20 February 2020
Q-switched lasers– zapping away dark spots and pigmentation is now a dream come true.
It’s true. Pigmentation has now met its match with lasers. Gone are the days when pigmentation was treated solely with topical medications. Results were lacklustre and slow and patients generally lost patience with their treatments. Today, lasers, specifically Q-switched lasers, are now a staple in almost every aesthetic clinic because of its ability to quickly remove pigmentation with almost zero downtime- in fact, Q-switched lasers is commonly used to treat a variety of pigmentation with good clearance. In our age of instant gratification, it is not surprising that Q-switched lasers are seeing their popularity rise with even non-doctors rushing to offer this treatment. So, before you rush to try out a laser treatment, here are 10 things you need to know before having your pigmentation treated.
Pimples, pore and pigmentation- the 3 P’s that Q-switch lasers target
True- and this is back up by science and many years of research. Q-switched Nd-Yag lasers have a wavelength of 1064nm and 532nm and are absorbed by melanin pigments in the epidermis and dermis, making them ideal for treating pigmentation such as sun spots. These melanin pigments are broken up and then quickly removed by the body naturally. The laser beam stays on the skin for nanoseconds and this spares the rest of the structures of the skin from any damage.
Newer Q-switched lasers also have a photoacoustic twin pulse mode (PTP) which is a revolutionary way of delivering two successive laser beams for synergistic results of faster pigmentation clearance. There is also no downtime incurred because the laser beams stay on the skin for nanoseconds, ensuring that the skin cells are not damaged in the process. Hence, Q-switched laser is fast becoming popular with both males and females.
Celebrities aren’t spared from the ravages of pigmentation too. Jenna Dewan has very bravely and publicly shown her battle with melasma on social media.
Pigmentation, regardless of its form- age spots, melasma, freckles, post-inflammatory hyperpigmentation..etc arises from the formation of melanin, a dark coloured pigment formed by melanocyte cells in the skin.
Melanin formation is affected mainly by sunlight, hormones and injury to the skin (e.g. acne). Q-switched lasers target melanin pigments and break them up for faster clearance from the body but does not in fact prevent the melanocyte cells from forming pigmentation.
The best way to prevent pigmentation formation is to combine your laser treatments with sunscreen and topical vitamin C. Please read All About Topical Vitamin C: One of the Best Ways to Protect Your Skin and Pigmentation Lightening Skincare.
I wrote an article for Buro Singapore about the different types of laser treatments in Singapore and you can read it here.
Pigmentation problems and treatments are highly individualised. It is more important to understand the cause of the pigmentation and nip the problem in the bud.
Laser treatments, as some beauty salons and laser-clinic chains will like you to believe, is a one size fits all treatment.
What determines the success of your laser treatments is your doctor’s diagnosis of your type of pigmentation which then determines your treatment. Not all types of pigmentations are the same and to be treated with the same blanket laser treatment. This may in fact worsen the pigmentation.
To make things more complex, patients can have more than one type of pigmentation. I have treated patients with a combination of treatments and having a good grounding in dermatology and pigmentation pathology and years of experience treating a variety of pigmentation has definitely been useful in my practice.
Lasers are medical treatments that should only be performed by trained medical doctors.
Laser treatments are a medical treatment with the potential to cause serious complications like blindness and burns. Before consenting to any medical procedure, you should first be consulted by a doctor to allow the doctor to understand your skin issues, pigmentation problems and your health issues that can affect your pigmentation and treatment.
Most types of pigmentation may need more than one treatment and in some cases, more than one modality of treatment. During the medical consultation, the doctor will be able to give you an assessment of what you need.
If an establishment promises you unlimited laser or laser three times a day or even allows you to sign up for laser without a consultation with a doctor, alarm bells should be ringing.
My friend Karman shares her experience with laser for treating pigmentation in this post, Eternal Sunshine of the Spotless Face.
Although Q-switched laser treatments may not cause downtime, it certainly is not a cause of the more the merrier. In fact, when performed too frequently, some types of pigmentation can turn darker (a complication called hyperpigmentation) or turn completely white (hypopigmentation).
For ablative lasers like fractional CO2 lasers, the ‘stronger’ is not necessarily better. In fact, complications like post-inflammatory hyperpigmentation and burns are known to happen when the fluence of these lasers are increased.
A quick search on laser complication on Google will give you more graphic images and clickbait titles like “Too Much Q-switch Lasers Can Kill Your Skin”. Contrary to what some laser chains and salons would like you to believe, weekly laser treatments are an absolute no-no because of complications. Likewise, any treatment that is improperly administered doctors who aren’t familiar with laser treatments- complications can arise.
A properly performed laser treatment session by a doctor should deliver enough laser energy to your skin and should not be done anything more frequent than 2 weekly. Personally, I’ve had Q-switch lasers to remove my pigmentation and brighten my skin for close to 10 years now. All has been safe for me with no complications!
As with all medical treatments and especially for laser, which have the potential to be dangerous and cause complications when performed by non-doctors with no training. Burns, blindness, hypo- and hyperpigmentation are known complications of laser.
In Singapore, laser treatments are not exclusively performed by doctors. Beauty salons are also offer laser and IPL treatments. Laser machines are classified into 5 classes (1, 2, 3a, 3b and 4) according to their emission parameters (more simply put, their ‘strength’ and risk of complications). The strongest class of lasers, class 4, are high power and high-risk lasers that can only be used by licensed doctors who have received their Certificate of Competency in the use of lasers and only at approved medical clinics. Class 4 lasers can cut, burn and carry the risk of permanent blindness. Read more on the NEA website here.
In other words, medical grade laser treatments can and should only be performed by doctors. Laser treatments of any sort at beauty salons or spas are too mild to have any tangible effect.
Sunlight exposure is known to worsen almost all types of pigmentation. To maximise the results of your laser treatments for pigmentation, it is only logical to have adequate sun protection to prevent new pigmentation formation. Laser does not increase your sensitivity to the sun, but ablative lasers like fractional CO2 laser can temporarily increase sun sensitivity when the skin is recovering from the laser.
Likewise, sun protection before commencing laser treatments is just as important. If you have a sunburn, laser cannot be done because your risk of burns or skin discolouration. Read about my Sunscreen Reviews and FAQs on sunscreen in Sunscreen Beyond the Basics.
Chemical peels are another good way to remove pigmentation and dull skin Although Q-switched laser is effective in clearing most types of pigmentation, they work best in combination with sunscreen and the right skincare like vitamin C and Vitamin A. Sun exposure is known to worsen almost all types of pigmentation, so keep your skin healthy and protected to prevent recurrence and ensure faster results.
Lasers are also not the only way of removing pigmentation. In fact, I usually combine lasers with chemical peels for my patients because dual modality treatment works more effectively than a single modality of treatment. Read more about chemical peels in The Truth About Chemical Peels.
Lasers are not a magic wand that the doctor waves to instantlyr emove pigmentation. You should be able to see your skin glow within 1-3 days of laser treatment and pigmentation lighting starts becoming obvious at the 2-3-week mark. This is because your body needs time to gradually clear the pigmentation that has been fragmented by the laser.
Most patients will need more than 1 session to get majority of the pigmentation removed because dark spots need to be continuously shattered by laser for greater removal of dark spots. Precisely how many sessions you need will depend on what is the type of pigmentation you have, its characteristics and of course your skincare habits.