Understanding and Treating Melasma: A Comprehensive Guide > Plastic Surgery

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What Causes Melasma?

Jamsil Melasma Dermatology

Melasma is not just a simple blemish caused by sunlight.

It is a complex pigmentation disorder that occurs when melanocytes (pigment cells that produce melanin) are excessively activated by various stimuli.

In other words, melasma develops as pigment cells become sensitive due to the combined effects of UV rays, hormonal changes, genetic factors, inflammation, and heat.

These cells then overproduce melanin, causing discoloration to appear on the skin.

Melasma is particularly common in people with medium to dark skin tones, such as Asians.

This is because melanin production is more active in their skin compared to Caucasians.

Furthermore, hormonal changes that begin in the 30s and 40s can make pigment cells more sensitive, potentially causing melasma to suddenly worsen after pregnancy, birth control use, stress, or lack of sleep.

Therefore, it is more accurate to view melasma not as a disease that disappears completely once it occurs, but as a "chronic pigmentation disorder that can improve and then reappear".

Why Cosmetics Alone Are Not Enough

Jamsil Melasma Dermatology

Many people find that melasma does not improve even with consistent use of whitening cosmetics because the pigmentation is located deep within the skin.

The skin's pigment layer is divided into the epidermis and dermis. Melasma is often a 'mixed type' where melanin is deposited up to the upper dermis.

Cosmetic ingredients mostly affect only the epidermis, making it difficult for them to reach the pigment in the dermis.

Also, melanin can be reactivated by UV rays or heat, so simply using a “whitening cream” is not enough to prevent recurrence.

Therefore, it is more important to ‘manage melasma to prevent it from recurring’ than to ‘eliminate it completely.’

The Principle of Laser Toning for Effective Melasma Treatment

Jamsil Melasma Dermatology

Laser toning uses a low-powered Q-switched laser to selectively target melanin pigment.

Rather than intensely burning away the pigment, this method gradually breaks down the pigment into smaller particles by repeatedly delivering weak energy over a short period of time.

This process causes minimal irritation to other skin tissues, resulting in almost no skin damage, scabbing, or long recovery periods, allowing patients to immediately return to their daily lives.

In addition, the gradual reduction of pigment through repeated stimulation promotes collagen regeneration in the skin, resulting in a clearer skin tone and overall brighter complexion.

This is why the formula “melasma treatment = laser toning” has become so popular these days.

What is Revlite SI?

Jamsil Melasma Dermatology

Revlite SI is a Q-switched Nd:YAG laser developed by Cynosure, USA, that uses two wavelengths: 1064nm and 532nm.

The 1064nm wavelength is used for deep dermal pigments (melasma, nevus of Ota, tattoos), and the 532nm wavelength is used for epidermal pigments (freckles, blemishes), allowing for uniform treatment of pigments at various depths.

In particular, Revlite SI's core technology, PTP (Photothermal & Photoacoustic) mode, divides one pulse into two short pulses, reducing thermal stimulation while increasing the melanin breakdown effect.

In other words, it is considered a very suitable device for sensitive and recurrent pigmentation disorders such as melasma because it reduces skin irritation while breaking down pigments more evenly.

Advantages of Revlite SI Laser Toning

Jamsil Melasma Dermatology

Smart Infinite (SI) Handpiece

Revlite SI can precisely control the laser beam spot size in 0.1mm increments through the Smart Infinite (SI) handpiece, enabling more precise and detailed procedures.

This allows energy to be delivered evenly according to the skin condition of each area, breaking down melanin pigment evenly and expecting a higher improvement effect.

Uniform Beam Energy Distribution

If the beam is not constant, one side may be irradiated excessively and the other side may be insufficient.

Revlite SI is designed with a uniform beam profile, so pigmentation is improved evenly without becoming blotchy.

Improved Safety with Low-Output Repeated Irradiation

Since pigments are gradually broken down by repeating low energy multiple times rather than strong stimulation, the risk of pigment recurrence or post-inflammatory hyperpigmentation (PIH) is low.

Overall Improvement of Skin Tone

In addition to pigment treatment, fine collagen regeneration is induced by stimulating the dermis, resulting in smoother and brighter skin.

Almost No Restrictions on Daily Life

Makeup and washing are possible immediately after the procedure, and there is no redness, swelling, or scabbing, making it a suitable treatment for 'office worker lunch procedures'.

The Real Difference in Laser Toning Lies in 'Know-How'

Jamsil Melasma Dermatology

The reason why results differ from hospital to hospital even when using the same Revlite SI is because it depends on the experience and delicacy of the practitioner, not the machine.

Because melasma makes the skin sensitive, approaching it with the idea that “if you do it strongly, it will disappear quickly” can actually make it worse.

Therefore, the more experienced the medical staff,

The first procedure starts weakly, looking at the skin reaction,

Gradually adjusting the energy,

Manage overall tone and pigment density together.

In addition, maintaining treatment intervals of 2 to 3 weeks and providing UV protection, soothing care, and moisture maintenance after treatment

Can reduce melasma recurrence.

In the end, the key to melasma treatment is ‘stable’ rather than ‘fast.’

What is more important than the machine is the skilled hand that carefully examines the patient's skin condition and performs the procedure with care.

All procedures may vary depending on the individual

Side effects such as swelling, inflammation, and bleeding may occur, so be careful.

Purple Clinic

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Source :https://blog.naver.com/purpleclinic/224063133364

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