It is common to equate pigment treatment to laser and vice versa. Some say that the laser is a wonder treatment for all pigmentation woes while others discourage and even curse the laser for worsening existing pigmentation.
While it is certainly not advisable to wait for a miraculous cure by itself, it is advisable to explore all possible options and know what is best for your condition.
What is laser?
A laser is a device that produces an intense beam of coherent light. It comes with many different wavelengths to target different molecules or tissues.
Besides treating or improving the skin, it is used in other surgeries for cutting purposes and is also used to rectify eye refractive errors.
There are many types of lasers in the market to cater for the different uses.
For pigmentation, the most widely used laser is the Q-switch Nd:Yag laser. Other effective lasers include CO2, erbium:yag, ruby, thullium, and alexandrite.
How does laser work against pigmentation?
Melanin is the pigment molecule that is responsible for pigmentation disorders.
Lasers work by delivering an intense beam of light that specifically targets melanin. This light is then absorbed and converted into heat, which either disperses the group of melanin cells or destroys the skin cells carrying the pigment molecule.
What are the side effects of pigment laser?
All treatment comes with a list of possible side effects. For pigment laser, there is a possibility that the patch undergoing treatment becomes darker (or even lighter) than the surrounding skin.
Adequate sun protection, including the frequent use of sunblock, reduces the probability of developing darker patches.
Fortunately, most of the time, when the skin becomes darker, it is often not permanent and tends to resolve in three to four months.
When the skin becomes lighter, it may be permanent for some patients. Occasionally, the skin may blister or turn crusty.
Are lasers more effective?
Are lasers always more effective than other treatments?
This depends on the cause of the pigmentation. Some conditions respond better with creams or chemical peels whilst others respond better with laser.
You have to juggle between the risks and benefits of each treatment.
Lightening cream also has its side-effects.
Conditions that respond better with lasers are freckles, hori's nevus, naevus of Ota, solar lentigo and lentigines.
Conditions such as melasma are better treated with creams and chemical peels.
In cases where there is no response to creams, lasers can then play a role in treatment.
More importantly, prevention of new pigment spots is very important during the course of treatment.
Adequate sun protection is essential. The use of a sunblock that protects against UVA and UVB with SPF of 30 or more is essential.
As sunblock tends to stay on the skin for only three to four hours, it is advisable to reapply sunblock frequently.
Now that I know about lasers, who should I consult to determine if using laser is a suitable treatment for my condition?
It is very important to get the correct diagnosis before deciding on the best treatment option. The best people to consult are dermatologists.
You can also consult your general practitioner on this issue. When your problem is more complicated, they will be able to advise and direct you to a dermatologist.
In short, lasers are not always the answer to pigmentation. However, when used correctly, it can curb the woes of many patients with hyperpigmentation.
Dr Irene Lee Chew Kek is a consultant dermatologist.