[Same Toning, Different Details] Laser Toning

Our Korean Medicine Clinic's Approach to Laser Toning

• We perform laser toning using sufficient energy, with over 2,000 shots. We avoid simply performing quick procedures with low output, instead precisely delivering the necessary energy to the skin to minimize irritation and promote pigment improvement.
• Various pigmentary disorders such as melasma, ABNOM, and freckles all have different depths and characteristics of occurrence. Based on clinical experience, we carefully adjust the laser intensity to match the depth and type of each pigment. For example, melasma is treated gently, ABNOM strongly, and in complex cases, different parameters are applied to different areas.
• Laser treatment is not just about operating the machine and finishing. During the procedure, we closely observe the skin's reaction and check it together with the patient using a mirror. If necessary, we adjust the laser's spot size, intensity, and even the handpiece in real-time to proceed in the most suitable way for each individual.
• We do not rely solely on visual inspection for pigment diagnosis. We utilize a Mark-Vu diagnostic device to precisely identify the type of pigment, its distribution within the skin, and its exact depth. Based on these objective diagnostic results, we meticulously establish an individualized treatment plan.
• When multiple types of pigments appear in combination, sticking to just one method can sometimes worsen hyperpigmentation. Especially when melasma and ABNOM are co-occurring, we first go through a process of stably calming the melasma. Afterward, we proceed with laser irradiation for ABNOM located in the dermal layer, delicately approaching complex pigment issues.

What makes our Korean Medicine Clinic's Laser Toning different?

Laser toning is a widely used treatment for managing pigmentary disorders. However, it is important to understand that the results can vary significantly depending on the type of equipment used, the number of shots delivered, and the method of laser intensity control.

Various pigmentary disorders such as melasma, freckles, and ABNOM exist at different depths within the skin, and their tissue responses to lasers also vary. It is crucial to meticulously plan the treatment considering these individual characteristics.

1. Standard for delivering sufficient energy with over 2,000 shots

According to several research reports, low-output laser toning can show relatively stable and effective improvement when performed within the range of approximately 1500 to 2500 shots.

At our clinic, we fundamentally adhere to the principle of delivering over 2,000 laser shots. We carefully plan the treatment to deliver sufficient energy for pigment improvement while minimizing unnecessary irritation to the skin.

Skin changes are not achieved by simply operating a laser device.

It is absolutely necessary to customize various factors such as laser shot count, output, irradiation speed, and spot size, taking into account the depth of the pigment, its distribution range, and each individual's skin sensitivity.

2. Customized Laser Toning According to Disease Type

1) Melasma

Melasma is one of the pigmentary skin diseases that primarily appears on both sides of the face.

Melasma, caused by the excessive activation of melanin cells, can react sensitively to external stimuli and potentially worsen.

At our clinic, we use the Mark-Vu precise skin diagnostic device to determine the exact extent and depth of melasma. Based on this, we begin treatment with laser toning that has a short pulse duration of 5 nanoseconds (ns).

This laser method focuses on selectively destroying only the melanosomes within the cells, without directly stimulating the melanin cells themselves, thereby reducing potential side effects after treatment.

During the procedure, the medical staff directly checks the skin's reaction using a mirror and continuously adjusts the laser intensity and focal areas. If necessary, they carefully adjust parameters by changing the handpiece or making fine-tuned settings to ensure no area is overlooked.

We proceed by checking the skin condition with the patient through a mirror before, during, and after the procedure.

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

ABNOM, like melasma, is a condition where pigment is located in the dermal layer. However, it may require higher laser intensity compared to melasma.

In complex cases where melasma and ABNOM appear together, a contrasting approach is simultaneously needed: a gentle laser for melasma and a stronger laser for ABNOM. This requires the careful judgment and skilled experience of the medical staff.

If high-intensity treatment is immediately performed without considering melasma, there is a risk of worsening the melasma.

We establish a customized treatment plan through thorough differential diagnosis before the procedure. This allows us to minimize the possibility of side effects while individually setting the laser intensity so that pigments like ABNOM can also be improved.

For ABNOM treatment, after accurate differentiation with the Mark-Vu diagnostic device, we apply personalized parameter settings. We meticulously adjust the spot size, number of repetitions, and output according to the skin type and condition.

3) Other Pigmentary Disorders

Pigments that respond relatively well to lasers, such as lentigines, freckles, and sunspots, can expect improvement with appropriate wavelength settings. However, when these pigments are accompanied by melasma or ABNOM, the treatment process requires a more delicate and complex approach.

For such complex pigmentary disorders, accurate differentiation is crucial, and a very delicate, customized approach is necessary, including checking skin reactions with a mirror and adjusting laser output and handpiece during each session. Beyond general laser toning, we focus on individually managing melanin pigments based on the skilled experience of our medical staff.

Differences between Picotoning and Laser Toning

Picotoning has the theoretical characteristic of using very short laser pulses in picosecond units to break down pigment particles even more finely.

In contrast, general laser toning uses nanosecond units, delivering energy to the skin for a relatively longer period.

Both of these laser toning methods selectively destroy melanin pigment to improve overall skin tone and are used to manage various pigmentary disorders such as melasma, freckles, and ABNOM.

Due to the difference in laser irradiation time, there is a perception that picotoning may have a faster response rate during the initial 2-3 treatment sessions. However, with consistent cumulative treatments of 10 or more sessions, both methods are often reported to show similar skin tone improvement effects.

Laser toning is a treatment method that has been clinically proven for approximately 20 years. Especially for conditions like melasma, which have sensitive skin or are vulnerable to irritation, it is considered a relatively stable approach.

Due to its characteristic of delivering strong energy intensively in a very short time, picotoning may be accompanied by temporary redness or a stinging sensation after the procedure.

Actual clinical studies show that when compared using the same 1064nm wavelength, many reports indicate no statistically significant difference between the two methods in terms of skin brightness improvement, reduction in melasma scores, and decrease in melanin index.

Conditions for achieving sufficient effects with laser toning

To achieve cumulative effects, it's important to undergo laser treatments at least 10 or more times.

During treatment, the energy should be carefully adjusted within the 1.0~2.0 J/cm² range, based on your skin's real-time reaction.

For optimal results, it is recommended to apply at least 2000 shots per session.

It is advisable to maintain intervals of 1 to 2 weeks. If treatment intervals are too long, the cumulative effect may be reduced.

It's best to receive treatment from a medical professional who can customize the procedure based on your individual skin type and real-time reactions.

When these treatment conditions are met, various studies suggest that you can expect similar improvement effects to picotoning.

This content was developed based on relevant research papers.

For instance, references include 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 that involves repeatedly applying low-intensity laser energy to the deeper layers of the skin, gradually breaking down melanin pigments and evening out overall skin tone.

Unlike high-power laser treatments that directly remove pigment, this method continuously provides subtle stimulation to effectively break down melanin and aid the skin's natural regeneration process.

It can be used to improve various types of pigmented conditions such as melasma, freckles, and acquired bilateral nevus of Ota-like macules (ABNOM), all while minimizing skin burden. It has become one of the most widely used pigment treatment methods today.

1. Type of laser used: Q-switched Nd:YAG

Typically, Q-switched Nd:YAG lasers are utilized for laser toning treatments.

The 1064nm wavelength of this laser effectively reaches the upper dermis, where melanin pigment is primarily located. It has the advantage of selectively targeting pigment without damaging the skin's surface.

By focusing on melanin removal while protecting the skin barrier, it can be applied relatively gently even to sensitive or thin skin.

2. Repeated ‘tone-up’ stimulation with low energy

While some traditional pigment treatments use powerful lasers to remove pigment quickly, laser toning employs a method of applying low-energy light repeatedly thousands of times.

This approach minimizes damage to skin tissue while gradually breaking down melanin pigment particles into tiny fragments. These broken-down pigments are then absorbed by your body's immune system, specifically macrophages, and are naturally expelled from the body.

Through this process, you can expect your skin tone to gradually improve, becoming more even and overall clearer.

3. Destruction of melanocyte dendrites and intracellular melanin removal

Beyond simply breaking down melanin pigment, laser toning also helps to inhibit the fundamental pathway of pigment production.

The main mechanism of this process is the destruction of melanocyte dendrites.

Dendrites serve as pathways that deliver mature melanosomes, which are melanin carriers produced in melanocytes, to the epidermis, the outer layer of the skin.

When the laser damages these dendrites, the movement of melanin carriers to the epidermis can be restricted. This helps reduce the formation of new pigments on the skin surface.

Furthermore, it can directly break down melanin pigment already accumulated within melanocytes, helping to improve existing hyperpigmentation.

This action is only observed with lasers that have short pulse durations, such as nanosecond or picosecond lasers.

This is a key mechanism of action primarily seen in treatments like laser toning or picotoning.

3 Core Principles of Laser Toning

Three main treatment principles of laser toning

Laser toning goes beyond simply removing melanin pigment; it works by regulating the entire process from melanin production to its migration.

1. Removal of already formed pigment particles

For pigmented lesions such as freckles or acquired bilateral nevus of Ota-like macules (ABNOM)—which differ from melasma—improvement can be expected by applying relatively strong treatment parameters to effectively remove melanin.

However, because melasma is sensitive to stimulation, very careful energy adjustment is required during treatment. A cautious approach is important to prevent excessive stimulation from inadvertently increasing melanocyte activity.

2. Inhibition of melanosome transport through destruction of melanocyte dendrites

By obstructing the migration of melanosomes produced by melanocytes to the epidermal layer, it can help prevent the formation of new hyperpigmentation.

3. Direct breakdown of melanin within melanocytes

Laser energy directly breaks down melanin pigment found within melanocyte cells. This reduces the amount of melanin, which can lead to an overall improvement in skin tone.

Expected Effects of Laser Toning

• 1. Tone-up effect for brighter, more even skin. Subtle laser stimulation gently breaks down melanin, which can help dull skin tone gradually become clearer overall.
• 2. Alleviation of Melasma and PigmentationBy selectively destroying melanosomes without directly stimulating melanin cells, we can manage melasma and pigmentation. This can also help improve melasma in sensitive skin.
• 3. Improvement of ABNOM (Acquired Bilateral Nevus of Ota-like Macules)Pigmentation located deeper in the dermal layer than melasma, such as Acquired Bilateral Nevus of Ota-like Macules (ABNOM), can also be improved. We adjust the intensity to target pigmented lesions based on each individual's condition.
• 4. Recurrence Management by Blocking Pigment FormationBy destroying the dendrite sheaths, which are pathways for pigment cells, we can reduce the migration of melanin to the skin surface. This process can help manage by suppressing the formation of new pigments.
• 5. Improvement of Fine Lines and Skin TextureLaser stimulation can also play a role in assisting the skin's regeneration process. As a result, you can expect an incidental improvement in which skin texture feels more even and fine lines are alleviated.
• 6. Minimizing Skin IrritationWe focus on reducing skin irritation by using a method that involves multiple irradiations with low energy. This helps individuals with sensitive skin consider the procedure.

Recommended for Laser Toning

• 1. Individuals who feel their skin tone is uneven and dull
• 2. Individuals whose concerns about pigmentation, such as melasma, blemishes, and freckles, are deepening
• 3. Individuals with pigmented lesions in the dermal layer, such as Acquired Bilateral Nevus of Ota-like Macules (ABNOM)
• 4. Individuals who desire pigment improvement despite having thin and sensitive skin
• 5. Individuals who expect overall improvement in fine lines and skin texture along with pigment management
• 6. Individuals who seek gradual skin changes while minimizing skin irritation

Laser Toning Procedure Process

• STEP 1. Precise Skin Diagnosis using Mark-Vu: We accurately analyze the depth and extent of pigmented lesions that are difficult to identify with the naked eye.
• STEP 2. 1:1 Medical Professional Consultation and Individual Treatment Plan Development
• STEP 3. Personalized Laser Parameter Setting and Laser Toning Procedure (Final confirmation with the medical professional using a mirror before the procedure)
• STEP 4. Real-time Progress Check with a Mirror During the Procedure and Reassessment of Areas Requiring Focus
• STEP 5. Result Confirmation via Mirror After the Procedure and Explanation of Future Progress

A Message from the Chief Director

We understand that many individuals have struggled for a long time with pigmentation issues such as melasma or ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

It seems many worry whether their condition will truly improve, or if it might even worsen.

We believe that pigment treatment goes beyond simply operating equipment; it's crucial to meticulously examine the unique characteristics of each individual patient.

We diligently assess each patient's skin condition and strive to perform treatments by focusing only on the necessary areas.

The approach must vary depending on the type and depth of the pigment, as well as your skin's sensitivity.

Laser toning procedures require a thorough diagnosis and a delicate approach. We conduct treatments in a way that aims for improvement, considering each individual's condition, and we will do our utmost to alleviate our patients' skin concerns.

Post-Procedure Precautions

• ㆍ시술 당일부터 세안 및 메이크업이 가능합니다. 자외선 차단에 특히 신경 써 주시길 당부드립니다.
• ㆍ시술 후 일시적으로 예민해진 피부에는 진정과 보습 관리를 꾸준히 해주시는 것이 좋습니다.
• ㆍ시술 후 간혹 붓기나 붉은 기운이 나타날 수 있으나, 대부분 시간이 지나면서 자연스럽게 가라앉습니다. 만약 이러한 증상이 며칠 이상 지속된다면 내원하시어 상담받으시는 것을 권해드립니다.