Reduced Pain and Recovery Burden! Laser Toning

Features of Oriental Medical Clinic Laser Toning

• At our oriental medical clinic, we precisely use sufficient laser energy of over 2,000 shots for effective improvement while minimizing skin irritation. During the procedure, we take a meticulous approach, not rushing with low power or a small number of shots.
• Various types of pigmentation such as melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and blemishes show different characteristics and depths within the skin. At our oriental medical clinic, the director directly adjusts the laser intensity according to the type and depth of the pigmentation. For instance, a gentle approach is used for melasma, while a stronger intensity is applied for ABNOM, performing the procedure through customized parameter adjustments for each area.
• Laser treatment is not simply a process of firing a laser. During the procedure, the director personally observes the skin's reaction closely with a mirror, adjusting the spot size, laser intensity, and handpiece in real-time according to the situation. This carefully prepared 1:1 customized treatment focuses on improving pigmentation issues beyond mere superficial toning.
• We don't rely solely on visual diagnosis. We utilize the Mark-Vu diagnostic device to objectively measure the type, distribution pattern, and depth of pigmentation. Based on these precise diagnostic results, we establish a suitable treatment plan for each patient.
• In cases of complex pigmented lesions where melasma and ABNOM appear simultaneously, treating only one type of pigmentation aggressively can exacerbate the symptoms. At our oriental medical clinic, we first go through a phase of stabilizing and soothing melasma. Subsequently, we devise a treatment plan that gradually approaches and targets ABNOM located in the dermis.

What Makes Our Oriental Medical Clinic Laser Toning Different

Laser toning is a widely used procedure for managing various pigmented conditions. However, treatment results can vary individually depending on the type of equipment chosen, the number of shots, and the intensity applied.

Various pigmented conditions such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) differ in their depth within the skin and the response of each tissue. Therefore, precise planning before treatment is crucial.

1. Sufficient Energy Usage with Over 2,000 Shots

Many medical research papers report that low-fluence laser toning shows relatively stable yet significant improvement with 1,500 to 2,500 shots.

At our oriental medical clinic, we typically use sufficient energy of over 2,000 shots. This method is a planned approach designed to minimize unnecessary skin irritation while achieving the desired treatment response.

Simply operating a laser device alone may not be enough to expect skin improvement.

The depth of pigmentation, its distribution pattern, and each patient's skin sensitivity must be carefully considered. Taking these various factors into account, various elements such as the number of shots, output intensity, laser irradiation speed, and spot size must be precisely adjusted.

2. Customized Toning According to Disease Type

1) Melasma Management

Melasma is known as one of the representative pigmented conditions that primarily occur on both sides of the face.

Since melanin-producing melanocytes are excessively activated, external stimuli can potentially worsen melasma symptoms.

At our oriental medical clinic, we use a Mark-Vu precise skin diagnostic device to accurately identify the distribution pattern and depth of melasma. Based on this information, we carefully begin treatment using a toning laser with short pulses of 5 nanoseconds.

We take care to avoid stimulating melanocytes as much as possible, using a method that selectively destroys only the melanosomes within the cells. Through this, we strive to reduce the possibility of side effects that may occur after treatment.

Even during the procedure, the director personally checks the patient's skin reaction carefully with a mirror. They meticulously adjust the laser intensity and the area where energy will be concentrated. To enable precise treatment without missing specific areas, they may change the handpiece or finely adjust laser parameter settings.

We proceed with treatment by checking the patient's skin condition together with them in a mirror at each stage: before, during, and after the procedure.

2) ABNOM (Acquired Bilateral Nevus of Ota-like Macules) Treatment

ABNOM, like melasma, involves pigmentation located in the dermis. However, compared to melasma, it typically requires relatively stronger laser energy.

If melasma and ABNOM are present together, there are times when melasma requires a gentle approach, while ABNOM requires a strong one. The delicate and skilled treatment capability to apply such contrasting treatment methods simultaneously is extremely important.

It is crucial to keep in mind that if high-intensity treatment is started immediately without first stably managing melasma, there is a possibility that existing melasma symptoms may worsen.

At our oriental medical clinic, we establish a personalized treatment plan through accurate diagnosis before the procedure. This allows us to delicately customize laser intensity to reduce the risk of side effects while simultaneously improving ABNOM symptoms.

For ABNOM treatment as well, the director personally handles the laser parameter settings based on Mark-Vu diagnostic results. Various elements such as spot size, repetition rate, and laser output are meticulously adjusted to suit each patient's skin characteristics during the procedure.

3) Other Pigmented Lesions

Pigments that respond relatively quickly to laser, such as lentigines, freckles, and blemishes, can expect improvement with appropriate wavelengths. However, when accompanied by melasma or ABNOM, an even more cautious approach to treatment is required.

In such complex cases, not only accurate diagnosis but also careful checking of the skin condition with a mirror during each treatment session is necessary. This means a delicate, customized strategy, including output intensity and laser handpiece adjustment, is required. At our oriental medical clinic, it's best to understand our approach not as standardized laser toning, but rather as meticulously customized melanin pigmentation management personally conducted by the director.

Pico Toning vs. Laser Toning: What's the Difference?

Pico toning has the theoretical advantage of being able to break down pigment particles more finely using extremely short laser pulses in picosecond units.

On the other hand, laser toning uses nanosecond-unit pulses, delivering energy to the skin for a relatively longer duration compared to pico toning.

Both toning methods can be utilized to selectively target melanin pigment, improve skin tone, and ameliorate various pigmented lesions such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to the difference in laser irradiation time, pico toning may show a faster response in the initial 2-3 sessions. However, reports suggest that both methods can achieve similar whitening effects when consistently treated for 10 or more sessions.

Laser toning is a treatment method that has been clinically validated for nearly 20 years. It is known to be a relatively stable option, especially for sensitive skin or skin prone to irritation like melasma.

Pico toning is characterized by delivering powerful energy in a short period, and rarely, patients may experience temporary redness or a stinging sensation.

Analyzing various clinical research data, when compared based on the same wavelength of 1064nm, consistent reports indicate that both pico toning and laser toning show no significant differences in improving skin tone brightness, reducing melasma indices, and decreasing melanin levels.

In conclusion, to achieve satisfactory results with laser toning treatment, a delicate and precise approach is paramount.

For overall skin improvement, it is known to be important to receive consistent treatments 10 times or more.

While observing the skin's reaction, energy should be appropriately adjusted between 1.0 and 2.0 J/cm².

During treatment, sufficient laser irradiation of at least 2,000 shots is recommended.

Maintaining a consistent treatment interval of about 1-2 weeks can lead to cumulative effects. If the interval becomes too long, it may be difficult to achieve the desired level of improvement.

It is recommended to receive treatment from medical staff who can adjust laser energy in real-time according to individual skin type and reactions during treatment.

If treatments are performed according to the conditions mentioned above, various research indicates that an improvement similar to picotoning can be expected.

This content was written based on several research papers.

For example, the Medicina (Kaunas) 2022 paper, the Lasers in Medical Science 2021 paper, and the Journal of Cosmetic and Laser Therapy 2021 paper were referenced.

Laser Toning: What is it?

Laser toning is a treatment that repeatedly delivers low-energy laser light deep into the skin to gradually break down pigments and evenly improve skin tone.

Unlike traditional treatments that remove pigments immediately with strong energy, laser toning repeatedly applies subtle stimulation to gradually break down melanin. This process can also aid in skin regeneration.

While minimizing skin irritation, it can be applied to various pigmentary conditions such as melasma, freckles, and acquired dermal melanocytosis. It is currently one of the most sought-after methods for pigment improvement.

1. Main type of laser used: Q-switched Nd:YAG

When performing laser toning, a Q-switched Nd:YAG laser is primarily used.

The 1064nm wavelength of this laser can reach the upper dermis, where melanin pigment is primarily located. This characteristic allows it to selectively target and destroy pigments without causing significant stress to the skin surface.

Because it can focus on pigment removal while protecting the skin barrier, it can be applied relatively comfortably even to sensitive or thin skin types.

2. Low-energy, high-repetition stimulation to brighten skin tone

While most pigment treatments opt for an approach that uses high energy to eliminate pigments in one go, laser toning uses a method of repeatedly delivering low-energy laser pulses multiple times.

This treatment method helps reduce the burden on skin tissue while gradually breaking down melanin particles into very small pieces. The broken-down melanin is then processed by our body's immune system, specifically macrophages, to be expelled from the body.

As a result, a gradual and even improvement in skin tone, leading to a clearer complexion, can be expected.

3. Destruction of melanocyte dendrites and removal of intracellular melanin

Laser toning goes beyond simply removing pigments; it also serves to regulate the very pathway by which melanin is produced.

At the core of this regulatory mechanism is the principle of destroying melanocyte dendrites.

Dendrites are crucial pathways that transport melanosomes, produced by melanin-generating cells (melanocytes), to the outer epidermal layer of the skin.

If these dendrites are damaged by laser irradiation, the process of melanin carriers moving to the outside of the skin can be inhibited. This may contribute to preventing excessive accumulation of pigment on the skin surface.

Furthermore, by directly breaking down melanin pigment already accumulated within melanocytes, it can help improve existing hyperpigmentation.

Such actions are mainly observed in laser devices with short pulse durations, in nanosecond or picosecond ranges.

In conclusion, it can be said to be one of the important principles of action in treatments such as laser toning or picotoning.

3 Main Principles of Laser Toning

The three main principles by which laser toning works are as follows:

Laser toning is a treatment method that not only removes melanin pigment but also helps regulate the entire process of melanin production and migration.

1. Removal of already formed pigment particles

In pigmentary conditions other than melasma, such as freckles or acquired dermal melanocytosis, improvement can be expected by removing melanin using appropriately adjusted treatment settings.

However, melasma is characterized by its sensitive reaction to stimulation, requiring more delicate energy control during treatment. Special care must be taken to prevent melanocytes from becoming excessively activated due to unnecessary stimulation.

2. Inhibition of melanosome transport through destruction of melanocyte dendrites

By inhibiting the process of melanosomes, produced by melanin-forming cells, from moving to the epidermal layer of the skin, it may contribute to proactively reducing the occurrence of hyperpigmentation.

3. Direct destruction of melanin accumulated within melanocytes

Laser energy directly breaks down melanin pigment present within melanin-forming cells (melanocytes), helping to reduce the overall concentration of melanin. This can ultimately contribute to brightening the skin tone.

Expected Effects of Laser Toning

• 1. Overall skin tone brightening effect: Subtle laser stimulation can alleviate melanin pigment, contributing to a gradual clarification of an overall dull-looking skin tone.
• It can contribute to reducing pigmentation such as melasma. By selectively acting only on melanosomes without overstimulating melanocytes, it can help improve melasma in sensitive skin.
• It aims to improve Acquired Bilateral Nevus of Ota-like Macules (ABNOM). The intensity is adjusted to be suitable for pigmentation located deeper than melasma, and it can help lighten dermal pigmentation.
• The focus is on blocking the pathways where melanin is produced, reducing its outward movement, and suppressing the excessive recurrence of pigmentation. This process can help reduce the recurrence of hyperpigmentation.
• It also helps promote skin recovery, contributing to an overall improvement in skin texture. Additionally, you can expect results such as the improvement of fine lines and a smoother skin texture.
• This is a treatment technique that minimizes irritation to the skin. Since it involves multiple irradiations with low energy, the burden on the skin is relatively low. Thanks to this, even those with sensitive skin can receive the treatment more comfortably.

Recommended Candidates for Laser Toning

• 1. Individuals who desire improvement due to dull or uneven skin tone across the entire face
• 2. Individuals experiencing recurring or worsening pigmented lesions such as melasma, blemishes, and freckles
• 3. Individuals with pigmentation located deep in the dermal layer of the skin, such as Acquired Bilateral Nevus of Ota-like Macules (ABNOM)
• 4. Individuals whose thin and sensitive skin characteristics require a cautious approach to pigmentation management
• 5. Individuals interested in addressing fine lines or improving skin texture in addition to pigmentation issues
• 6. Individuals who desire gradual improvement without putting a burden on their skin

Laser Toning Treatment Process

• STEP 1. A precise skin diagnosis is performed using Mark-Vu equipment. The depth and distribution area of pigmentation, which are difficult to see with the naked eye, are carefully examined.
• STEP 2. A personalized treatment plan is established for each patient through a 1:1 in-depth consultation with the medical staff.
• STEP 3. After setting the optimal parameters for each patient, the laser toning treatment begins. Immediately before the treatment, the patient and medical staff reconfirm the treatment area using a mirror.
• STEP 4. During the treatment, we continue to look in the mirror with the patient, carefully checking areas that require intensive care.
• STEP 5. After the treatment, we show the patient the changed appearance through the mirror and provide detailed explanations about future care methods and expected progress.

A Message from Our Head Director

We understand that many patients have long experienced discomfort due to pigmented diseases such as melasma or Acquired Bilateral Nevus of Ota-like Macules (ABNOM).

You may experience various anxieties, such as whether improvement is truly possible, or if pigmentation might worsen after treatment.

Therefore, our medical team does not simply limit pigment treatment to machine operation;

We consider thoroughly analyzing the patient's skin condition and carefully delivering the precise energy needed for each area as a crucial principle of our practice.

Since the depth of pigmentation and skin sensitivity vary for each individual, a customized approach is extremely important.

Laser toning is a procedure that requires a cautious approach. We have established a systematic treatment system for the satisfactory improvement our patients expect, and we always strive to deliver the best results.

Precautions After Treatment

• ㆍYou can wash your face and apply makeup from the day of the treatment. It is especially important to pay close attention to UV protection.
• ㆍSince the skin may become temporarily sensitive after treatment, we urge you to pay special attention to soothing care and moisturizing.
• ㆍSwelling or redness may occur after the treatment, but most often, these symptoms gradually subside over time. If these symptoms persist for more than a few days, it is advisable to visit the clinic for a consultation.