Lasers and light therapies for pigmentation

Abstract

With the ever-increasing interest in minimally invasive cosmetic procedures and the growing non-Caucasian population of the USA, demand for research in photorejuvenation for darker skin tones is high. Lasers, specifically, have progressed tremendously in the last 20 years, becoming more elegant, efficient, and most of all, safer for all skin tones. They are no longer reserved just for fair skin, and can safely and effectively treat the ailments of individuals with dark skin. The use of lasers and light sources for pigmentation is generally based on wavelengths targeting melanin or pigment as the chromophore. Patients with darker skin tones present a challenge because light therapies are limited by their potential to cause postinflammatory dyspigmentation. Any therapy resulting in robust inflammation may induce this unwanted response. Although oftentimes temporary, postinflammatory hyperpigmentation may persist for many months, oftentimes becoming even more pronounced when approaches are taken to treat it. Strict perioperative use of topical bleaching agents and sun-protective measures are valuable in optimizing outcomes. Inciting factors such as sun exposure and other topicals need to be identified and discontinued to prevent further dyspigmentation during and after surgical treatment. Test spotting a representative lesion 4 weeks before treating the entire area is always recommended. © 2009 Springer-Verlag London.