Pigment Removal (Including stubborn Melasma)
Thereare various types of pigmentation that occur on the body and face, which can be either congenital or acquired. Causes of acquired pigmentation include photodamage, hormones, medication, trauma, skin diseases and the natural aging process.
There are various ways to remove unwanted facial and body pigmentation, but the method chosen depends on the nature and depth of the pigments. Much also depends on the individual's skin type, as well as their personal preference. There is no single individual method of removing all pigments; in fact, in many cases, combination treatments are neccesary to successfully remove pigments.
At Reviva Medical Laser & Vein Clinic in Richmond, multiple treatment modalities are available to remove skin pigments. These include
- Lasers
- Intense Pulsed Light (IPL) devices
- chemical peels
- microdermabrasion-electrosurgery
- radiofrequency surgery
- Excisional biopsy
A consultation with the physician is necessary before any laser or surgical intervention because a proper diagnosis must be established before treatment. There are certain lesions which should not be treated by lasers or any ablative technology and proper tissue handling is necessary to allow histological examination.
Scabbing is more prominent after laser treatment as compared with IPL treatment. But on the other hand, more IPL treatment sessions are needed for the same clearance rate as a laser. However, if the patient requires minimal down time, IPL would be a better alternative because of its less-obvious residual outcomes.
Treatment of pigmented lesions on Asian skin is always a challenge. Some lesions will respond to both laser and IPL, yet there are cases where a lesion will respond only to one and not the other. Asian skin is also prone to post treatment pigmentary change and proper skin care is needed before and after treatment to reduce these effects.
Questions & Answers:
What is the difference between IPL (Intense Pulsed Light) and laser?
Both IPL and lasers use the same principle to remove unwanted pigment on the skin. IPL emits multiple wavelengths of light, while lasers emit light of a single wavelength. For instance, IPL emits light consisting of wavelengths between 515-1200nm, while a laser might only emit light at 532nm.
What is the advantage of IPL over laser for pigment removal?
If one single wavelength can perform one function, a machine such as IPL which can emit multiple wavelengths could theoretically perform multiple functions. However, things are not as simple as they seem. We find that lasers outperform IPL in certain aspects; at Reviva Medical Laser and Vein Clinic, we have great success in using IPL in treating many skin conditions, including rosacea, age spots, sun spots, scars, leg and facial veins as well as melasma. IPL is the treatment of choice for treatment for melasma and certain types of sun spots at our clinic.
Which laser do you use in the removal of facial pigments?
Depending on the skin type and lesion type, different types of lasers are used to remove body and facial pigments. Laser treatment is usually most effective in treating discreet lesions and thickened age spots; in other words, dermal pigmented lesions can only be removed with lasers.
How many treatments will I need for pigment removal?
Depending on the type of pigmentation you have, anywhere from one to six treatments are needed. Age spots, for instance, typically respond very quickly even after one treatment. In the treatment of birthmarks, typically 4-8 treatments are needed to create good clearance.
Are the treatments painful?
Laser treatment is a little more uncomfortable than IPL. In most cases, the discomfort is reduced to the minimum by the use of numbing cream before the procedure is commenced.
What are the side effects of the two treatment methods?
IPL typically results in much less scabbing or crusting compared with lasers, and the crust usually falls off between 5-10 days. Occasionally, reduced pigmentation or increased pigmentation is evident after the crust falls off. The color typically normalizes in 3-6 months. Scarring is very unusual but can occur, especially if the operator is inexperienced. Reviva Medical Laser and Vein Clinic has treated over a thousand Vancouver-area patients, and we have not encountered any scarring as a result of either IPL or laser treatment.
What is the cost of pigment removal treatment?
The cost depends on the methods used, as well as the number of lesions that require treatment. In some cases, more than one session is required for optimum results. The cost will be discussed with you in detail when you come in for a consultation.
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Treatment and Removal of Melasma
Melasma is a very common skin condition seen in the general population. It occurs mostly in women but it can also affect men. Melasma usually occurs in the facial areas, but it can also found in the neck, chest, and upper arms where sun exposure may occur.
Melasma presents as irregular patches with indistinct and irregular borders. In the face, it occurs on the cheek, forehead, upper lip as well as the chin. Melasma is typically symmetrically distributed. That means that if melasma affects one side of the face, it is most likely the other side of the face is also affected. The color of melasma can be grey, grayish-black, brown or dark brown. Although melasma is more pronounced in darker-skinned individuals, it can also affect people of light skin.
Melasma is notoriously difficult to manage. People have tried different means to treat melasma. These include topical creams, chemical peels, microdermabrasion., laser peel, and herbal medications. People are often left frustrated because the condition can be unresponsive or made worse by the treatment process.
At Reviva, we have worked for the past 7-8 years finding a treatment for melasma. We wanted to find a treatment that is safe, effective and has zero down time. We now realize that if one wants to treat melasma successfully, one has to treat the root of the problem which is the pigment overproduction by the skin. Once the production issue is addressed, special treatment is performed to break up the melasma pigments and to clear the pigment from the skin. Our Reviva melasma treatment protocol is designed to do just that and more. It is safe, painless, very effective and with absolutely zero recovery time. One would see result after the first or second treatment. We have treated many patients who come to us after they have exhausted all the other options at other clinics. The procedure has an extremely high satisfaction rate.
Questions and Answers:
What causes Melasma?
Melasma is triggered by sunlight and the incidence increase with age. Another important contributing factor is hormonal changes. Melasma is also called “mask of pregnancy” because it appears during pregnancy or shortly after child birth. Oral contraceptives and hormone replacement therapy frequently aggravate pre-existing melasma.
What has been the traditional treatment strategies for melasma?
Various treatment options are used to treat melasma including chemical peels, IPL, LED, topical creams, lasers, as well as proprietary skin care systems such as, Obagi and Cosmelan. Unfortunately, none of these modalities produce consistent and dramatic result. Some procedures, such as chemical peels (Cosmelan, TCA peel, etc) and IPL, can produce rebound hyperpigmentation so that any initial improvement will disappear a few weeks after treatment. Fraxel laser has been promoted to treat melasma but it comes with significant risk of post-treatment hyperpigmentation in Asians, treatment discomfort, significant down time, and a big price tag.
Dr. Ngai has explored and performed all these procedures in the past. The Reviva Melasma Treatment Protocol is far superior to any of these old technologies
What is the Reviva Melasma Treatment Protocol?
The protocol usually consists of 3 stages:
Pre-treatment phase – This phase lasts for 2-4 weeks. During this period, we educate patients on skin care and sun protection. Various pre-treatment skin care products are introduction.
Active treatment phase – This phase may last for 8-12 weeks. Patients are to come in every 2-4 weeks for specialized light treatment based on skin type and the depth of the melasma pigments. Careful monitoring of treatment progress is performed with professional photographic system to ensure treatment efficacy and also help us to modulate the light energy we deliver to the affected areas.
Post-treatment phase - Ongoing surveillance of possible recurrence of melasma. Post-treatment skin care is used to maintain or at least prolong treatment result.
What are the side effects of Reviva Melasma Treatment Protocol?
We have not seen any untoward side effect since we implement the strict treatment protocol as mentioned in the answer to the previous question. Careful monitoring of the treatment process is the key we use to prevent any side effect.
Are there any recovery time to the treatmemt?
There is absolutely no down time with our Reviva Melasma Treatment Protocol. We guarantee that you can go back to work immediately right after treatment.
What is the cost of the Reviva Melasma Treatment Protocol?
The cost depends on the size of the area on the face affected by melasma. The cost is much less than one single full face IPL and far much less than Fraxel.
