Particularly for chloasma and melasma the use of lightening creams associated with the use if sunscreens to prevent to prevent further pigmentation is helpful. We can offer an appropriate cream if over-the-counter preparations have not been helpful. We find that to achieve real benefit it needs to be combined with medical microdermabrasion.
Vitamin A creams also give an additive benefit. See an alternative under the Dual Yellow laser heading.
For chloasma and melasma this can be used alone or in combination with a lightening cream. The combination carries the benefit of the increased penetration the cream has to the pigmented area as the upper cornified layers are removed by the process. Resolution is greatly enhanced. People that have not responded to the cream notice it becomes very effective.
Microdermabrasion alone can be quite useful in reducing the pigmentation. See an alternative in the Dual Yellow laser heading.
Xeo Cool Glide NdYAG Laser
The Xeo Cool Glide NdYAG 1064nm laser gives some excellent results in pigmentation reduction. Using the low energy, very short pulses, with high repetitions in the Genesis programme, excessive pigment areas can be broken down very well especially in people with more olive to darker skins. A series of sessions is required.
Xeo Cool Glide OPS 600 Head
The OPS 600 Intelligent Pulsed Light source on the Xeo Cool Glide platform will reduce pigment problems especially of the types related to freckles and lentigos (which are larger pigmented areas). Usually about three sessions each several weeks apart will cause significant lightening. The darkest lesions reduce first, and lighter ones with each successive treatment.
Some people have elected to have more treatments to produce even greater overall evenness.
After each treatment the brown areas appear darker and remain that way until the skin turns over. This is about a week on the face and around three weeks on other body areas. Once this occurs the next treatment can take place.
The Dual Yellow Laser
Particularly for the more raised pigmented lesions such as seborrhoeic keratoses and moles this works very well. Flat pigmented lesions work well.
And to restore an even skin colour a scanning treatment on the dual yellow is very effective. In one, and sometimes two, sessions this can produce a dramatic lightening. Again the treated areas become quite dark over the first one to three weeks while they are turned over. In scanning with the Dual Yellow laser there is the added benefit it will treat background redness.
The raised lesions are treated by the more ablative powers of the the combined green 511nm and yellow 578nm lights, although the green light can be used alone. It can be used without anaesthetic but tends to be a more slow process. By numbing the area, the lesion can be rapidly vapourised, leaving a flat slightly dark area that sheds usually leaving a slightly pink base until it reorganises and assumes the surrounding skin colour. The green light can be used to treat flat brown lesions effectively.
Melasma can be quite effectively treated with a new protocol with the Dual Yellow laser. It requires about four sessions. But it can result in some long term control which is very helpful.
This radiofrequency based cautery type apparatus can quickly slice off a raised lesion or other problem. The base usually tends to be weepy for a few days as it reforms. At Springdale we tend to reserve it for some special applications.
Treatments Used Elsewhere
These have been used quite effectively. The difficulty with them at times is they can be unpredictable in effect. Some will create uneven peeling or deeper peels which can result in uneven pigmentation results. Different skins react differently to each agent. And predicting which person will react a certain way is difficult until a treatment is finished.
Cautery and Curettage
For seborrhoeic keratoses, this is a useful means. It can be done by electrocautery, radiofrequency ablation, cryocautery with liquid nitrogen, or laser. Care needs to be exercised with the heat (and cold) generated by these procedures to ensure the deeper tissues are not damaged affecting the underlying normal skin pigmentation, or even causing scarring.