Pigmented Lesions

Pigmented Lesions
Just about everyone has a few obvious brown spots on their skin. Freckles, age spots, liver spots, and various birthmarks are some of the common conditions referred to as pigmented lesions. These are caused by the deposit of pigmented cells (melanocytes) at various depths under the skin surface.

Before the development of pigment-specic lasers, most pigmented skin lesions could only be treated with surgical excision, often leading to an ugly scar formation. Modern lasers can now treat unwanted pigment without damaging the skin.

What results can I expect?
Light freckles and “age spots” may resolve with just one or two treatments. However multiple laser treatments are usually necessary for pigmented birthmarks such as cafe-au-lait spots, naevi of Ota and Becker’s nevus.

How frequent do I need laser treatment?
Follow-up reviews are usually scheduled at intervals of six to eight weeks. Your dermatologist will advise you, if another treatment is needed.

Is the process painful?
The impact of the laser feels like a snap of a rubber band on the skin. Although most people find the sensation mildly uncomfortable and without the need for any anaesthesia. Some patients with larger marks or those who are more sensitive may require an anaesthetic cream or injection before treatment. After treatment, the area will feel similar to that of sunburn. Typically, any discomfort will disappear within a day or so.

What happens after the process?
Some swelling, bruising, crusting and scabbing can occur but all these should resolve within one to two weeks.

What type of post-treatment care is necessary?
Frequent applications of cold pack during the first 12 hours can help in reducing the swelling and redness, and relieve the sunburn sensation.

A gentle skin cleanser and an antibacterial ointment will be prescribed for the treated area. Avoid scrubbing, scratching and picking on the scabs and crusts.

Sunscreen is absolutely necessary as exposure to sun may darken the treated area during healing, and also cause new pigmented lesions.

Your specialist may later prescribe other medications such as tretinoin cream, bleaching cream, vitamin C serum or AHA products to further improve your complexion.

Any other possible side effects?
Although complications of this procedure are minimal, a small risk of the following could occur after the laser treatment:

•  Skin darkening (hyperpigmentation)
  “Tanning” of the skin can occur in the treated areas and will fade within two to six months. This reaction is more common in patients with dark skin tones and worsens if the laser-treated area is exposed to the sun.
  
  
• Skin lightening (hypopigmentation)
  Light spots can appear in an area of skin that has already received several treatments. These pale areas will usually darken or repigment in three to six months. In rare cases, this can be permanent.
  
  
• Infection and scarring
  It is extremely rare to have infection and scarring after laser treatment but you should notify your dermatologist. Follow all post-operative instructions to reduce the possibility of this occurrence.
  
  
• Lesion persistence or recurrence
  Some pigmented lesions, especially the dark-coloured birthmarks, may not disappear completely or may recur after treatment even with the best efforts made.

Always feel free to discuss your fears and concerns with your dermatologist as they are there to help and guide you through your treatment.