How Do Lasers Lighten Skin Discoloration?

LASER is an acronym for “Light Amplification by Stimulated Emission of Radiation”. A laser is a focused beam of light energy that can be used to selectively heat and destroy highly specific targets.

In the case of lightening dark patches on the skin, the targets are known as chromophores, which includes the skin pigment known as melanin. Because melanin absorbs light at a wide range of wavelengths, many different lasers can be used to remove pigmented lesions of the skin. Conservative settings (low energy levels and short pulse durations) should be used during skin lightening laser treatments. Shortening the pulse duration allows for more specific pigment targeting while less heat is created to damage surrounding cells and tissue.

Even with conservative treatment, however, there is a risk of rebound pigmentation and worsening. That’s why lasers are considered second or third line treatment options for skin hyperpigmentation.

    What Is Post-Inflammatory Hyperpigmentation?

    PIH is a temporary condition that can start with a pimple, rash, scrape, burn, or any other type of skin trauma that causes inflammation. As a result of this inflammation, the skin over-produces a skin pigment called melanin. This extra melanin pigment gets deposited in the skin and is what causes the dark patches to remain long after the initial injury or inflammation has healed.

    PIH can often fade on its own, although it may take weeks, months, or even years to do so. Sun exposure without sunscreen or sun protection can make PIH worse by stimulating cells in the skin to produce additional pigment, which is why it’s important to wear sunscreen or avoid sun exposure when you have a skin injury.

    Who Gets PIH?

    Since PIH occurs after skin injury or inflammation, anyone can get this condition regardless of gender or age. Post-inflammatory hyperpigmentation can develop in all skin types, but it can be more common and more intense in people who have darker skin tones (Davis).

    How Is PIH Treated?

    Post-inflammatory pigmentation spots can fade on their own over time. However, this process can take weeks to months, and sometimes years.

    Fortunately, there are many treatment options for PIH, including:

    Topical creams: Topical creams inhibit the formation of additional melanin and promote new skin growth, accelerating how quickly PIH spots fade.

    Sun protection: UV rays cause certain cells in your skin to create additional pigment, making PIH worse. Sun protective measures can improve the effectiveness of treatment as well as speed up how quickly PIH spots fade on their own.

    Lasers: Laser treatments use precise, focused beams of light energy to damage pigment-producing cells and fade PIH spots.

    Chemical peels: Chemical peels work by ‘peeling off’ the topmost layer of skin, which includes PIH spots.

    Everyone’s skin is different, and what works for one person may make PIH worse in another. It’s important to consult with your dermatologist to determine the best treatment for you.

    What Is Melasma?

    Melasma, also known as ‘chloasma’, is a chronic skin pigmentation disorder that can cause dark patches on the skin, especially on the face and upper lip. This skin condition is thought to affect more than 5 million Americans, especially women with darker skin types.

    To better understand this skin condition, let’s first define melasma. The word ‘melasma’ comes from the Greek root melas, which means ‘black’. The same root is in the word ‘melanin’ (skin pigment). Your skin color is based on the amount of melanin present in your cells.

    Melasma occurs when your skin produces excessive amounts of melanin. Melasma triggers, whether internal or external, stimulate an increased production of melanin that causes the dark patches on your skin.

     

    Melasma Symptoms

    Melasma most commonly occurs on the face, although it can also appear on the arms and back. Melasma on the face typically appears on the forehead, the upper lip, the chin, or cheeks. Melasma may appear as ‘macules’, which resemble freckles, as well as larger dark patches that feature irregular borders.

     

    Melasma symptoms include:

    • Symmetrical patches of dark, brown or greyish skin
    • Enlarged melanin cells called melanocytes
    • An increase in the number of melanin cells
    • Abnormal accumulation of elastic tissue
    • An increase in blood vessels in the face

    Melasma unfortunately cannot be cured, but it can be effectively managed with sun protective measures and professional dermatologic care.

    Who Gets Melasma?

    Melasma occurs in about 1% of the general population (Ogbechie). However, this number can range between 9-50% in high-risk populations. The difference in prevalence may be attributed to an individual’s degree of sun exposure, geographic location, and genetics.

    Women develop melasma at a rate disproportionately higher than men. Some studies have found a 9:1 ratio of female predominance (Hexsel) while others have found differences as high as 39:1 (Vazquez). This disparity is due to the naturally higher levels of estrogen in women’s bodies. Pregnancy and oral contraceptives – both of which increase the amount of estrogen in the body – can trigger melasma as well.

    Genetics play a large role in the development of melasma. Women of Hispanic or Indian descent are especially prone. If you have family members who have melasma, you are more likely to develop the condition yourself. Studies have shown that more than half of people with melasma have a family history (Ogbechie).