Laser Toning is a procedure that repeatedly applies low-energy laser pulses deep into the skin to gradually break down pigmentation and achieve a more even skin tone.

Unlike methods that burn pigment with strong energy, this principle gently removes melanin by accumulating subtle stimuli, promoting skin regeneration.

It can be applied to improve various types of pigmentary disorders, such as melasma, freckles, and acquired bilateral nevus of Ota-like macules (ABNOM), without causing significant skin irritation. It is currently one of the most popular pigment treatment methods.

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

Q-switched Nd:YAG lasers are primarily used for laser toning treatments.

The 1064nm wavelength of this laser can reach the upper dermis, where melanin pigment is highly concentrated. It offers the benefit of selectively destroying pigment without damaging the skin surface.

While focusing on pigment removal, it also helps preserve the skin barrier relatively well, making it a viable option for sensitive or thin skin.

2. 'Tone-Up' Stimulation Through Low Power and High Repetition

Traditional pigment treatments involved removing pigment in a single session with a strong laser. In contrast, laser toning repeatedly delivers low-energy laser pulses thousands of times.

This method minimizes skin tissue damage while gradually breaking down melanin particles into smaller fragments. Subsequently, the body's immune system, specifically macrophages, absorbs and helps excrete them.

As a result, you can expect a change in skin tone to become more even and clearer over time.

3. Melanin Removal within Melanocytes and Dendrite Destruction

Laser toning not only breaks down existing pigment but also plays a role in inhibiting the melanin production pathway itself.

One of the core principles of this process is the destruction of melanocyte dendrites.

Dendrites are pathways that transfer mature melanosomes (melanin carriers) produced by melanocytes to the epidermis, the outer layer of the skin.

When the laser destroys these dendrites, it can prevent melanin carriers from migrating to the epidermal layer of the skin. Consequently, this helps inhibit the new formation of pigment on the skin surface.

Furthermore, by directly breaking down melanin pigment already accumulated within melanocytes, it can positively contribute to improving existing hyperpigmentation.

These actions are primarily characteristic of lasers with short pulse durations, measured in 'nanoseconds' or 'picoseconds'.

In other words, it is an important mechanism of action observed in treatments like Laser Toning or Picotoning.

Three Main Principles of Laser Toning

The three main ways Laser Toning works are as follows:

Laser Toning can be understood as a treatment that goes beyond simply eliminating pigment; it also regulates the overall process of melanin production and migration.

1. Improvement of Existing Pigment Particles

For pigmentary conditions other than melasma, such as freckles or acquired bilateral nevus of Ota-like macules (ABNOM), melanin can be broken down with relatively strong energy settings to encourage improvement.

However, melasma can react sensitively to laser stimulation, requiring delicate energy adjustment during treatment. Care must be taken to ensure that excessive stimulation does not inadvertently activate melanocytes.

2. Inhibition of Melanosome Migration Through Dendrite Destruction

By hindering the migration of melanosomes, produced in melanin-producing cells, to the epidermal layer of the skin, it contributes to proactively inhibiting the occurrence of hyperpigmentation.

3. Direct Breakdown of Melanin Accumulated within Melanocytes

Laser energy directly breaks down the melanin pigment present within melanocytes. This leads to a reduction in melanin concentration and the expectation of a brighter skin tone.

Laser Toning: Expected Changes

• 1. Improved Skin Tone As subtle laser stimulation gently breaks down melanin, you can expect an overall dull skin tone to gradually become clearer and brighter.
• 2. Improvement of Melasma and Pigmentation By selectively removing melanosomes without affecting melanocytes, it can help resolve melasma issues for sensitive skin.
• 3. Management of ABNOM (Acquired Bilateral Nevus of Ota-like Macules) With customized intensity that can reach pigments deeper than melasma, improvement in dermal pigmentation issues can be expected.
• 4. Reduced Recurrence Risk through Pigment Pathway Management By regulating the activity of dendrite sheaths, which are pigment migration pathways, it can help reduce melanin from rising to the surface and inhibit excessive pigment production.
• 5. Smooth Skin Texture and Fine Line Management During laser treatment, skin regeneration processes can be promoted, which can lead to improved skin texture and reduced fine lines.
• 6. Treatment with Reduced Skin Irritation By using a method of irradiating multiple times with low energy, it causes less irritation to the skin. Thanks to this, even sensitive skin types can consider the treatment.

Recommended Candidates for Laser Toning

• 1. Those concerned about dull or uneven skin tone
• 2. Those who frequently develop or have deepening pigmentation such as melasma, blemishes, or freckles
• 3. Those with dermal pigmentation, such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• 4. Those hesitant about pigmentation treatments due to thin and sensitive skin characteristics
• 5. Those also considering improvement in fine lines or skin texture
• 6. Those seeking consistent skin improvement while minimizing skin irritation

Laser Toning Procedure

• STEP 1. Precise Skin Diagnosis using Mark-Vu Identifying the depth and distribution of pigmentation that is difficult to confirm on the skin surface.
• STEP 2. Treatment Plan Establishment through 1:1 Consultation with the Director
• STEP 3. Individualized Parameter Setting and Laser Toning (Final confirmation with the Director in front of a mirror before treatment)
• STEP 4. In-Treatment Confirmation via Mirror and Re-evaluation of Necessary Areas
• STEP 5. Post-Treatment Change Confirmation and Guidance on Future Progress

Director's Thoughts

We are well aware that pigmentation issues such as melasma and ABNOM are areas many people struggle with for a long time.

You may have concerns about whether it can truly be improved, or if it might worsen.

Accordingly, we strive to ensure that pigmentation treatment is not just a mechanical procedure.

Our important principle is to carefully examine the patient's skin condition and perform precise treatment only as needed.

An individualized approach is required depending on the type of pigmentation, skin depth, and sensitivity.

Laser toning treatment is not just performed routinely; we have established a system to ensure sufficient improvement can be expected. We will continuously strive for our patients' satisfactory results.

Post-Treatment Care Instructions

• ㆍFacial cleansing and makeup are possible from the day of the procedure, and we recommend paying special attention to UV protection.
• ㆍFor temporarily sensitive skin, it is advisable to pay extra attention to soothing and moisturizing care.
• ㆍSlight swelling or redness may appear after the procedure, but it usually subsides naturally over time. If it persists for more than a few days, we recommend visiting the clinic for a consultation.