Indications of Laser Treatment for Pigmentary Disorders (For Professionals)

Indications of Laser Treatment (For Professionals)

Indications according to pathology:

• Freckles (Ephelides)

1. 1st choice: IPL (intense pulsed light)
2. 2nd choice: Pigmentary laser (532nm). It is important to know that this wavelength carries a higher risk of postinflammatory hyperpigmentation, but that the risk of scarring is very low.

• Lentigenes / Solar Lentigo

1. 1st choice: pigmentary laser
2. 2nd choice: IPL

• Chloasma (melasma) (Pregnancy Mask)

1. Topicals then IPL. No other treatment gives spectacular results (the 532nm pigmentary laser for instance does not work)
2. The usage of the pigmentary laser at a 1064nm wavelength can induce guttate hypomelanosis
3. Treatments that are initally ineffective can then respond to constant fluences but with an increase of the pulse duration (20ms). However an increase in fluences can darken the lesions.

• Hori’s Nevus

1. Pigmentary laser at a wavelength of 1064nm
2. IPL and pigmentary laser at a wavelength of 532nm are quite inefficient

• Scars

1. Fractionated Laser
2. IPL and pigmentary laser are rather ineffective

• Tattoos

1. The pigmentary laser at a wavelength of 1064nm is useful for the removal of black colour (not green)
2. The pigmentary laser at a wavelength of 532nm is useful for the removal of red colour
3. The alexandrite laser (755nm) is useful for the removal of green colour (but it doesn’t always work)

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source. Dr CHUA Sze Hon. Pitfalls and Complications in Laser Surgery – My Experience