Precise Pigment Identification [Laser Toning]

Key Features of Our Clinic's Laser Toning

• 1. Applying over 2,000 shots of energy, we avoid rushed procedures. Our clinic meticulously applies over 2,000 shots of energy to the skin, aiming to achieve the desired improvements while minimizing skin irritation.
• 2. Customized intensity adjustment by medical staff based on pigment depth and type. Various pigmentary conditions like melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and freckles differ in their depth and characteristics. We approach melasma gently, use a more intensive method for ABNOM, and for complex cases, we use different intensities and settings tailored to the condition of each area.
• 3. We closely monitor skin reactions during the procedure and adjust parameters in real-time. Laser application is not the end; during the procedure, our medical staff directly observes the skin's reaction using a mirror and can change the spot size, intensity, and even the handpiece as needed. This is a precisely planned, individually customized procedure that focuses on actual skin improvement, rather than merely being called 'toning.'
• 4. We use Mark-Vu diagnostic equipment to accurately determine the location and depth of pigmentation. We do not rely on guesswork; instead, we meticulously confirm the type, distribution, and depth of pigmentation using Mark-Vu diagnostic equipment, then use this information to create a personalized treatment plan.
• 5. We attempt a multi-layered approach to complex pigmentation issues. When melasma and ABNOM coexist, treating only one aggressively can risk worsening the condition. We first stably soothe the melasma, then apply a controlled and intensive approach to the dermal ABNOM.

What makes our clinic's laser toning special?

Laser toning is a commonly used method for managing pigmentary conditions. However, there can be significant differences in treatment results depending on the equipment used, the number of shots applied, and the intensity of the procedure.

Various pigmentary conditions such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) are located at different depths within the skin and show diverse tissue reactions. Therefore, careful planning considering individual characteristics is crucial before treatment.

1. Application of over 2,000 shots of energy

Many studies report that when performing low-energy laser toning, stable and effective results can be achieved with between 1500 and 2500 shots.

At our clinic, we generally apply over 2,000 shots of energy, planning the treatment to ensure sufficient improvement is expected while minimizing skin irritation.

Simply operating the device alone is not enough to bring about skin changes.

The procedure must be carried out by individually adjusting the number of shots, output, pulse speed, and spot size, taking into account the depth and distribution of the pigmentation, and the skin's sensitivity.

2. Customized toning by medical staff, considering the characteristics of the condition

1) Melasma

Melasma is one of the common pigmentary disorders characterized by widespread discoloration, primarily appearing on both sides of the face.

Since it involves overly active melanocytes that produce melanin pigment, unnecessary stimulation can potentially worsen melasma.

We utilize the Mark-Vu precise skin diagnostic device to meticulously identify the extent and depth of melasma. Based on this, we cautiously attempt improvement using a toning laser with a short pulse width of 5 nanoseconds (ns).

Our clinic's toning method, which selectively targets melanosomes within cells without directly stimulating melanocytes, helps reduce the possibility of side effects.

During the procedure, our medical staff directly reviews the skin's reaction with the patient using a mirror. We adjust the intensity and focus where needed, ensuring no area is neglected, by changing the handpiece or finely tuning parameter settings as necessary.

We perform the procedure while checking the skin condition with the patient through a mirror, before, during, and after the treatment.

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

ABNOM is a condition where pigmentation is located in the dermal layer, similar to melasma, but may require higher energy adjustment than melasma.

When melasma and ABNOM appear together, conflicting strategies are simultaneously required: melasma needs a gentle approach, while ABNOM requires an appropriate intensity. In such cases, the skilled experience and meticulous judgment of the medical staff are crucial.

If strong treatment is performed without first considering melasma, there is a risk of exacerbating the melasma.

At our clinic, we establish individual customized treatment plans through thorough differential diagnosis before the procedure. This helps reduce the possibility of side effects and allows us to individually set the appropriate intensity for each patient so that ABNOM can also be improved.

For ABNOM treatment, after an accurate diagnosis using Mark-Vu, our medical staff sets individualized parameters for each patient. Spot size, repetition rate, output, and other factors are carefully adjusted according to skin type.

3) Other Pigmentary Conditions

Pigmentation that responds relatively quickly, such as lentigines, freckles, and blemishes, can often be improved with the appropriate wavelength. However, if they appear alongside melasma or ABNOM, the treatment approach can become more complex.

In such complex cases, accurate diagnosis is crucial, and a delicate, individualized strategy involving monitoring the condition with a mirror, adjusting output, and changing laser handpieces at each session is required. At our clinic, you can understand our approach not as a standardized laser toning, but as melanin pigment management through the precise judgment and adjustments of our medical staff.

Comparison of Picotoning and Laser Toning

Picotoning theoretically offers the advantage of breaking down pigment into smaller units using extremely short laser pulses in picosecond units.

In contrast, laser toning uses a method that delivers energy for a relatively longer duration, in nanosecond units, compared to picotoning.

Both toning methods can selectively break down melanin pigment to help improve skin tone and can be used for pigmentary conditions such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to the difference in laser irradiation time, picotoning might feel faster in its initial 2-3 treatment sessions. However, after 10 or more consistent sessions, both methods can be expected to yield similar skin tone improvement effects.

Laser toning is a treatment method whose efficacy has been verified for nearly 20 years. It can be a relatively stable approach, especially for sensitive skin or conditions like melasma that react sensitively to irritation.

Due to picotoning's characteristic of delivering concentrated energy in a short burst, some may experience temporary redness or stinging after the procedure.

Clinical studies, when comparing with a 1064nm wavelength as a baseline, have also reported numerous results indicating no significant differences between picotoning and laser toning in terms of skin tone improvement, reduction in melasma indicators, and decrease in melanin index.

So, can sufficient improvement be expected with laser toning alone?

It is important to receive repeated treatments steadily, 10 times or more. Improvement can be expected through the cumulative effects of the treatment.

The treatment is performed by observing the skin's reaction and adjusting the appropriate energy intensity within the range of 1.0~2.0 J/cm².

For sufficient effectiveness, irradiation of at least 2000 shots may be necessary.

It is recommended to maintain a treatment interval of 1-2 weeks. This is because if the interval becomes too long, the cumulative effects of the treatment may decrease.

It is advisable to receive treatment from a medical professional who can adjust the treatment settings in real-time according to your individual skin type and reaction.

When these conditions are met, some research suggests that similar effects can be expected compared to picotoning.

All the contents mentioned above were written with reference to relevant research papers.

This includes papers such as Medicina (Kaunas), 2022, Lasers in Medical Science, 2021, and Journal of Cosmetic and Laser Therapy, 2021.

What is Laser Toning?

Laser toning is a treatment method that gradually breaks down pigmentation and evens out overall skin tone by repeatedly irradiating low-power laser energy deep into the skin.

This treatment differs from conventional methods that directly burn pigmentation with strong energy. Instead, it continuously provides subtle stimulation to gently break down melanin and can help promote skin regeneration.

It is a treatment that can be applied to various pigmented lesions such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules), while minimizing skin irritation. It is also one of the most widely used methods among various pigmentation treatments today.

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

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

The 1064nm wavelength of this laser can penetrate deeply into the upper dermis, where melanin pigment is primarily located. This is advantageous for selectively destroying only the desired pigment while minimizing damage to the skin surface.

Thanks to these characteristics, it can help protect the skin barrier while focusing on pigmentation issues. Therefore, it can be considered for sensitive or thin skin types.

2. Low Power, High Repetition 'Tone-up' Stimulation

While typical pigmentation treatments remove pigment at once with high energy, laser toning differs by repeatedly irradiating low-energy lasers thousands of times.

This approach focuses on gradually and finely breaking down melanin particles while minimizing damage to skin tissue. The broken-down pigment is then absorbed by the body's immune system, specifically macrophages, and is naturally expelled.

Through this process, you can expect a gradual improvement in skin tone, becoming more even and clear.

3. Dendrite Sheath Destruction + Melanin Removal within Melanocytes

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

A crucial part of this action lies in damaging the dendrites, or sheaths, of melanocytes.

Mature melanosomes (melanin carriers) produced in melanocytes travel through dendrites (sheaths) to the epidermis, the outer layer of the skin.

When the laser damages these sheaths, melanin carriers cannot be delivered to the epidermis. As a result, this can help inhibit the formation of new pigmentation on the skin surface.

Additionally, it directly breaks down the melanin pigment accumulated within melanocytes, which is useful for improving existing pigmentation.

These specific actions primarily occur with lasers that have short pulse durations, measured in 'nanoseconds' or 'picoseconds'.

This can be considered one of the important mechanisms observed in treatments like laser toning or pico toning.

Laser Toning: 3 Key Points

Three Main Treatment Principles of Laser Toning

Laser toning is a treatment method aimed at controlling the overall process of melanin, from its production to its transport, rather than simply removing pigment.

1. Removal of Existing Pigment Particles

For other pigmented lesions, such as freckles or ABNOM (Acquired Bilateral Nevus of Ota-like Macules) rather than melasma, improvement can be expected by breaking down melanin through relatively strong treatment settings.

However, since melasma can react sensitively to stimulation, very careful energy control is required. Special attention must be paid to ensure that unnecessary stimulation does not inadvertently activate melanocytes.

2. Inhibition of Melanosome Transport by Damaging Dendrites (Sheaths)

It prevents melanosomes produced in pigment cells from being transported to the epidermal layer of the skin, thereby inhibiting the formation of new pigmentation.

3. Direct Destruction of Melanin within Melanocytes

The laser directly breaks down the melanin pigment accumulated within melanocytes, reducing melanin concentration. Through this, an overall improvement in skin tone can be expected.

Laser Toning Effects

• 1. Skin Tone Improvement Effect: Melanin pigment is gently broken down through subtle laser stimulation. This can help dull skin become brighter and more radiant overall.
• By selectively targeting melanosomes without stimulating melanocytes, it can help improve sensitive melasma and hyperpigmentation.
• With customized intensity that can reach ABNOM (Acquired Bilateral Nevus of Ota-like Macules) located deeper than melasma, you can expect improvement in dermal pigmentation.
• By destroying the dendritic processes, the main transport pathways for pigment, it helps suppress melanin from migrating to the epidermis and reduces pigment production.
• The laser stimulation promotes skin regeneration, refining skin texture and offering additional benefits such as the softening of fine lines.
• By irradiating multiple times with low energy, we minimize skin burden, allowing for comfortable application even on sensitive skin types to help improve pigmentation.

Recommended for Laser Toning

• 1. Those with an overall dull and uneven skin tone.
• 2. Those who experience recurring or deepening pigmented lesions such as melasma, blemishes, and freckles.
• 3. Those with deep dermal pigmentation, such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules).
• 4. Those with thin or sensitive skin who are cautious about pigment treatment.
• 5. Those who desire both fine line reduction and skin texture refinement.
• 6. Those who wish to minimize skin irritation while consistently achieving skin improvements.

Laser Toning Procedure Steps

• STEP 1. We conduct a precise skin diagnosis using Mark-Vu to identify the depth and distribution of pigmentation that is difficult to confirm with the naked eye.
• STEP 2. Through a 1:1 consultation with the director, we establish a treatment plan tailored to your individual skin condition.
• STEP 3. We proceed with the laser toning treatment by setting customized parameters for each individual (final confirmation is made with the director while looking in the mirror before the treatment).
• STEP 4. We monitor the progress during the treatment using a mirror and meticulously re-check areas that require focused attention.
• STEP 5. After the treatment, we examine the skin condition with a mirror and provide detailed guidance on the post-treatment progress.

A Message from Our Head Director

Many patients often experience discomfort for a long time due to pigmentation issues like melasma or ABNOM.

We understand that you may also have significant worries and anxieties, thinking 'Will it truly get better?' or 'Will it get worse?'

Understanding the concerns of these patients, we prioritize an approach to pigment treatment that goes beyond mere mechanical procedures.

We adhere to the principle of personally examining each skin condition and performing treatments delicately and precisely, only as much as each patient truly needs.

Pigmented lesions require different approaches depending on their depth and the skin's sensitivity.

Laser toning is a procedure that should never be taken lightly, and we approach it with utmost care and effort to ensure patients experience satisfactory improvement.

Post-Treatment Precautions

• ㆍYou can wash your face and apply makeup from the day of the treatment, and it is crucial to apply sunscreen thoroughly.
• ㆍFor temporarily sensitized skin, it is recommended to provide ample soothing and moisturizing care.
• ㆍSwelling or redness may appear immediately after the treatment, but these typically subside naturally over time. If symptoms persist for several days, it is advisable to contact the clinic for guidance.