Some studies have shown that the aesthetic impact of marks is greater than wrinkles and it is therefore absolutely logical that the demand for treating brown marks should be very frequent. The marks appear most frequently as time goes by and are concentrated above-all in the areas that are exposed to light, that is, on the face, the back of the hands and on the décolleté. The marks on the skin are caused by an excess in the pigment of the skin, usually caused by ultra-violet exposure or to acquired or congenital factors. A concentration of melanocytes or of melanin in a restricted area can produce a hyper-pigmented blemish. The marks can, however, have a different structure and nature, and therefore, before carrying out the treatment it is important to have a precise diagnosis, as not all marks are the same and can require different types of treatment from one to another. The specialist is able to formulate a diagnosis of this nature, but in the case of doubt it is advisable to carry out a biopsy and not to carry out any kind of laser treatment.
Pigment targeting laser treatment
The laser technologies designed to treat pigments are based on the principle of selective photothermolysis, that is, the ability to selectively hit a specific target based on its wavelength. These types of laser are therefore able to hit the pigments inside the skin specifically, respecting the surrounding tissues. The treatment of marks and pigmented blemishes with lasers requires the use of machines that use suitable wavelengths (principally 532, 694, 755, 1064 nm) which are able to transport extremely high quantities of thermal energy selectively towards the targets which are represented by the pigment, in a time span which is in the order of thousands or millionths of a second.
In the case of melanocytic nevi (common moles) it is good practice not to use laser treatments. On the other hand, it is possible to treat age spots (senile lentigo), freckles, ephelides, café-au-lait spots, and some pigmented malformations (like the nevi of Ota and of Ito), and other types of pigmented blemishes, such as, for example, tattoos (both traumatic and professional). The most common benign pigmented lesions to be treated with laser technologies, but also with pulsed light, are, in any case, age spots, which in reality, can have different causes and can be treated with different laser technologies, and always with a high level of safety.
Preparation to treatment with pigmentary laser
No particular preparation is needed for the treatment, but it can be preceded by the use of smoothing or depigmenting creams, which are useful in reducing the thickness of the corneous layer. The use of the laser creates only a slight discomfort on the skin and is carried out without any anaesthetic. It is rapid and the post-operative stage is normally eventless. In some cases there may be the formation of small scabs where the spot was, which, once they have dropped off, leave room for new skin without spots. Even after this type of laser treatment it is necessary to stay absolutely clear of any exposure to the sun for at least 45 days, to avoid the risk of the spots reappearing.