Solar lentigo: removal of excess pigmentation with a laser

 

The process of hand aging is associated with the influence of internal (genetic) and external factors. The most significant damaging factor acting from the outside is ultraviolet radiation. Therefore, one of the most effective ways to slow down external aging – use sunscreen since childhood. Unfortunately, about 90% of irreversible photodamages on the skin are already present by the age of 20, and they can manifest themselves years later in various forms. These include thinning of the skin, wrinkles, and pigmentation disorders. Dr. David Goldberg in the article estet-portal.com talks about the case of therapy solar lentigo laser and provides an overview of approaches to hand skin rejuvenation.

• Signs of aging of the skin of the hands and approaches to their elimination
• Case report: solar lentigo therapy with a picosecond laser

Signs of aging of the skin of the hands and approaches to their elimination

There are a number of approaches to rejuvenating the skin of the hands, which are based on the solution of a specific problem.

Skin thinning

Aging skin, thinned and photodamaged, needs to be restored. Typically, dermal fillers are used to improve the overall appearance of the skin on the hands. The synthesis of collagen, elastin and proteoglycans is triggered by products based on hyaluronic acid, poly-L-lactic acid, calcium hydroxyapatite and PMMA.

 

 

Various topical products can also enhance collagen production, which include:

• vitamin A analogs (retinoids);
• growth factors;
• antioxidants, etc.

Wrinkles

The above approaches can also be used to smooth out wrinkles, but for maximum results, additional treatments based on lasers and radio frequency devices are often needed.

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When performed correctly, laser therapy can reduce the appearance of wrinkles without:

• long recovery period;
• scarring;
• post-procedure hyperpigmentation.

You may also be interested in: Fillers for hand rejuvenation: zone anatomy and procedure protocol

Pigmentation disorders

There is a wide range of pigmentation disorders caused by solar radiation. The most common is solar lentigo, which is also called senile or liver spots. However, solar lentigo has nothing to do with age or liver. These age spots – a direct result of excessive exposure to sunlight, and they appear exclusively on open areas of the skin, more often – on the face or hands.

Lentigo solaris is the most common pigmentation disorder caused by sun exposure.

To lightening the solar lentigo, different methods are also used:

• peelings: less aggressive substances do not give a pronounced effect, while effective substances are associated with a long recovery period);
• destructive methods (e.g. cryotherapy): associated with the risk of scarring and pigmentation disorders;
• IPL-therapy: may be effective in lightening solar lentigo, however a course of treatments is required and the results are less pronounced than with pigment lasers;
• Q-switched lasers or nanosecond lasers (alexandrite, ruby ​​and Nd:YAG) destroy pigment and can give good results, but significant discomfort and relatively long recovery compared to picosecond lasers, – the main disadvantages of this method of influencing the solar lentigo;
bleaching products
• with or without hydroquinone are effective in melasma, but not lentigo solar.
Case report: picosecond laser treatment of solar lentigo

A patient,

65 years old

, came to Dr. Goldberg with extensive pigmentation (solar lentigo) on her arms. For nearly a year, the patient had been using prescription hydroquinone whitening creams. However, the therapy was ineffective. The woman wanted to get rid of hyperpigmentation in one procedure, with minimal discomfort and a quick recovery. After discussion of available options for the treatment of solar lentigo, laser therapy. In the treatment of solar lentigo, the desired result was achieved after 1 session of picosecond laser therapy.

For the procedure, the doctor chose a laser that emits waves of different colors (532 nm – green, 650 nm – red, 585 nm – yellow and 1064 nm – infrared). The powerful apparatus generates nanosecond and picosecond pulses of various spot sizes – from 2 to 15 mm. Solar lentigo treatment requires

very low energy

which results in minimal trauma, discomfort and rapid recovery.

Read also:

Laser removal of age spots on hands depending on skin phototype

The doctor warned the patient that:

the healing process of the skin on the hands is longer than on the face;

• new spots may appear in the treated area after the procedure, even with regular application of a product with a high SPF;
• may need 2 more laser treatments.
 

Patient photo, 65 years old, before (left) and one month after (right) solar lentigo picosecond laser treatment

During the procedure, the author used a

low-energy

laser, and therefore the patient almost did not feel discomfort during the treatment, and it took a week for the complete recovery of the skin of the hands. The photo shows the results before and one month after laser pigmentation removal. Since the effect was more pronounced than expected, a second treatment was not needed – lentigo has been completely removed. The author advised the patient to continue to use sunscreen with SPF  30 or higher in the treated area to maintain results and prevent further damage to the skin.

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