[Making a Difference in Pigmentation Management] Laser Toning

The Uniqueness of Herbal Clinic Laser Toning

• At our herbal clinic, we use sufficient energy of over 2000 shots during laser toning. We do not rush the procedure with low output or a small number of shots. We focus 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 freckles are located in different skin layers and have unique characteristics. At our herbal clinic, the director personally considers the depth and type of pigmentation, applying delicate settings 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 is simply about irradiating energy. During the procedure, the 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 this precise customized treatment, we strive to help improve pigmentation in a way that is suitable for each individual patient.
• Accurate pigment diagnosis is the first step in precise treatment. We do not rely solely on visual diagnosis; we utilize a Mark-Vu diagnostic device to precisely analyze the type and distribution of pigmentation, as well as its depth within the skin. Based on these diagnostic results, we establish and proceed with a customized treatment plan for each individual.
• In cases where multiple types of pigmentation, such as melasma and ABNOM, appear together, treating one type aggressively without considering the others can actually worsen the pigmentation. A multi-layered approach is crucial for such complex pigmentation. At our herbal clinic, we first focus on stably calming melasma, and then approach ABNOM, which is located in the dermis layer, with appropriate intensity.

What are the characteristics of herbal 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, freckles, 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-fluence laser toning can achieve relatively stable and effective results within a range of approximately 1500 to 2500 shots.

At our herbal clinic, we provide a minimum of 2,000 shots during treatment, ensuring that sufficient energy is delivered for pigment improvement without causing excessive skin irritation.

Skin changes are difficult to achieve simply by 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, according to the depth and distribution of pigmentation, and the individual's skin sensitivity.

2. Customized Laser Toning Adjustment by Condition

1) Melasma

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

Since it is a state where melanocytes that produce melanin pigment are excessively activated, unnecessary stimulation can potentially worsen melasma.

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

Our clinic's toning method is designed to selectively destroy only the melanosomes, where melanin pigment is clumped within the cells, without stimulating the melanocytes themselves. This can reduce the burden of skin irritation and the occurrence of side effects.

Even during the procedure, the 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 is changed or parameter settings are delicately altered as needed.

From before the treatment, during the treatment, and after the treatment, we meticulously check the patient's skin condition together through a mirror throughout the entire 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.

If melasma and ABNOM appear together in a complex case, melasma requires a gentle approach, while ABNOM needs more aggressive energy. Applying such contrasting treatment strategies simultaneously requires highly skilled treatment capabilities.

In particular, if strong treatment for ABNOM is performed without sufficiently stabilizing melasma, there is a possibility that melasma may worsen.

At our herbal clinic, we provide thorough pigment differentiation and a corresponding treatment plan before the procedure. This allows us to customize the laser intensity to reduce the burden of side effects while expecting improvement in ABNOM.

ABNOM treatment is also accurately differentiated with Mark-Vu diagnosis, and customized parameters are set according to the director's judgment. Various treatment factors such as spot size, laser repetition rate, and output are carefully adjusted to match the patient's skin type.

3) Other Pigmentary Disorders

Pigments like lentigines, freckles, and general blemishes that react relatively quickly to lasers are usually easy to improve with appropriate wavelengths. However, if these pigments appear together with melasma or ABNOM, the treatment must be even more cautious.

For such complex pigmentary disorders, accurate diagnosis, along with checking the skin's reaction in a mirror during each session, and delicate customized strategies such as adjusting output and changing laser handpieces, are crucial. Our herbal clinic does not simply adhere to the term 'laser toning' but provides melanin pigment treatment optimized for each individual, based on the director's diagnosis and experience.

Comparison of Pico Toning and Laser Toning

Pico toning theoretically features the ability to fragment melanin pigment more finely by using very short laser pulses in picosecond (ps) units.

In contrast, general laser toning operates in nanosecond (ns) units, delivering laser energy over a relatively longer period compared to pico toning.

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

Due to the difference in laser irradiation time, pico toning may show a relatively faster response during the initial 2-3 sessions. However, when treated consistently for more than 10 sessions, both methods can be expected to show a similar degree of skin tone improvement.

Laser toning is a method 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 method.

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 report that when compared based on a 1064nm wavelength, both pico toning and laser toning show no significant differences in improving skin brightness, reducing melasma severity, and lowering melanin index.

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

For cumulative effects, it is recommended to consistently receive treatments repeatedly 10 times or more.

The appropriate energy intensity is adjusted to match the individual's skin reaction within the range of 1.0~2.0 J/cm².

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

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

It is important to receive treatment from medical staff who can create and adjust a customized treatment plan, considering your skin type and real-time reactions.

If these conditions are met, reports suggest that similar results can be expected compared to Pico Toning, when synthesizing various research findings.

All of the above content has been written with reference to 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 treatment that repeatedly delivers low-power laser energy deep into the skin to gradually break down pigments and even out skin tone.

Unlike methods that burn pigments with strong energy, it works by accumulating subtle stimuli to gently remove melanin and induce skin regeneration.

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

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

The Q-switched Nd:YAG laser is primarily used for laser toning treatments.

The 1064nm wavelength of this laser can reach the upper dermis where melanin pigments are densely distributed. It has the advantage of selectively destroying pigments without damaging the skin surface.

It focuses on pigment removal while relatively preserving the skin barrier, making it a viable option for sensitive or thin skin.

2. 'Tone-Up' Stimulation through Low Power, High Repetition

Traditional pigment treatments involved removing pigments all at once with a strong laser. In contrast, laser toning repeatedly delivers low-energy laser thousands of times.

This method minimizes skin tissue damage while gradually breaking down melanin particles into smaller pieces. Subsequently, the body's immune system, macrophages, absorb these particles and help excrete them from the body.

As a result, you can expect your skin tone to become more even and radiant over time.

3. Melanin Removal and Dendrite Destruction within Melanocytes

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

One of the core principles of this process is the destruction of dendrites (dendritic processes) of melanocytes.

Dendritic processes, or dendrites, are pathways that transport mature melanosomes (melanin carriers) produced by melanocytes to the outer layer of the skin, the epidermis.

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

Furthermore, by directly breaking down melanin pigments already accumulated within melanocytes, it can positively impact the improvement of existing hyperpigmentation.

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

In other words, it is a significant mechanism of action observed in treatments like laser toning or pico toning.

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 pigments, controlling the overall process of melanin production and migration.

1. Improvement of Already Formed Pigment Particles

For pigmented lesions 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 induce improvement.

However, melasma can react sensitively to laser stimulation, requiring delicate energy control during treatment. Care must be taken to avoid excessive stimulation, which could potentially activate melanocytes.

2. Inhibition of Melanosome Migration through Dendrite (Dendritic Process) Destruction

By hindering the migration of melanosomes, produced by melanin-generating cells, to the epidermal layer of the skin, it contributes to the pre-emptive suppression of hyperpigmentation.

3. Direct Breakdown of Melanin Accumulated within Melanocytes

Laser energy directly breaks down melanin pigments present within melanocytes. This reduces melanin concentration, leading to an expected effect of brighter skin tone.

Laser Toning: Expected Changes

• 1. Skin Tone Improvement Effect: As subtle laser stimulation gently breaks down melanin, you can expect your overall dull skin tone to gradually become clearer and brighter.
• 2. Improves Melasma and Pigmentation By selectively removing melanosomes without affecting melanocytes, it can help resolve melasma issues in sensitive skin.
• 3. ABNOM (Acquired Bilateral Nevus of Ota-like Macules) Management With customized intensity that can reach pigments deeper than melasma, improvement in dermal pigmentation problems can be expected.
• 4. Reduced Recurrence Risk by Managing Pigment Production Pathways By regulating the activity of dendrites, which are pigment migration pathways, it can reduce melanin rising to the surface and contribute to inhibiting excessive pigment production.
• 5. Smooth Skin Texture and Fine Line Management Laser treatment can promote skin regeneration, which in turn 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 minimizes irritation to the skin. This makes it a suitable treatment option even for sensitive skin types.

Recommended for Laser Toning

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

Laser Toning Procedure Steps

• STEP 1. Precise Skin Diagnosis using Mark-Vu We identify the depth and distribution of pigments that are difficult to confirm on the skin surface.
• STEP 2. Establishing a Treatment Plan through 1:1 Consultation with the Director
• STEP 3. Setting Personalized Parameters and Proceeding with Laser Toning (Final confirmation with the Director looking in a mirror before treatment)
• STEP 4. Checking via Mirror During Treatment and Re-examining Necessary Areas
• STEP 5. Confirming Changes After Treatment and Providing Guidance on Future Progress

Director's Thoughts

We understand that many people struggle with pigmentation issues like melasma or ABNOM for a long time.

You might worry about whether it can be improved, or if it might even worsen.

Therefore, we strive to ensure that pigment treatment is not merely a mechanical procedure.

We meticulously examine the patient's skin condition and adhere to the principle of performing precise treatments only as needed.

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

Laser toning is not just a simple procedure; we have established a system to ensure significant improvement can be expected. We will continuously strive for satisfactory results for our patients.

Post-Treatment Care Instructions

• ㆍFacial cleansing and makeup are possible from the day of the procedure, and we recommend paying special attention to sun 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 these usually subside naturally over time. If they persist for more than a few days, we recommend visiting the clinic for a consultation.