[Results-Changing] Laser Toning

Principles of Laser Toning Treatment in a Traditional Korean Medicine Clinic

• Laser toning treatments typically use energy equivalent to more than 2,000 shots. We do not insist on low output or insufficient shot counts to avoid excessive irritation to the skin. Our goal is to carefully adjust the energy for stable treatment, reducing the burden on your skin.
• Each pigmented lesion has unique characteristics depending on its depth and type within the skin. We meticulously analyze the location and characteristics of various pigments such as melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and freckles within the skin. Based on this diagnostic result, the intensity of the laser treatment is adjusted to suit the individual's lesion characteristics. For example, for melasma, the treatment is planned in a way that reduces irritation, while for ABNOM, higher energy is applied cautiously.
• During the treatment, we observe the skin's reaction closely with the patient using a mirror. We immediately adjust the laser spot size, energy intensity, and handpiece type as needed, according to the situation. We expect that such delicate treatment, tailored to individual skin conditions, can bring about better improvement.
• To more accurately identify the characteristics of pigmentation, we use a Mark-Vu diagnostic device. This device allows us to analyze in detail the type of pigment, its distribution within the skin, and its depth of deposition, which are difficult to observe with the naked eye. Based on this precise diagnostic information, we create a suitable treatment plan for each patient.
• In complex cases where various pigmented lesions appear simultaneously, a phased treatment plan is necessary. For example, when melasma and ABNOM are present together, concentrating strong energy on only one specific lesion could potentially worsen the other. Therefore, treatment can proceed by first stabilizing the melasma, then carefully treating ABNOM located in the dermal layer.

Characteristics of Laser Toning Treatment at a Traditional Korean Medicine Clinic

Laser toning is a treatment that can contribute to the improvement of various pigmentary disorders. However, individual results may vary depending on the type of equipment used, the number of shots delivered during the treatment, and the method of energy intensity adjustment.

Various pigmentary disorders such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) have different depths of skin deposition and tissue responses. Therefore, it is necessary to establish a detailed treatment plan that carefully considers the unique characteristics of each lesion.

1. We apply laser energy with over 2,000 shots

According to some research, low-fluence laser toning has shown relatively stable results within the range of 1500 to 2500 shots.

Generally, we use laser energy equivalent to more than 2,000 shots. This treatment method is designed to reduce skin irritation while aiming for pigment improvement.

Mechanically using laser equipment only according to a fixed manual may make it difficult to expect skin improvement.

It is necessary to comprehensively consider the depth and distribution range of pigmentation, as well as each patient's skin sensitivity. A process of finely adjusting various factors such as shot count, output intensity, pulse speed, and spot size is required.

2. We adjust toning according to the lesion type

1) Melasma Treatment

Melasma is a relatively common pigmentary disorder that is widely distributed on both sides of the face.

Since it is a condition where melanocytes, which produce melanin pigment, are overly active, strong irritation could potentially worsen the symptoms.

We use the Mark-Vu diagnostic device to precisely confirm the extent of melasma and its depth of deposition within the skin. Based on these diagnostic results, we perform treatment using a toning laser with a short pulse width of 5 nanoseconds (ns).

We approach this by selectively destroying only melanosomes within the cells, without directly stimulating melanocytes. This treatment method can help lower the possibility of potential side effects.

During the treatment, we carefully observe the skin's reaction with the patient using a mirror. We adjust the laser intensity or focus area as needed, and sometimes change handpieces or finely tune treatment parameters to ensure all areas are treated evenly.

Throughout the entire treatment process, we monitor skin changes with the patient by looking in a mirror.

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

ABNOM, like melasma, is a condition where pigment is deposited in the dermal layer. However, during treatment, a higher energy intensity is often required than for melasma.

In complex cases where melasma and ABNOM coexist, a delicate treatment plan is essential. This is because relatively gentle energy must be applied to melasma, while higher energy is needed for ABNOM.

If high-intensity treatment is performed focusing only on ABNOM without prior consideration for melasma, there is a possibility that melasma lesions could worsen.

Before treatment, we create a suitable treatment plan for each patient based on precise differential diagnosis. Through this process, we reduce the possibility of side effects and carefully adjust and apply energy intensity to help improve ABNOM lesions.

ABNOM treatment is also precisely differentiated with Mark-Vu diagnosis, and then suitable treatment parameters are determined for the patient. We carefully consider the patient's skin type and finely adjust parameters such as laser spot size, number of repeat irradiations, and output intensity during treatment.

3) Other Pigmented Lesions

Pigments that react relatively quickly, such as lentigines, freckles, and general spots, can expect improvement when an appropriate wavelength laser is used. However, if these lesions are present along with melasma or ABNOM, the treatment process can become more complex.

In such cases with complex pigment patterns, accurate differential diagnosis is absolutely necessary. A delicate approach is required, such as checking the skin condition with the patient and a mirror during each treatment, and adjusting the output or laser handpiece. We focus on treatments that manage melanin pigment tailored to each patient's specific lesion characteristics.

Differences between Pico Toning and Laser Toning

Pico toning has the characteristic of being able to finely break down pigment particles using very short laser pulses in picosecond units.

In contrast, laser toning uses nanosecond unit pulses, delivering laser energy to the skin over a relatively longer period of time.

Both of these toning treatments can selectively destroy melanin pigment to contribute to skin tone improvement. They can be applied to various pigmentary disorders, including melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to the difference in laser irradiation time, pico toning may show a somewhat faster response during the initial 2-3 sessions. However, it is known that if treatments are consistently received 10 times or more, both methods can expect similar levels of whitening improvement.

Laser toning is a treatment method whose efficacy has been confirmed in clinical practice for about 20 years. It can be a relatively stable option, especially for those with sensitive skin or pigmentary disorders sensitive to irritation, such as melasma.

Pico toning is characterized by delivering high energy in a very short time. Due to this, temporary redness or a slight stinging sensation may occur after treatment.

Clinical study results comparing the two treatments based on the same 1064nm wavelength also report that no significant differences were found in various evaluation indicators such as skin brightness improvement, reduction in melasma severity, and decrease in melanin index.

To expect effects comparable to pico toning with laser toning, it is necessary to

Consistent, repeated treatments are considered for satisfactory results.

Laser energy will be delicately adjusted within the range of 1.0 to 2.0 J/cm², while closely observing the individual's skin condition and reaction.

Generally, better treatment results can be expected with over 2000 shots.

It is recommended to visit at intervals of approximately 1 to 2 weeks to accumulate treatment effects. This is because longer intervals may reduce the cumulative treatment effects.

It is recommended to receive treatment from medical staff who can adjust treatment conditions in real-time, according to the individual patient's skin characteristics and reactions observed during the procedure.

If these treatment conditions are met, improvements comparable to Pico Toning can be expected, as demonstrated in numerous academic studies.

All content provided for understanding is based on academic research papers.

Related academic research includes papers such as Medicina (Kaunas, 2022), Lasers in Medical Science (2021), and Journal of Cosmetic and Laser Therapy (2021).

Laser Toning: What Kind of Treatment Is It?

Laser toning repeatedly delivers low-intensity laser energy to deep areas of the skin. This treatment gradually alleviates pigmentation and evens out overall skin tone.

It differs from past methods that directly removed pigmentation using high-energy approaches. This treatment utilizes the principle of continuously providing subtle stimulation to gently break down melanin and induce skin activation.

Laser toning has the advantage of being relatively gentle on the skin, making it suitable for various pigmented lesions such as melasma, freckles, and acquired bilateral nevus of Ota-like macules (ABNOM). It is currently one of the most frequently chosen methods for pigmentation management.

1. Commonly Used Laser Device: Q-switched Nd:YAG

Q-switched Nd:YAG laser equipment is primarily used for laser toning treatments.

This laser utilizes a 1064nm wavelength to penetrate the upper dermis where melanin pigment is primarily distributed. It can contribute to lesion improvement by acting intensively on pigment alone, without causing significant irritation to the skin surface.

This laser is designed to improve pigmented lesions while maintaining the health of the skin barrier. Therefore, it can be applied relatively gently even to sensitive or thin skin.

2. Inducing Repeated 'Skin Tone Improvement' with Low Energy

In the past, some pigment treatments tended to remove pigmentation all at once with high-intensity lasers. However, laser toning utilizes a method of repeatedly irradiating with low-energy lasers over several sessions.

This treatment minimizes the burden on skin tissue while gradually and subtly destroying melanin particles. These broken-down particles are then naturally processed by the body's immune system, specifically macrophages, and are helped to be expelled from the body.

Consequently, after the treatment, you can expect a change where the overall skin tone becomes more even and clear.

3. Melanin Regulation within Melanocytes through Dendrite Damage

Laser toning not only breaks down existing pigment but can also influence and help regulate the melanin production process itself.

One of the main mechanisms of this treatment is to stimulate the dendrites of melanocytes, causing damage.

Mature melanosomes (melanin-carrying organelles) produced in melanocytes travel through dendrites to the epidermis, the outermost layer of the skin.

When laser energy acts on the dendrites and breaks this connection, it can hinder the process of melanin carriers moving to the epidermis. Consequently, this can contribute to reducing the appearance of pigmentation on the skin surface.

In addition, it can directly break down melanin pigment accumulated within melanocytes, which can help improve existing pigmentation.

These mechanisms are primarily observed in lasers with short pulse durations, such as nanosecond or picosecond lasers.

Therefore, this can be understood as one of the core mechanisms of treatments like laser toning or Pico toning.

Three Main Mechanisms of Laser Toning

The effects of laser toning treatment on the skin can be explained through three main principles.

Laser toning is a treatment method that goes beyond simply removing pigment; it intervenes in the overall process of melanin production and migration, leading to positive effects on skin condition improvement.

1. Regulation of Existing Pigment Particles

Pigmentary conditions such as freckles and acquired bilateral nevus of Ota-like macules (ABNOM), other than melasma, can achieve positive results by managing melanin through appropriate adjustment of treatment conditions.

However, melasma tends to react sensitively to stimulation, requiring very delicate energy control. Special care must be taken to prevent excessive stimulation from activating melanocytes.

2. Inhibition of Melanosome Migration through Dendrite Damage

By inhibiting the movement of melanosomes, produced in melanocytes, to the epidermal layer, it can contribute to reducing the appearance of pigmentation.

3. Direct Regulation of Melanin within Melanocytes

By directly destroying melanin pigment within melanocytes, laser energy can reduce the amount of melanin, leading to positive effects on skin tone improvement.

Expected Changes After Laser Toning Treatment

• 1. Skin Tone Improvement: Through the process where subtle laser stimulation gently breaks down melanin, you can expect the overall dull skin tone to gradually become clearer and more even.
• While avoiding direct stimulation to melanocytes, we selectively target only melanosomes, which are the cause of pigmentation. This method can contribute to gently improving excessive pigmentation caused by sensitive melasma lesions.
• For pigmentary lesions located deep within the skin, such as Acquired Bilateral Nevus of Ota-like Macules (ABNOM), treatment is performed with precisely controlled energy, considering the individual's skin characteristics. By proceeding with such delicately customized energy, a gradual improvement in the condition of the lesion can be expected.
• We also manage dendrites, which are the pathways through which melanin pigment moves to the skin's surface. This approach reduces epidermal transfer of pigment, which can help prevent the recurrence of hyperpigmentation and lower the possibility of new pigment formation.
• Laser treatment induces skin revitalization, contributing to an overall even and refined skin texture. Furthermore, various improvements in skin condition, such as the reduction of fine lines, can also be expected.
• To minimize skin irritation, we use a method of repeatedly irradiating the laser with low energy multiple times. Thanks to this process, even those with sensitive skin can feel less burdened by the treatment and proceed relatively stably.

When Laser Toning Can Be Helpful

• 1. Individuals concerned about dull or uneven overall facial skin tone
• 2. Individuals who frequently develop various pigmentations such as melasma, blemishes, or freckles, or whose existing spots are gradually darkening
• 3. Individuals experiencing discomfort due to pigmentary lesions deep within the skin, such as Acquired Bilateral Nevus of Ota-like Macules (ABNOM)
• 4. Individuals with thin or sensitive skin who have hesitated to undergo pigment-related treatments
• 5. Individuals desiring overall skin condition improvement, including fine lines and skin texture, not just pigment issues
• 6. Individuals who prefer gradual changes without significant burden on their skin

Laser Toning Treatment Process Guide

• STEP 1. We thoroughly analyze the skin condition using Mark-Vu equipment to accurately identify the depth and distribution of pigments that are difficult to discern with the naked eye.
• STEP 2. After a private consultation with the medical team and receiving a thorough explanation, the most suitable treatment plan is established, considering the individual's skin condition and primary concerns.
• STEP 3. After precisely adjusting the laser parameters (variables) according to each individual's skin condition, the toning treatment begins. Immediately before the treatment, the medical team conducts a final review of the treatment plan with the patient while looking in a mirror.
• STEP 4. During the treatment, we continue to monitor the progress carefully with the patient using a mirror. If it is determined that additional energy is needed for a specific area, the energy is precisely adjusted, and the treatment continues.
• STEP 5. After the treatment is completed, we compare the before and after results together in a mirror. Afterwards, we thoroughly explain post-treatment care methods and the expected future progress.

Our Medical Team's Treatment Philosophy

Many individuals experience discomfort for a long time due to complex pigmentary lesions such as melasma and Acquired Bilateral Nevus of Ota-like Macules (ABNOM).

We believe it is natural for patients to feel worried and anxious about whether their skin condition will improve or worsen.

Empathizing with these deep concerns of our patients, the medical team considers pigment treatment as a precise approach that goes beyond simple device operation.

Our core principle in treatment is to precisely examine each individual's skin condition and ensure that accurate and necessary energy is delivered to the pigmented lesion area.

An optimized, customized treatment approach is required for each individual, tailored to the depth of the pigmentary lesion and varying skin sensitivities.

Laser toning treatment strives to apply a systematic approach not just to address visible symptoms, but to improve the root cause of the problem. We will always approach our treatments with utmost care and diligence to ensure that everyone who visits experiences positive skin changes.

Post-Treatment Skin Care and Precautions

• ㆍFacial cleansing and makeup are possible from the day of the treatment. However, we recommend diligent use of sunscreen.
• ㆍImmediately after treatment, the skin may be temporarily sensitive. Consistent and sufficient soothing and moisturizing care during this period can aid in skin recovery.
• ㆍSwelling or redness may occur after treatment, but these usually subside naturally over time. If these symptoms persist for more than a few days, it is advisable to consult the medical team.