Lasers and Light Devices in the Treatment of Cosmetic Pigmentary Disorders in Asian Skin

Goh Chee Leok

Disclosures

Dermatology Nursing 

In This Article

Pigment Lasers Treatment: Perioperative Morbidity and Care

Treatment of the pigmented skin lesions is usually done in stages under topical anesthesia (such as EMLA®), which is often applied for about 1 hour before the procedure. When the laser hits the skin, a pricking pain is felt. The pain is usually bearable and short-lived.

Generally, pigment lasers tend to cause superficial and deep epidermal injury; good post-operative skin care is necessary. Immediately post-laser treatment, whitening is observed, followed by mild, pinpoint redness, bleeding, and mild swelling lasting for several hours. Patients may experience slight burning discomfort after the laser treatment. Pain and discomfort can be relieved by painkillers (such as acetaminophen) and by applying ice.

The laser wound should be cleansed gently with sterile normal saline solution. Topical antibiotic or moisturizer is then applied on the treated areas. Over the next 3–5 days, superficial scabs form over the treated areas. They will be dislodged with cleansing (such as normal saline two to three times daily).

Post-inflammatory hyperpigmentation is common after the initial skin inflammation has subsided especially if 532 nm wavelengths are used. It is usually seen 2–4 weeks after the laser procedure and is often made worse if the skin is further exposed to the sun. PIH can be prevented or minimized by avoiding direct exposure to the sun and regular use of broad-spectrum sunscreen during the day after the wound has healed completely.

Scarring is a very rare occurrence from pigment laser treatment. It may result from skin infections following the laser treatment. Hence, it is important for patients to report to their doctor immediately if there is prolonged pain, redness, tenderness, and oozing of the laser-treated skin.

Superficial pigmented lesions such as freckles and lentigines require only one to three treatment sessions for excellent clearance. Deeper-pigmented lesions such as Hori's nevus often require seven to ten treatment sessions spaced 2 months apart to be cleared.

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