Skin hyperpigmentation is usually caused by excess production and clumping of the skin pigment ′melanin′ with the appearance of darker brown or even black spots on the skin. Pigmented lesions can be classified either based on
location of pigment as epidermal and dermal (superficial or deep)
causes such as nevoid, hereditary,
acquired - drug induced, post inflammatory, hormonal, etc.
Treatment depends on the underlying cause. Various topical applications, chemical peels, microdermabrasion, etc., have been used with variable benefits. However, lesions like nevus, tattoos, freckles, etc., are not amenable to the above treatment line.
This resulted in a search for an ideal laser/light system to target skin melanin without damaging the surrounding skin effectively. Twenty years of laser dermatology improvements have resulted in the invention of Q switched ND YAG laser, which only targets the melanin (dark pigmented areas) without targeting the surrounding normal skin.
What Is Q Switching?
A laser can either deliver energy in a continuous form or a pulsed form when the laser provides high-intensity power in pulses. It's known as q switching. These pulses can be milliseconds long or nanoseconds long. Q switched ND YAG lasers are nanoseconds long (3 to 7 nanoseconds in length).
What is the advantage of Q switching?
Due to this Q switching technique, only the pigmented areas are targeted instead of the surrounding normal skin, thus minimizing the damage.
Clinical Applications
Whether superficial or deep, acquired or congenital, most pigmentary skin lesions can be treated with Q-switched lasers.
Tattoos: both professional and amateur tattoos can be removed via Q switched ND YAG lasers.
wrinkles and acne scars
Q-switched NdYAG laser 1064 nm offers a new technology that helps treat scars and wrinkles at their root, deep in the skin. Using laser energy that penetrates deeply without injuring the top layer of skin, the deep dermis is stimulated to produce natural collagen and other vital proteins that make up healthy, youthful skin. Painlessly done in less than 20 minutes, you′ll leave with only mild redness that will fade within a few hours. After 3-6 treatments, done at monthly intervals, wrinkles soften, and skin gets toned. Hence it is also referred to as laser skin toning. This is a good option for improving acne scars, wrinkles, and stretch marks without complicated procedures and long recovery times.
Laser-assisted hair reduction
It can be safely done for fine hair as well as terminal hair in all skin types.
Vascular lesions
vascular lesions like telangiectasia, cherry angiomas, and small spider nevi can be treated. More than one treatment could be required.
Dark lips
Dark lips are a common cosmetic concern in India. Two to four sessions of Q-switched is an effective treatment for lip lightening.
Combination Treatments
I prefer to combine the laser treatment with chemical peels, micro-needling, and other topical medications for faster resolution.
In some acne scars, wrinkling etc- micro needling with radio frequency or fractional CO2 laser can also be used.