The Uniqueness of Kkeut Korean Medicine Clinic's Laser Toning

• During laser toning, we use sufficient energy, performing the procedure with over 2000 shots. We do not opt for low power or fewer shots to rush the process. We precisely deliver the necessary energy to the skin to help improve pigmentation and strive to minimize skin irritation.
• Pigmentary disorders vary in depth and characteristics depending on their type. Melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and blemishes each have their own distinct characteristics. Considering the depth and type of these pigments, our director personally adjusts the treatment intensity. For example, melasma is approached with minimized skin irritation, ABNOM uses strong energy as needed, and in complex cases, parameters suitable for each area are applied.
• Laser treatment is not simply a process of using a machine. During the procedure, our director carefully observes the skin's reaction with the patient, looking in a mirror. If necessary, the laser's spot size, intensity, and even the handpiece are adjusted in real-time. Through this process, we provide highly customized treatments for each individual, aiming for effective pigment improvement.
• To accurately diagnose pigmentary disorders, we utilize the Mark-Vu diagnostic device. Beyond visual assessment, Mark-Vu precisely identifies the type of pigment, its distribution within the skin, and its depth. Based on this objective information, we formulate the most suitable treatment plan for each patient.
• For complex pigmentation cases where multiple pigmentary disorders like melasma and ABNOM appear simultaneously, insisting on only one intense treatment method can actually worsen the symptoms. Considering this, we apply a step-by-step strategy: first stabilizing melasma without irritation, and then more intensively treating ABNOM located in the dermis.

Why is Kkeut Korean Medicine Clinic's Laser Toning Special?

Laser toning is a procedure used to improve various pigmentation issues. However, beyond merely using a device, treatment results can vary individually depending on the type of equipment used, the number of shots, and the intensity of the irradiation.

Various types of pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) are located at different depths within the skin and react differently to lasers. Considering these characteristics, it is crucial to formulate a meticulous plan before treatment.

1. Minimum 2,000 shots or more, ensuring sufficient energy

According to many research findings on low-fluence laser toning, significant effects can be expected while maintaining relative safety when treatments are performed within the range of 1500 to 2500 shots.

To deliver sufficient energy for pigment improvement without excessively irritating the skin, we fundamentally consider using over 2,000 laser shots. Through this, we plan to achieve more satisfactory treatment results.

Skin improvement is not achieved merely by operating a laser device.

Considering the depth of pigmentation, distribution area, and each individual's skin sensitivity, various parameters such as the number of laser shots, output intensity, irradiation speed, and spot size must be meticulously adjusted.

2. Director's Customized Toning Adjustment by Disorder

1) Melasma

Melasma is one of the common pigmentary disorders that primarily appear on both sides of the face.

Melasma often occurs when melanin-producing cells are excessively activated. Therefore, applying strong irritation may even deepen the pigmentation.

We clearly identify the distribution and depth of melasma using the Mark-Vu precision skin diagnostic device. Based on this information, we initiate toning laser treatment using short pulses measured in 5-nanosecond (ns) units.

The treatment is performed by selectively destroying only the melanosomes within the melanocytes, without directly irritating the melanocytes themselves. This approach can help reduce the risk of side effects.

During the procedure, our director observes the skin's reaction with the patient using a mirror, immediately adjusting the laser intensity or areas of focus as needed. To ensure no specific area is missed, the handpiece may be changed or parameters finely tuned.

The procedure is carried out while checking the skin condition with the patient in a mirror, not only before and after but also throughout the treatment.

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

ABNOM (Acquired Bilateral Nevus of Ota-like Macules) is a pigmentary disorder that occurs in the dermal layer of the skin, similar to melasma. However, it may require treatments with higher energy intensity than melasma.

If melasma and ABNOM appear together, the treatment strategy becomes more complex. This is because melasma requires minimized irritation, while ABNOM may demand stronger energy. As such, applying opposing approaches simultaneously requires the practitioner's delicate skill.

Specifically, if strong treatment for ABNOM is performed without sufficient preparation when melasma is also present, there is a possibility that the melasma symptoms could worsen.

Before treatment, we meticulously differentiate the types of pigmentation and establish a personalized treatment plan. Through this, we aim to improve ABNOM while reducing the burden of side effects, adjusting the appropriate treatment intensity according to each individual's condition.

Even during ABNOM treatment, after precise confirmation through Mark-Vu diagnosis, our director personally sets customized parameters. The procedure is carried out with meticulous adjustments to the laser's spot size, number of repetitions, and output intensity to suit the patient's skin type.

3) Other Pigmentary Disorders

Pigmentations that show relatively quick responses, such as lentigines, freckles, and blemishes, can be easily improved with the use of appropriate wavelengths. However, if these pigmentations appear alongside melasma or ABNOM, the treatment plan can become complex.

Even in cases of such complex pigmentary disorders, precise differentiation is essential, and a delicate customized strategy is required for each treatment, including checking the condition with the patient in a mirror and adjusting laser output or the handpiece. We aim for personalized melanin pigmentation treatment based on the director's diagnosis, going beyond simple laser toning.

Pico Toning vs. Laser Toning

Pico toning is known to have a theoretical advantage in breaking down pigment particles more finely by irradiating laser pulses in extremely short time units called picoseconds.

On the other hand, conventional laser toning uses a method that delivers energy through slightly longer pulse durations, measured in nanoseconds.

Both of these toning procedures are utilized to improve skin tone by selectively targeting and destroying melanin pigments, and for various pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to the difference in laser irradiation time, pico toning may show faster responses in the initial 2-3 treatment sessions. However, when compared after more than 10 consistent treatments, both methods are known to yield similar levels of skin brightening effects.

Laser toning is a verified treatment method that has been consistently used for over 20 years. Especially for sensitive skin or pigmentary disorders like melasma, which are susceptible to irritation, it can be a relatively stable option.

Due to pico toning's characteristic of delivering strong energy instantaneously, some individuals may experience temporary redness or mild stinging after the procedure.

Clinical studies show many reports indicating no significant differences in skin brightening, reduction of melasma symptoms, or changes in melanin index when comparing the two treatments based on the same 1064nm wavelength.

So, how can we expect laser toning to deliver effects comparable to pico toning?

Cumulative effects can be expected when laser treatments are consistently received 10 or more times.

During treatment, energy should be delicately adjusted to the individual's skin reaction within the range of 1.0-2.0 J/cm².

For sufficient efficacy, it is recommended to apply at least 2,000 shots per treatment session.

It is advisable to maintain a 1-2 week interval between treatments. If the interval becomes too long, the cumulative effect may not be fully realized.

It is important to receive treatment from a skilled practitioner who can delicately consider the individual's skin type and real-time reactions during the procedure.

If the treatment is performed while sufficiently meeting the conditions mentioned above, positive changes in pigmentary lesion improvement can be expected. Related studies emphasize the importance of consistent treatment protocols regardless of specific equipment.

The information presented has been compiled with reference to numerous medical research papers.

Key references include Medicina (Kaunas, 2022), Lasers in Medical Science (2021), and Journal of Cosmetic and Laser Therapy (2021).

What is Laser Toning?

Laser toning is a procedure that delivers low-energy laser multiple times deep into the skin to gradually break down pigments within the skin and balance the overall skin tone.

Rather than directly removing pigments with strong output, this treatment uses a method of repeatedly delivering subtle laser stimulation to gently break down melanin pigments and aid the skin's natural regeneration.

It is a treatment method that can be applied to various pigmentary problems such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) while reducing the burden of skin irritation. It is currently one of the methods utilized in managing various pigmentary lesions.

1. Type of Laser Used: Q-switched Nd:YAG

Q-switched Nd:YAG lasers are primarily used for laser toning treatments.

The 1064nm wavelength of this laser can reach the upper dermis, where melanin pigments are mainly located. Its characteristic feature is that it selectively acts on and destroys pigments without causing significant damage to the skin surface.

As it can help preserve the skin barrier while focusing on pigment problems, it can be considered for relatively comfortable application even on sensitive or thin skin.

2. Skin Improvement Effect of Low-Output, High-Repetition Method

Laser toning is performed by repeatedly applying low-energy laser multiple times, rather than removing pigments strongly in one go.

This approach reduces the burden of damage to skin tissue while gradually segmenting melanin particles. The finely fragmented pigments are then absorbed by our body's immune system, particularly macrophages, and naturally eliminated.

As a result, you can expect a more even and overall clearer skin tone.

3. Dendrite Destruction and Intracellular Melanin Removal in Melanocytes

Laser toning goes beyond simply destroying pigments; it contributes to regulating hyperpigmentation by influencing the overall pathway of melanin production.

The core of this process lies in destroying the dendrite (branching process) structures of melanocytes.

Dendrites act as channels that transport mature melanosomes (melanin carriers) produced in melanocytes to the outer epidermal layer of the skin.

When the laser damages these dendrites, melanosome transport to the epidermis becomes inefficient. This can help reduce the occurrence of new pigmentary deposits on the skin surface.

Furthermore, it can directly destroy melanin pigments accumulated within melanocytes, which can help improve existing hyperpigmentation.

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

This is an important mechanism that can be expected from treatments utilizing specific wavelengths and pulse durations, such as laser toning or pico toning.

Three Key Principles of Laser Toning

These are the three core ways laser toning treatments address pigmentary issues.

Laser toning goes beyond merely removing melanin; it employs a therapeutic approach that manages the entire process from pigment generation to transport.

1. Management of Already Formed Pigment Particles

For general pigmentary disorders (e.g., freckles, ABNOM) that are not melasma, improvement can be expected by breaking down melanin with appropriate parameter settings.

However, melasma can react sensitively to stimulation, requiring very delicate energy control. It is important to be careful not to over-activate melanocytes with unnecessary stimulation.

2. Melanosome Transport Regulation through Dendrite Destruction

Physically regulating the migration of melanosomes, produced in pigment cells, to the epidermal layer can help reduce the occurrence of new pigmentation.

3. Direct Breakdown of Melanin within Melanocytes

Laser energy can directly break down melanin pigments accumulated within melanocytes, thereby contributing to reducing the overall melanin concentration and brightening the skin tone.

Expected Effects of Laser Toning

• 1. Effect of brightening skin tone: Subtle laser stimulation gradually breaks down melanin pigments, which can help make dull skin generally clearer.
• 2. Melasma and Pigmentation Relief By selectively controlling melanosomes without affecting melanocytes, it can help improve sensitive melasma.
• 3. ABNOM (Acquired Bilateral Nevus of Ota-like Macules) Management Through customized energy control that can reach pigmentation in the deeper dermal layer than melasma, pigments are effectively managed.
• 4. Reduced Recurrence Risk by Blocking Pigment Production Pathways It aims to regulate dendritic sheaths, the main pathway for pigment transfer, to prevent melanin migration and suppress excessive pigment production.
• 5. Fine Lines and Skin Texture Refinement Laser stimulation activates the skin's regeneration process, leading to additional improvements such as smoother overall skin texture and reduced fine lines.
• 6. Reduced Skin Irritation and Comfortable Treatment By using a method of repeatedly irradiating with low energy, the burden on the skin is reduced. This allows even sensitive skin to receive treatment comfortably.

Recommended for Laser Toning

• 1. Those concerned about dull or uneven-looking skin tone
• 2. Those who frequently experience and see darkening pigmentation such as melasma, blemishes, and freckles
• 3. Those with deep dermal pigmentation, such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• 4. Those with thin and sensitive skin who still desire pigmentation management
• 5. Those also considering improvement in fine lines or skin texture
• 6. Those who desire consistent skin changes with minimal irritation

Laser Toning Treatment Process

• STEP 1. Mark-Vu Precise Skin Diagnosis: Accurately identifies the depth and distribution of pigmentation that is difficult to determine with the naked eye.
• STEP 2. Development of an Individual Treatment Plan through a 1:1 Consultation with the Director
• STEP 3. Laser Toning Treatment after Setting Personalized Parameters (Final confirmation is made with the director while looking in the mirror before the treatment.)
• STEP 4. During the treatment, progress is checked in the mirror, and areas requiring focused attention are re-examined.
• STEP 5. After the treatment, the mirror is checked again, and information on future progress and care methods is provided.

Director's Toning Philosophy

Many patients have likely experienced discomfort for a long time due to pigmentation issues such as melasma or ABNOM.

I believe there is also significant internal anxiety, wondering, 'Can it truly improve?' or 'What if it actually gets worse?'

Understanding the feelings of these patients, we do not view pigment treatment as merely a procedure using a machine.

We directly check even the smallest details of the patient's skin and adhere to the principle of precise laser irradiation only as needed.

Pigmentation requires different treatment approaches depending on varying skin depths and sensitivities.

Laser toning is by no means a procedure to be approached lightly. We will do our best to ensure that each individual patient achieves optimal results.

Post-Treatment Precautions

• ㆍFace washing and makeup are possible from the day of the procedure. We recommend paying special attention to UV protection.
• ㆍIt is advisable to pay extra attention to soothing and moisturizing care for temporarily irritated skin.
• ㆍSlight swelling or redness may appear after the procedure, but it usually subsides naturally over time. If it persists for several days, please visit the clinic for a consultation.