Treating pigmented lesions is the second most popular cosmetic laser procedure at Dr. Battle’s practice.
“At my practice, we call it “complexion blending,” which helps to eliminate unwanted dark spots to even out the patient’s skin color and tone,” Dr. Battle says. “Its popularity is approaching hair removal because our dark spots can originate from anything: hormonal issues like melasma to acne to any form of scar or injury to the skin.”
The safest lasers and devices to treat pigmented lesions on skin of color are low-fluence, high hertz, microsecond Nd:YAG lasers, according to Dr. Battle.
“I personally like Cutera, Cynosure and Quanta,” he says. For low-energy, low-density fractional lasers, his favorites are Solta’s Fraxel and Clear and Brilliant Primea, and Palomar’s Icon and low-fluence Q-switched lasers.
Like with hair removal, treating patients for pigmented lesions requires multiple treatments of about four to eight sessions at four to six week intervals.
Dr. Battle combines a top-down approach by using products and prescriptions, including bleaching creams and chemical peels with lasers. “We are not trying to blast the dark spots away, but just gently nudging the spots, which is why the parameters we use involve low-fluence, low energy and low density,” Dr. Battle said.
One of the exciting new approaches of treating pigmented lesions is using a low-fluence Q-switch laser, either an Nd:YAG or an Alexandrite in the picosecond pulse-duration mode. Options include PicoSure (by Cynosure), Enlighten (by Cutera), Picoway (by Syneron) and Discovery Pico Plus (by Quanta).
“There is still a need for the nanosecond laser, however,” Dr. Battle says. “But the picosecond appears to provide us with increased safety in treating skin of color.”