Unique Features of Our Clinic's Laser Toning

• 1. We aim to deliver sufficient energy with over 2,000 shots. Rather than proceeding quickly with low power and fewer shots, our clinic precisely delivers over 2,000 shots of energy to the skin, minimizing skin irritation and helping achieve desired improvements.
• 2. Customized intensity control is performed, considering the depth and type of pigmentation. Various types of pigmentation such as melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and freckles differ in their depth of occurrence and characteristics. At our clinic, for complex pigmented lesions, we adjust the energy intensity and parameters according to each area during the treatment, approaching melasma delicately and applying more concentrated intensity to ABNOM.
• 3. During the procedure, we directly check the skin condition and adjust parameters. We don't just finish by applying the laser; even during the treatment, we look at the mirror with the patient to observe the skin's reaction. If necessary, we change the spot size, energy intensity, or even the handpiece, proceeding delicately to ensure a personalized treatment.
• 4. We use a Mark-Vu diagnostic device to precisely diagnose the location and depth of pigmentation. Rather than relying solely on visual inspection or experience, the Mark-Vu diagnostic device allows us to precisely confirm the type, distribution, and depth of pigmentation. Based on these diagnostic results, we establish and proceed with an individualized treatment plan.
• 5. We apply a multi-layered approach to complex pigmented lesions. When melasma and ABNOM are present together, treating only one type of pigmentation aggressively may risk worsening the other. Our clinic considers a strategy of first stably managing melasma, and then proceeding with intensive treatment for ABNOM located in the dermis.

What are the Features of Our Clinic's Laser Toning?

Laser toning is a widely used procedure for improving various pigmented skin conditions. However, treatment results can vary significantly depending on the equipment used, the number of shots delivered, and the energy intensity.

Various types of pigmented conditions, such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules), differ in their depth of distribution within the skin and tissue reactions. Therefore, a precise treatment plan that considers the characteristics of each condition is crucial.

1. We emphasize delivering sufficient energy with over 2,000 shots.

According to numerous research reports, relatively stable and effective treatment results can be expected with low-fluence laser toning within the range of approximately 1,500 to 2,500 shots.

Our clinic generally applies over 2,000 laser shots. This approach is designed to deliver sufficient energy for pigmentation improvement without causing excessive skin irritation.

Skin changes are difficult to achieve by simply operating the equipment.

A customized approach is necessary, delicately adjusting the number of shots, power output, pulse repetition rate, spot size, and other parameters, considering the depth and spread of pigmentation, as well as individual skin sensitivity.

2. Customized Toning Adjustment Considering Disease Characteristics

1) For Melasma

Melasma is one of the pigmented conditions that primarily appears broadly across both sides of the face.

Since melanocytes, which produce melanin pigment, are excessively activated, unnecessary stimulation can potentially worsen the symptoms.

Our clinic utilizes the Mark-Vu skin precision diagnostic device to accurately diagnose the extent and depth of melasma. Subsequently, we perform the treatment using a toning laser with a short pulse width of 5 nanoseconds (ns).

We focus on reducing treatment-related burden by not stimulating the melanocytes themselves, but selectively destroying only the melanosomes within the cells.

Even during the procedure, the director personally checks the patient's skin with a mirror, adjusting the energy intensity and areas of focus. We carefully coordinate handpiece changes and parameter settings to ensure no area is neglected.

We assess the patient's skin condition with them in the mirror not only before and after, but also during the treatment.

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

ABNOM is a pigmented condition that occurs in the dermis, similar to melasma, but may require stronger energy intensity than melasma.

When melasma and ABNOM appear together as a complex presentation, different treatment strategies must be employed simultaneously, such as a delicate approach for melasma and a concentrated intensity for ABNOM. In such cases, the skilled expertise of the medical staff is crucial.

In particular, if a high-intensity treatment is performed without first stably managing melasma, there is a possibility that melasma symptoms may worsen.

At our clinic, we differentiate each pigmented condition through thorough pre-treatment diagnosis and establish a personalized plan. This helps reduce treatment-related burden and we perform the procedure by adjusting energy intensity to ensure ABNOM can also be improved simultaneously.

For ABNOM treatment as well, after accurate differentiation with Mark-Vu diagnosis, we proceed with parameter settings tailored to each individual's skin characteristics. We meticulously adjust the spot size, repetition rate, power output, and other factors according to skin type to continue the treatment.

3) Approach to Other Pigmented Conditions

Pigmentation like lentigines, freckles, and general blemishes, which show relatively quick responses, can be expected to improve with appropriate wavelength settings. However, if these pigmentations are accompanied by melasma or ABNOM, the treatment approach must be even more cautious.

Even in such cases, accurate diagnosis is required along with checking the patient's skin with a mirror at each session, and a delicate customized strategy, including adjusting power output and changing laser handpieces. Our clinic aims for melanin pigmentation treatment that considers each patient's individual characteristics, moving beyond standardized laser toning methods.

Comparison of Pico Toning and Laser Toning

Pico toning has the theoretical advantage of being able to destroy pigmentation more finely by using very short laser pulses in picosecond units.

In contrast, laser toning operates in nanosecond units, delivering energy for a somewhat longer duration than pico toning.

Both toning methods can selectively destroy melanin pigment to help brighten skin tone and are used for improving various pigmented conditions such as melasma, freckles, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to the difference in laser irradiation time, pico toning may show a faster response in the initial 2-3 treatment sessions. However, some perspectives suggest that after 10 or more cumulative sessions, both methods can be expected to yield similar levels of whitening effects.

Laser toning is a clinically utilized and proven treatment method for nearly 20 years. Especially for sensitive skin types or melasma conditions sensitive to irritation, it can be a relatively stable option.

Due to pico toning's characteristic of delivering high-intensity energy in a short time, temporary redness or a slight tingling sensation may occur after the procedure.

Several reports from actual clinical studies comparing the two treatment methods based on the same 1064nm wavelength indicate no significant differences in improvements such as skin brightening, reduction in melasma severity, and decrease in melanin index.

How to Achieve Sufficient Treatment Effects with Laser Toning?

It is important to consistently receive laser toning treatments more than 10 times. This is a necessary process for gradual effects.

During the treatment, energy is adjusted based on skin condition and reaction, within the range of 1.0 to 2.0 J/cm².

To achieve effective results, sufficient laser irradiation of at least 2000 shots is recommended.

Treatments are usually performed at intervals of 1 to 2 weeks. Be cautious, as longer intervals may reduce the cumulative effect.

It is advisable to receive treatment from a medical professional who can delicately adjust the energy according to each individual's skin type and the reactions observed during the procedure.

If these treatment conditions are well-adhered to, improvement effects similar to those of pico toning can be expected, as indicated by various research findings.

The information mentioned above is based on academic research papers.

For example, Medicina (Kaunas), 2022, Lasers in Medical Science, 2021, and Journal of Cosmetic and Laser Therapy, 2021.

What is Laser Toning?

Laser toning is a treatment method that gradually improves skin pigmentation and evens out overall skin tone by repeatedly delivering weak laser energy deep into the skin.

Unlike traditional treatments that directly remove pigments with strong energy, this method focuses on delivering repetitive micro-stimuli to gently break down melanin and induce the skin's own regeneration.

It can be applied to various pigmentary disorders such as melasma, freckles, and acquired bilateral nevus of Ota-like macules (ABNOM), without placing a heavy burden on the skin. It is currently one of the most widely used methods for pigment improvement.

1. Laser used: Q-switched Nd:YAG

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

The 1064nm wavelength of this laser deeply penetrates to the upper dermis, where melanin pigment is abundant. It has the characteristic ability to selectively destroy pigment without damaging the skin surface.

While focusing on pigment improvement, the skin barrier can be relatively well-protected. Therefore, it is a treatment that can be considered even for sensitive or thin skin.

2. Repeated stimulation with low energy

In the past, it was common to remove pigments in one go with strong lasers. However, laser toning uses a method of irradiating low energy thousands of times repeatedly.

This approach helps to slowly break down melanin particles while reducing the burden on skin tissues. Afterward, the body's immune system (macrophages) absorbs and eliminates these broken-down pigments.

Over time, a gradual change to a more even and clear skin tone can be observed.

3. Dendrite destruction and melanin removal within melanocytes

Laser toning not only destroys pigment particles but also plays a role in suppressing the process of melanin production.

A crucial part of this action is damaging the dendrites, or dendritic processes, of melanocytes.

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

When the laser damages these dendrites, melanin carriers are unable to move to the epidermal layer. This can help reduce the appearance of pigment on the skin surface.

Furthermore, it can directly destroy the melanin pigment accumulated inside the melanocytes themselves. This can also contribute to clearing up existing hyperpigmentation.

These actions can only be observed when using lasers with short pulse durations, in 'nanosecond' or 'picosecond' units.

In other words, it is a key principle primarily observed in treatments such as laser toning or pico toning.

Three Main Principles of Laser Toning

Three main ways laser toning works

Laser toning aims not just to remove pigment, but to regulate the entire process of melanin creation and its migration to the skin surface.

1. Improvement of existing pigment particles

Pigmented lesions other than melasma, such as freckles or acquired bilateral nevus of Ota-like macules (ABNOM), can be targeted for improvement by controlling melanin with relatively strong energy settings.

However, melasma can react sensitively to laser stimulation, requiring very delicate control. Care must be taken to avoid over-stimulation, which could paradoxically activate melanocytes further.

2. Inhibition of melanosome transfer through dendrite destruction

By preventing melanin-containing melanosomes from being delivered to the epidermis, it helps to pre-regulate the occurrence of hyperpigmentation.

3. Direct regulation of melanin within melanocytes

Laser energy directly breaks down the melanin pigment inside melanocytes, reducing its concentration. This can lead to an overall improvement in skin tone.

Expected Effects of Laser Toning

• 1. Overall brightening of skin tone. As subtle laser stimulation gradually breaks down melanin, dull skin can be expected to become brighter and more evenly toned.
• 2. Alleviation of Melasma and Pigmentation By selectively targeting only melanosomes without stimulating melanin cells, improvement in sensitive melasma and pigmentation can be expected.
• 3. Improvement of ABNOM (Acquired Bilateral Nevus of Ota-like Macules) By delivering energy with customized intensity even to deep skin pigments such as Acquired Bilateral Nevus of Ota-like Macules, it can help manage pigmentation in the dermal layer.
• 4. Recurrence Management through Pigment Production Suppression By managing the dendritic sheath, which is the pathway for melanin movement, it helps reduce the appearance of pigment on the skin surface and contributes to inhibiting the formation of new pigment.
• 5. Smooth Skin Texture with Improved Fine Lines and Texture Laser stimulation promotes skin regeneration, leading to ancillary improvements in overall skin condition, such as refined skin texture and reduced fine lines.
• 6. A Method that Reduces Irritation and Increases Effectiveness By using a method of repeatedly irradiating low-output lasers, irritation to the skin can be reduced. This is an advantage that allows even those with sensitive skin to comfortably consider the procedure.

Candidates for Laser Toning

• 1. Those concerned about dull and uneven skin tone
• 2. Those who frequently develop pigmentary lesions such as melasma, blemishes, and freckles, and find them gradually darkening
• 3. Those with pigments located deep in the dermal layer, such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• 4. Those with thin or sensitive skin who felt burdened by pigment treatment
• 5. Those who desire improvement in fine lines or skin texture in addition to pigment concerns
• 6. Those who wish to manage consistent skin changes while minimizing skin irritation

Laser Toning Procedure Steps

• STEP 1. Mark-Vu Skin Precision Diagnosis The depth and distribution of pigments, which are difficult to identify with the naked eye, are accurately analyzed using Mark-Vu.
• STEP 2. 1:1 Consultation with the Director and Customized Treatment Plan Establishment
• STEP 3. Laser Toning Procedure Begins After Individualized Parameter Setting (Final confirmation with the director in the mirror before the procedure)
• STEP 4. During the procedure, checking areas requiring focused care together while looking in the mirror
• STEP 5. Post-procedure Change Confirmation and Aftercare Guidance

A Message from the Director

Whether it's melasma or acquired bilateral nevus of Ota-like macules, many people often harbor deep concerns for a long time over even a single pigment issue.

I believe there is also great anxiety about whether treatment will truly improve the condition, or perhaps even worsen it.

That is why we do not view pigment treatment as merely a mechanical process;

instead, we make it a principle to personally examine the skin condition of each and every patient and perform precise treatments only on the necessary areas.

Pigmentation requires different approaches depending on skin depth and sensitivity.

We will do our best to ensure that laser toning is not just a perfunctory process, but leads to meaningful improvements tailored to each individual's skin condition.

Precautions After Procedure

• ㆍFace washing and makeup are possible from the day of the procedure. However, we recommend paying special attention to UV protection.
• ㆍIt is recommended to focus more on sufficient soothing care and moisturizing for temporarily irritated skin.
• ㆍSlight swelling or redness may appear after the procedure, but these usually subside naturally over time. If these symptoms persist for more than a few days, please contact the clinic for detailed guidance.