Features of Kkeut Korean Medicine Clinic's Laser Toning

• Laser toning treatments utilize sufficient energy of over 2000 shots. We do not use low output or fewer shots to reduce treatment time. We carefully irradiate the skin with the necessary energy to help improve pigmentation, while minimizing skin irritation.
• Various pigmentary disorders differ in their depth of occurrence and characteristics. Melasma, acquired bilateral nevus of Ota-like macules (ABNOM), and blemishes each have their own unique features. The director carefully ascertains the depth and type of pigmentation and directly adjusts the treatment intensity. For example, melasma is approached with minimal skin irritation, ABNOM is treated with appropriate energy depending on the situation, and complex lesions use parameters tailored to each area.
• Laser treatment means more than simply operating equipment. During the treatment process, the director carefully checks the skin's reaction with the patient, looking in a mirror. The laser spot size, energy intensity, and even the handpiece if necessary, are adjusted in real-time according to the situation. Through such a delicate process, we provide more suitable treatment for each individual and expect positive results in improving pigmentation.
• To accurately diagnose pigmentary disorders, we use Mark-Vu diagnostic equipment. This helps precisely analyze the type of pigmentation, its distribution pattern within the skin, and even its depth, which are difficult to confirm with the naked eye. Based on this objective data, a suitable treatment plan is established for each patient.
• When multiple pigmentary disorders, such as melasma and acquired bilateral nevus of Ota-like macules (ABNOM), appear together, approaching them aggressively with a single treatment method can actually worsen the symptoms. Considering this situation, we first focus on minimizing irritation to stabilize melasma. Subsequently, a strategy of progressively concentrated treatment is applied to ABNOM located in the dermal layer.

Key Approaches of Kkeut Korean Medicine Clinic's Laser Toning

Laser toning is a treatment that can be used to improve various pigmentation issues. However, beyond simply using equipment, individual differences in treatment results can arise depending on the type of device, the method, the number of shots, and the intensity of irradiation.

Various pigmentary disorders such as melasma, blemishes, and acquired bilateral nevus of Ota-like macules (ABNOM) differ in their depth within the skin and also in how they react to lasers. It is crucial to accurately understand these individual characteristics and establish a careful plan before treatment.

1. Application of Sufficient Energy, Over 2,000 Shots

Several studies related to low-fluence laser toning report that when treatments are performed with 1500 to 2500 shots, relatively stable and significant improvements can be expected.

To deliver sufficient energy for pigment improvement while avoiding unnecessary skin irritation, we fundamentally consider over 2,000 shots of laser irradiation. Through this approach, we aim for more positive treatment outcomes.

Improvement in skin condition is difficult to expect simply by operating laser equipment.

Not only the depth and distribution range of pigmentation but also each individual's skin sensitivity must be fully considered. Accordingly, the process of meticulously adjusting various parameters such as the number of laser shots, output intensity, irradiation speed, and spot size is crucial.

2. Customized Laser Toning Adjustment by Disease

1) Melasma

Melasma is classified as a relatively common pigmentary disorder that primarily occurs on both sides of the face.

Melasma often arises when cells that produce melanin pigment react excessively. Therefore, there is a risk that strong irritation during treatment could actually darken the pigmentation.

We utilize a Mark-Vu precise skin diagnostic device to accurately confirm the distribution pattern and depth of melasma. Based on these diagnostic results, we plan laser toning treatments using short pulses in 5-nanosecond (ns) units.

The treatment is performed by selectively destroying only melanosomes within the cells, without directly irritating melanocytes. This approach can contribute to reducing the burden of potential side effects after treatment.

During the treatment, the director continuously monitors the skin's subtle reactions with the patient, observing in a mirror. If necessary, the laser intensity or the area requiring focused energy can be adjusted immediately. To ensure no specific area is neglected, the handpiece may be changed or parameter settings finely tuned.

We go through the process of checking the skin condition with the patient in a mirror, not only before and after the treatment but also during the treatment itself.

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

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

If melasma and ABNOM appear together, the treatment strategy must be even more cautious. While melasma requires minimizing irritation, ABNOM may require relatively stronger energy. Since these conflicting approaches must be applied simultaneously, the precise skill of the practitioner plays a crucial role.

It is particularly important to note that if ABNOM is treated aggressively without sufficient prior preparation in the presence of melasma, melasma symptoms could actually worsen.

Our medical team meticulously differentiates the types of pigmentation before treatment and establishes a customized treatment plan for each patient. Through this process, we aim to improve ABNOM while minimizing the burden of side effects. We adjust the treatment intensity appropriately according to each individual's skin condition.

Prior to ABNOM treatment, after accurately identifying the lesion through Mark-Vu diagnosis, the director directly sets personalized parameters. The treatment is carried out by meticulously adjusting the laser's spot size, number of repetitions, and output intensity to match the patient's skin type.

3) Other Pigmentary Disorders

Pigmentations that respond relatively quickly to lasers, such as lentigines, freckles, and blemishes, can be easily improved when appropriate wavelengths are used. However, if these pigmentations appear alongside deeper lesions like melasma or ABNOM, the treatment plan needs to be even more cautious.

When dealing with such complex pigmentary disorders, precise differential diagnosis is essential. For each treatment, we check the condition with the patient in a mirror, and a delicate, customized strategy, including laser output and handpiece adjustment, is required. Beyond simply performing laser toning, we pursue customized melanin pigment treatment based on the director's accurate diagnosis.

Pico Toning vs. Laser Toning

Pico toning is a method of irradiating laser pulses in extremely short time intervals called picoseconds. This is theoretically known to be advantageous for breaking down pigment particles more finely.

In contrast, general laser toning utilizes a method of delivering energy to the skin using relatively long pulse durations in nanosecond (ns) units.

Both of these toning treatments can help improve skin tone by selectively targeting and destroying melanin pigment. They can be applied to various types of pigmentary disorders, including melasma, blemishes, and acquired bilateral nevus of Ota-like macules (ABNOM).

Due to the difference in laser irradiation time, Pico toning may show relatively faster responses in the initial 2-3 sessions. However, when compared after 10 or more continuous treatments, both methods are reported to show similar levels of skin tone improvement.

Laser toning is a treatment method that has been consistently used for over 20 years, with its safety confirmed. Especially for pigmentary disorders like melasma, where the skin is sensitive or vulnerable to irritation, it can be a relatively less burdensome option.

Pico toning has the characteristic of delivering strong energy instantaneously. As a result, some individuals may experience temporary redness or a slight stinging sensation after the treatment.

According to several clinical studies, when comparing the two treatments based on the same 1064nm wavelength, numerous reports indicate no significant differences in skin brightening, melasma symptom relief, or changes in melanin index.

So, how can comparable effects to Pico toning be achieved through laser toning?

Gradual cumulative effects can be experienced when laser treatments are consistently performed 10 or more times.

During treatment, it is crucial to precisely adjust the energy within the range of 1.0~2.0 J/cm², considering each patient's individual skin reaction.

For satisfactory results, consider applying at least 2,000 shots or more per treatment.

Maintaining a treatment interval of 1-2 weeks is recommended. If the interval is longer, it may be difficult for the cumulative effects to fully manifest.

It is important to receive treatment from experienced medical professionals who can closely observe the patient's skin type and reactions during the procedure, and adjust energy in real-time.

If treatments are performed under these conditions, positive changes in the improvement of pigmented lesions can be expected. Relevant studies emphasize the importance of consistent treatment protocols rather than specific equipment.

The information provided is based on numerous medical research papers.

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

What is Laser Toning?

Laser toning is a procedure that delivers low-energy laser light deep into the skin multiple times, gradually breaking down pigments within the skin and evening out overall skin tone.

Rather than directly removing pigments with strong output, this treatment uses a method of repeatedly applying subtle laser stimulation to gently break down melanin pigments into smaller particles and assist the skin's natural recovery.

It is a treatment method that can be considered for various pigmentation issues such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules), while reducing the burden of skin irritation. It is currently utilized in the management of various pigmented lesions.

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

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

The 1064nm wavelength of this laser can reach the upper dermis, where melanin pigment is primarily located. It is characterized by selectively acting on and destroying pigments without causing significant damage to the skin surface.

It can help preserve the skin barrier while focusing on pigmentation issues, making it a relatively comfortable option even for sensitive or thin skin.

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

Laser toning is performed by repeatedly applying low-energy laser light multiple times, rather than strongly removing pigments all at once.

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

As a result, a more even and overall clearer skin tone can be expected.

3. Destruction of Dendrites and Removal of Pigment within Melanocytes

Beyond simply destroying pigments, laser toning can influence the overall melanin production pathway, contributing to the control of hyperpigmentation.

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

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

When the laser damages these dendrites, melanosome carriers are prevented from being smoothly delivered to the epidermis. This can help reduce the occurrence of new pigmentation on the skin surface.

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

These actions are characteristics primarily observed in lasers with short pulse durations, measured in 'nanoseconds' or 'picoseconds'.

This is an important mechanism that can be expected in 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 methods by which laser toning treatments address pigmentation issues.

Beyond simply removing melanin, laser toning employs a therapeutic approach that manages the entire process from pigment creation to transport.

1. Management of Already Formed Pigment Particles

For general pigmented lesions (e.g., freckles, ABNOM) other than melasma, improvement can be expected by breaking down melanin through appropriate parameter settings.

However, melasma can react sensitively to stimulation, thus requiring extremely delicate energy control. It is important to ensure that melanocytes are not excessively activated by unnecessary stimulation.

2. Regulation of Melanosome Transport through Dendrite Destruction

Physically controlling the movement of melanosomes, produced in pigment cells, to the epidermal layer can help reduce the occurrence of new hyperpigmentation.

3. Direct Breakdown of Melanin within Melanocytes

Laser energy can directly break down melanin pigment accumulated within melanocytes, contributing to the reduction of overall melanin concentration and brightening the skin tone.

Expected Effects of Laser Toning

• 1. Skin Tone Brightening Effect: Subtle laser stimulation gradually breaks down melanin pigment, which can help make dull skin appear brighter overall.
• We focus on alleviating pigmented lesions such as melasma. Without affecting melanocytes themselves, we can help improve the condition of sensitive melasma by regulating the activity of melanosomes, which are pigment pockets.
• We delicately treat pigmentation located deeper in the dermal layer than melasma, such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules). We aim to effectively improve pigmentation by adjusting laser energy according to each individual's skin condition.
• We can reduce excessive pigment production, thereby alleviating concerns about recurrence. We focus on inhibiting pigment migration by regulating the movement of dendrites, the main channels through which melanin pigment is delivered, and preventing new pigment deposits from forming.
• Laser stimulation can promote skin regeneration, positively influencing the improvement of fine lines and skin texture refinement. After the treatment, you can expect your skin to become smoother overall and fine wrinkles to diminish.
• We minimize skin irritation to ensure comfort during treatment. By delivering low energy in multiple passes, we reduce the burden on the skin. This allows even those with sensitive skin to receive treatment comfortably.

Recommended for Laser Toning

• 1. Those who desire improvement for dull and uneven skin tone
• 2. Those whose skin appears darker due to pigmentation such as melasma, blemishes, or freckles
• 3. Those with deep dermal pigmentation, such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• 4. Those with thin and sensitive skin looking for irritation-free pigmentation management
• 5. Those who also wish to achieve effects such as fine line improvement or skin texture refinement
• 6. Those who expect gradual skin improvement without the burden of irritation

Laser Toning Treatment Process

• STEP 1. Mark-Vu Precision Skin Diagnosis: Precisely analyzes the depth and distribution of pigments that are difficult to see with the naked eye.
• STEP 2. Develop a personalized treatment plan through a 1:1 customized consultation with the director.
• STEP 3. Perform laser toning treatment by adjusting parameters suitable for your skin condition. (Before the procedure, the final treatment area is reconfirmed with the director while looking in a mirror.)
• STEP 4. Check the progress in a mirror during the treatment. During this step, we re-examine if any areas require more detailed attention.
• STEP 5. After the treatment, check the results in a mirror and receive detailed explanations about future skin changes and management methods.

Director's Toning Philosophy

I believe many have long suffered from pigmentary disorders such as melasma or ABNOM.

You may have had significant worries and concerns like, 'Can it be improved?' or 'What if it gets worse?'

Understanding these feelings of our patients, we do not view pigment treatment as merely a procedure performed with equipment.

Our fundamental treatment principle is to meticulously examine each patient's skin condition and apply precise energy to the necessary areas.

Pigmentation requires different approaches depending on its depth and skin sensitivity.

Laser toning is a process that requires precise diagnosis and skilled application. We meticulously perform treatments, considering each patient's unique characteristics to achieve satisfactory results.

Post-Treatment Precautions

• ㆍFacial cleansing and light makeup are possible on the day of the procedure. It is recommended to make sunscreen use a daily habit to protect your skin.
• ㆍYour skin may be temporarily sensitive after the treatment, so please pay attention to soothing and moisturizing care.
• ㆍLight swelling or redness may appear after the treatment. This generally subsides naturally over time. If symptoms persist for more than a few days, we recommend contacting the clinic for consultation.