Lasers to treat Pigmentation

Lasers to treat pigmentation: All operate according to the Q-switched mode (pulse of very short duration):

• alexandrite laser
• ruby laser
• NdYAG laser

Before using lasers, other treatments are to be tried:

• topical (creams, depigmentation cream).
• surface ablation (chemical peels)
• lasers

Does it work?

• lentigines: Laser pigment work better than IPL (intense pulsed light or flash lamp)
• freckles (ephelides): respond to pigmented laser and IPL (3 sessions), Chemical Peels do not work
• PIH (post inflammatory hyperpigmentation): Neither IPL nor laser pigment work
• Nevus of Hori:  IPL does not work but the pigment laser may have interesting results
• SK (seborrheic keratoses): responds to laser but other cheaper and effective methods are available
• Melasma (Chloasma, Pregnancy Mask): Works partially with IPL but does not respond at all to pigment laser
• Nevus of Ota: responds to pigment laser but not IPL.

The risks of laser treatment:

• especially for darker skin types (IV-VI)
• Post-inflammatory hypopigmentation
• Post-inflammatory hyperpigmentation

It is especially important to know that we treat. The presenter showed the example of a lichen planus pigmentosus not responding to treatment due to misdiagnosis (of chloasma (melasma) (pregnancy mask))

Source of information: 2012 (02) – 20th Regional Conference of Dermatology (RCD) – Manila, Philippines

Original article: here