Removal of Pigmentation

Treatment

Pigmentations present a challenge in treatment because some types of hyperpigmentation depend on internal factors, hormones, and accumulated damage. Pigmentations located epidermally (in the superficial layer of the skin) are easier to treat than pigmentations located deeper in the dermis. However, numerous methods available in our center successfully address most pigmented spots.

The Nd Yag laser is one of the most effective methods for removing epidermal and dermal pigmentations. Working on the principle of selective photothermolysis, it recognizes melanin in pigmented changes and selectively removes it. It’s the gold standard for removing melasma and is also effectively used for the removal of sunspots, café au lait spots, naevus Ota, naevus Ito, post-inflammatory hyperpigmentation, and pigmentations caused by other factors. For sunspots, one treatment is sufficient, while more sessions are required for melasma and café au lait spots.

The CO2 fractional laser is an ablative laser and is one of the best and most effective treatments for evening skin tone and removing both superficial and deeper pigmentations. It removes the superficial layer of the skin (epidermis) and, by heating the dermis, stimulates collagen production. Just one treatment produces excellent results.

Plasmage is a device that operates on the principle of plasma energy and effectively removes epidermal pigmentations such as solar lentigines (sunspots). It evaporates the surface pigment, erasing it like an eraser. Only one treatment is required for complete removal.

Chemical peels with glycolic, lactic, and trichloroacetic acid work by weakening the bonds between skin cells. This promotes skin peeling and renewal, evening out skin color, making pigmentations less pronounced.

Apocalypsis therapy is a SkinBooster, a combination of phyto-peeling with 20% fruit acids that synergistically act as a medium-depth chemical peel. Post-treatment, the skin intensely peels for up to 5 days, effectively lightening and removing post-inflammatory hyperpigmentation, melasma, and sunspots.

Micropen mesotherapy is a treatment where rotating needles are used in combination with a mesotherapy cocktail. The needles create damage that the skin recognizes as trauma, resulting in collagen production, skin renewal, and tonal balance. The mesotherapy cocktail typically contains vitamin C, arbutin, rumex, and other active substances that prevent new hyperpigmentations.

Candidates

Ideal candidates for the mentioned procedures have the following hyperpigmentation forms:

• Solar lentigines
• Post-inflammatory hyperpigmentation
• Melasma
• Café au lait spots
• Other forms of pigmentation

Treatments are not performed on pregnant women, those with acute infections, inflammations, scar tendencies, and during summer months.

Results

The number of treatments depends on the type of pigmentation being treated with the Nd Yag laser; while solar lentigines generally disappear after one session, melasma, café au lait spots, naevus Ota, and Ito require multiple sessions.

After the CO2 fractional laser, initial results are seen after the completed exfoliation (usually lasting 7-10 days) with improved skin tone, smoother, and even skin. However, the skin is slightly pink, and during the maturing process that can last for several months, there is a visible reduction in unwanted pigmentations, improved texture, and even skin tone.

After the Plasmage device treatment for sunspot removal, the result is visible immediately after the session. A scab remains at the treated site, healing over several days. For other methods, multiple treatments are required for a full result. After chemical peeling, mild facial redness and flaking can be expected a few days after the session. Initial results are visible a few days post-treatment with a fresher facial appearance. The procedure is performed every two weeks, with the number of sessions varying, typically between 3 to 6.

After the Apocalypsis therapy, a recovery of 5 days can be expected in terms of redness, skin peeling, and facial tightening. During this period, the treated area should not come into contact with water, sweat, or steam, ensuring the peeling process goes smoothly. On the fifth day after treatment, you should return for a skin renewal treatment, where any remaining unpeeled skin is removed with a peel, and the skin is rejuvenated with nourishing masks, serums, and creams. After just one Apocalypsis Skin Booster, significant improvement can be observed. The therapy is conducted once a month, with at least 3 treatments recommended. Depending on the intensity of the pigmentation, up to 10 treatments may be required.

After the Micropen treatment, local redness, sensitivity, and mild skin peeling can be expected a few days after the session. Improvement in skin toning and reduced pigmentation is noticeable after just one treatment. It’s recommended to undergo 3 treatments with a month-long gap between each session.

Recovery

When removing pigmented changes with the Nd Yag laser, frosting (a white glaze visible at the end of the treatment over the treated spot, usually disappearing within 20-40 minutes) and purpura (intense redness with possible capillary bleedings that typically fade in a few days) may appear. Subsequently, scabs form on the skin surface, peeling over a period of 3-10 days (sometimes up to 15 days). During this period, it’s essential to apply rejuvenating creams and protect the area from sun exposure.

After the Plasmage treatment, small scabs form at the application sites, which should be treated with maxitrol ointment for the first 3-4 days. These scabs fall off after 5-7 days. During this time, the area should not be dampened, treated with other creams, or exposed to the sun. Once the scabs fall off, apply a high SPF sunscreen if the area is exposed to the sun, as skin renewal continues for several weeks.

After the Co2 fractional laser treatment, there’s swelling and redness. The swelling lasts 2-3 days, while the redness intensifies, leading to the formation of small scabs on the skin surface followed by skin peeling, usually concluding 6-10 days post-treatment. It’s important to hydrate the skin during this period, and physiological saline wraps can be applied. Sun exposure should be avoided until the skin fully recovers, and applying a high SPF sunscreen is mandatory if the area is exposed to the sun.

After a chemical facial peel, the skin remains slightly red for 1-2 days, followed by exfoliation. The intensity of the peeling depends on the type, concentration, and pH of the acid and the duration of the application, based on the desired effect. Sun exposure, tanning beds, saunas, and aggressive products should be avoided until the skin recovers. It’s essential to apply a high SPF sunscreen.

The Apocalypsis phyto-peeling treatment also requires post-treatment care. For the first 2 days, the face is red with a burning and tightening sensation, followed by intense exfoliation lasting 3-5 days. Until the exfoliation ends, it’s forbidden to touch the face, wash, apply cleaners, serums, and creams. Only sunscreen application is allowed. Sun exposure is prohibited. We recommend Juliette Armand Sun Film SPF 50, which also contains antioxidants. After the exfoliation, a Recovery skin renewal treatment is required. At-home care with Dermaheal gel and Dermaheal cream is recommended for faster skin recovery.

After the Micropen treatment, the skin appears red with a feeling of tightness and burning. The redness typically fades within 1-2 days, and the sensations of tightness and burning gradually decrease. Applying a high SPF sunscreen is essential, along with avoiding sunbathing, tanning beds, saunas, and intense workouts for the first week. We recommend applying a repairing cream for the first month during the most intensive renewal phase and daily use of sunscreen, which should be a part of the regular beauty routine. Our suggestion is Repair Cream or Dermaheal Cream by Juliette Armand, containing innovative ingredients that soothe and regenerate the skin. We also recommend Sun Film SPF 30 or 50+ with added antioxidants and pigments that adapt to every skin tone.