Can Q-Switched Laser Remove Any Type of Pigmentation?

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Clear, spotless skin is the hallmark of beauty and youth.

There are many different types of pigmentation. Pigmentation is caused by an oversupply of melanin in an area of skin. This could be due to natural inborn factors or external causes such as sun exposure.

It is not uncommon nowadays to consider a “Q-switched laser package” as part of a personal grooming routine.

What exactly is a “Q-switched Laser”?

A “Q-switched Nd: YAG laser” is one of the most common lasers which removes excess pigments.

The laser beams in nanosecond pulses break down excess pigmentation, which is slowly removed by your body’s immune system.

It can range from $50 to even $500 per laser session.

Is it really effective in achieving flawless skin?

Yes, it is. But only for some people. This is because there are different types of pigmentation issues which vary in terms of difficulty to remove.

What types of pigmentation are easy to remove?

Freckles

Freckles are small brown marks that usually appear on sun-exposed areas. Usually removed with 2-4 sessions of Q-switched laser.

Solar Lentigos

Solar lentigos, also known as sun or age spots, on the other hand, are larger and have more defined outlines compared to freckles. They usually arise in middle age and appear on sun-exposed areas such as the face, arms and hands.

Usually removed with 2-4 sessions of Q-switched laser.

Post-Inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation is seen after skin injury, infection, or inflammation (e.g. Acne, Eczema) to the skin.

It can be temporary lasting a couple of months or may become a permanent feature on your skin.

Usually, 3-5 sessions of Q-switched laser are required.

The challenging cases – Melasma

Unfortunately, Melasma may never be fully removed with Q-switched lasers despite multiple sessions as well as skin whitening creams.

Melasma

Melasma results in symmetrical, brownish patches on the face. It is more common in women and also in darker skin types. It is caused by a variety of factors such as:

  1. Sun exposure
  2. Pregnancy
  3. Hormonal treatments or imbalances

Due to the unique nature of melasma, it is more difficult to treat compared with most other types of pigmentation. It can be slow to respond to treatment and may need more sessions before lightening effects are observed. Once treatment is discontinued, melasma may still return.

There are 2 options:

  1. Stop Laser treatments & Creams – risk relapse of Melasma
  2. Continue with monthly Q-switched lasers indefinitely to keep partially treated melasma in check

Neither options are ideal.

Option 1: wasted time, effort and money when there is a relapse of melasma

Option 2: on-going effort and money just to maintain results. Laser treatment sessions can cost a monthly expenditure of easily $200/session upwards.

New generation of pigment-removing Lasers: Picosecond/ Pico Lasers

In 2016, the Picosecond Laser technology was approved for removal of pigments. It is an improved technology from traditional Q-switched Lasers which fire laser beams in the nanosecond (billionth of a second) duration.

Picosecond lasers are approximately 10 times faster than nanosecond Q-switched lasers.

Is a Picosecond/ Pico laser better than Q switched laser for pigment removal?

Picosecond/ Pico Lasers was initially developed for removal of tattoo pigments (acquired pigments) but subsequently adapted for used in natural pigmentary conditions like melasma.

The second-generation Picosecond/ Pico Lasers like Lutronic PicoPlus from Korea were developed with the primary focus of treating natural pigmentary conditions like melasma.

Let’s understand the science behind pigment removal: high energy is required to shatter the pigment ink, which will then gradually be removed by your immune system.

There were two problems with traditional pigmentation removal:

  1. Certain lasers do not have enough power to shatter stubborn pigment particles – hence the plateau in results of Melasma.
  2. Surrounding tissues might get damaged during the process of delivering Laser energy to shatter the pigmentation particles.

Picosecond/Pico lasers solve these problems by emitting laser beams in shorter picosecond pulses. This means that there is less time for surrounding tissue to be damaged by heat from each laser beam.

Hence, pigment removal treatments using a Picosecond/ Pico Laser are safer with lower risks of side-effects like hyperpigmentation.

Compared to the older nano-second lasers, Picosecond/ Pico lasers are also able to deliver higher energy laser beams to shatter these pigments more effectively.

Fewer laser treatment sessions needed when using Pico Lasers

A top Taiwanese Dermatology research centre conducted a split-face, head-to-head research study between a pico laser versus a Q-switched laser which proved that a pico laser gives better results, which means fewer number of treatment sessions required to achieve best results.

In my clinical practice, I have observed that Pico lasers achieve results approximately twice as quickly which means fewer treatment sessions.

Pico Lasers are able to treat stubborn and challenging cases that Q-switch Lasers cannot

A top Taiwanese Dermatology research centre conducted a split-face, head-to-head research study between a pico laser versus a Q-switched laser which proved that a pico laser gives better results, which means fewer number of treatment sessions required to achieve best results.

In my clinical practice, I have observed that Pico lasers achieve results approximately twice as quickly which means fewer treatment sessions.

Does Pico Lasers make Q-switched nanosecond lasers obsolete?

Well, both yes and no.

Pico Lasers are used to remove difficult pigments/tattoos that cannot be removed by Nanosecond Lasers.

In one Korean research study, nanosecond lasers can be used to shatter large pigments into smaller fragments first.

Subsequently, Pico lasers are used to shatter these smaller fragments into tiny fragments that are more easily removed by your immune system.

I personally use both picosecond and nanosecond modes to provide optimal results for complex melasma. This is a laser treatment protocol that was innovated by top Korean laser dermatologists.

Amongst the first group of doctors from Singapore to be trained in Lutronic PicoPlus, a US FDA-approved multi-wavelength second-generation pico laser, I constantly exchange clinical pointers with leading Korean laser dermatologists to ensure that my patients get the best results from this market-leading laser.

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