A great effect for melasma with Pico Toning after generating ‘LIOB’
There are a lot of treatments in medical aesthetic clinics. This is because even if treatments seem to make similar effects, they are divided according to the device, product, and treatment method used. Regarding you can see as much as you know, I would like to make the representative aesthetic treatments that is confusing clear. Following laser toning and IPL previously discussed, this time I will discuss about ‘Pico Toning’. The second interviewee is Dr. Seung Choi, the founder of CL clinic, who is using PicoWay of Candela. Let’s talk about how to use Pico Toning from Dr. Choi.
When the picosecond laser launched, many doctors expected that pigment treatment would make a huge leap forward. Especially, there was much anticipation that the picosecond laser will be able to make an excellent pigment treatment effect that is differentiated from the nanosecond(ns) laser. However, there are a lot of doctors who are using nanosecond laser instead of picosecond, especially for melasma treatment, because picosecond laser is expensive and is needed more confidence in the treatment. Melasma easily causes side effects such as pigmentation when it treated incorrectly. If you repeatedly treat melasma several times with laser toning using a nanosecond laser, there is no major irritation, and the probability of side effects is low. Even though that, Dr. Seung Choi said that it is better to use a picosecond laser to treat melasma.
“When you treat melasma with nanosecond laser toning, it might be safe, but it is difficult to improve the melasma beyond a certain limit. I think that pico toning would be better if only one of laser toning and pico toning could treat melasma. A picosecond laser with a short pulse duration is advantageous for removing pigments in cells without damaging normal cells.”
Dr. Seung Choi is using pico toning with the ‘Zoom handpiece’ and ‘Fractional handpiece’ that splits one laser beam into several small beams to treat melasma. When using the fractional handpiece of pico laser, the ‘LIOB(Laser Induced Optical Breakdown)’ phenomenon occurs, which creates a microscopic space by instantaneously generating plasma in the deep layers of the skin without damaging the outer surface of the skin. It can make a good effect on the treatment of melasma.
Dr. Seung Choi explained, “I treat melasma by using fractional handpiece of pico laser and then treat pico toning. Melasma is most distributed in the basal layer, which is the lowest layer of the epidermis, and if microscopic holes are made densely using LIOB and then pico toning is performed, the laser beam can penetrate deeply.” There were melasma that did not disappear for about a year or six months, and it showed an excellent effect on those melasma. In some cases, 80 to 90% of the melasma disappear after three treatments. If this method is used well, I think the treatment period for melasma can be shortened.”
The one that Dr. Choi uses together with the pico laser is the vascular laser. In many cases, telangiectasia appears in spots where melasma appear. Although the exact mechanism has not been elucidated, it is believed that melasma and vascular indication appear at the same time because melanocytes are stimulated and pigmented when blood vessels develop. In other words, after melasma treatment, the capillaries must be well removed with a vascular laser to keep the skin clean and reduce the chance of the melasma reoccurring.
Dr. Choi emphasizes that for the treatment of melasma to develop in the future, more aggressive methods must be implemented.
“When the laser toning was first applied to the treatment of melasma, it was very innovative, but I think that s more aggressive method should be used for the development of melasma treatment in the future. In the past, there were technical difficulties, but with the advent of the pico laser, the technical difficulties were solved to some extent. Now I think I should try something else. For fear of problems, you may miss out on what you can achieve if you only look for a safe way. If I can control the side effects well, I think I can try it.”