As we age, pigmentation gradually accumulates within the body, leading many to develop facial spots. Consequently, numerous individuals seek laser spot removal procedures. However, some claim that laser treatments can make spots appear darker over time. What exactly is happening here? Let's explore this together.
Laser spot removal is widely praised for its precision, noticeable results, and minimal side effects—though it may leave marks requiring long-term post-treatment care and sun protection.Many have noticed: Laser spot removal seems to make the spots darker instead. What's going on?
Laser spot removal making spots darker?
"Doctor, I had laser spot removal on my face at another clinic last time, but after the scabs fell off, the spots actually darkened. It's really troubling. What should I do now?"Many patients seeking quick results experience post-inflammatory hyperpigmentation (PIH) after laser or IPL treatments due to genetic predisposition or inadequate sun protection. This leads to darkening of the treated area, prompting them to seek alternative treatments.
What exactly causes post-laser hyperpigmentation? Experts indicate that ethnicity and individual skin type are key factors. Asian melanocytes are more active than those in Caucasians, making post-inflammatory melanin deposition and proliferation more likely. Studies show that post-laser hyperpigmentation occurs in over 10% of Asians.Patient constitution also plays a role, including hormonal influences that activate melanin production. Additional causes include improper energy settings during laser treatment, using an unsuitable laser device for the patient's skin type, medication interactions, inadequate sun protection post-treatment, or excessive consumption of lemon, lime, or spicy foods after the procedure.
Laser spot removal practitioners should disclose specific details
Both laser spot removal and pulsed light treatments involve thermal energy that may cause some degree of skin inflammation during the procedure. To prevent post-treatment hyperpigmentation disputes, practitioners should thoroughly inform patients beforehand, provide detailed precautions, obtain signed consent forms, and carefully select laser or light therapy devices suitable for each patient.Additionally, a test spot treatment on a few pigmentation areas can be performed pre-operatively to observe for hyperpigmentation. If observed, treatment should proceed, combining oral and topical medications. Oral options include tranexamic acid, vitamin C, and alpha-lipoic acid injections. Topical treatments encompass hydroquinone, retinoic acid, and arbutin.
Are there alternatives if oral or topical medications are undesirable? Physicians indicate that multiple sessions of the 1064nm long-wavelength skin-clearing laser can provide progressive improvement by penetrating the dermis to break down melanin. Some practitioners also employ fractional laser therapy to address post-laser hyperpigmentation, while others adjust the wavelength of intense pulsed light (IPL) for treatment.If no post-treatment hyperpigmentation occurs after a test session, subsequent laser treatments can be tailored to individual needs in staged sessions to achieve the desired results.
Due to skin characteristics, Asians typically have mixed-depth spots. Therefore, an optimal laser treatment approach involves separating and addressing different types of pigmentation: superficial spots like age spots,freckles, sunspots, café-au-lait spots, etc., while deeper pigmentation like Nevus of Ota, Nevus of Becker, and malar macules require specialized assessment. Dermatologists can accurately determine the depth of pigmentation to select appropriate medication or laser (light) therapy, ensuring optimal laser spot removal outcomes.
Post-laser hyperpigmentation is difficult to absolutely guarantee or prevent. Therefore, thorough pre-treatment assessment and diagnosis, along with effective communication with the patient, are crucial for developing a tailored treatment plan. For a successful laser spot removal procedure, the selection of laser device, wavelength, and energy level is highly important. Patients must also adhere to post-treatment precautions, including diligent sun protection for four weeks post-procedure and avoiding any irritating products, to minimize the risk of hyperpigmentation.
Regardless of whether post-treatment hyperpigmentation occurs, diligent sun protection remains essential after laser spot removal. The skin is more fragile and light-sensitive following the procedure, so extra caution is advised.