Why treat pigmentation disorder in Asians? Softer and clearer skin is a key to looking younger and improved self satisfaction

Transcription

1 Peter Kim FACCS

2 Why treat pigmentation disorder in Asians? Prevalent especially in Asians High demand Fore-ever try to disguise it with thick make ups, c osmeceuticals and other remedies. Self esteem Softer and clearer skin is a key to looking younger and improved self satisfaction

3 Why treat pigmentation disorder in Asians? My grandma told me.. You have to have a good teeth and good skin even when you get older...

4 Why treat pigmentation disorder in Asians? Now I am Happy, I have good teeth and GOOD SKIN

5 What are Asians presenting with? Various different types of pigmentations and other skin conditions Depends on the age group We commonly see : Younger : Middle: Middle & above: 45 +

6 What are Asians presenting with?

7 What are Asians presenting with?

8 What are Asians presenting with?

9 What are Asians presenting with?

10 What are Asians presenting with?

11 What are Asians presenting with?

12 What are Asians presenting with?

13 What are Asians presenting with?

14 What are Asians presenting with?

15 What are Asians presenting with?

16 What are Asians presenting with?

17 What are Asians presenting with?

18 What are Asians presenting with?

19 What are Asians presenting with?

20 End point Clearer Skin my friend ask me whether i had face lift

21 KEY IS: Selective Photothermolysis

22 How does it work? Selective Photothermolysis Anderson RR, Parrish JA. Selective photothermolysis. Precise microsurgery by selective absorption of pulsed radi ation. Science 1983;220:524 7.

23 How does it work? Selective Photothermolysis

24 How does it work? Selective Photothermolysis

25 How does it work? Selective Photothermolysis Anderson RR, Parrish JA. Selective photothermolysis. Precise microsurgery by selective absorption of pulsed radi ation. Science 1983;220:524 7.

26 How does it work? Selective Photothermolysis

27 How does it work? Selective Photothermolysis

28 ULTRASTRUCTURAL FINDINGS Journal of Electron Microscopy, 2011; 60: 11 18

29 3D reconstruction (All images courtesy JY Mun) Dendritic processes Two melanocytes are seen in 3D, reconstructed from the data from 500 x 50 nm slices and computer rendered: color is for illustrative purposes only. Image is of skin from a melasma patient before skin toning A melanocyte from the same patient after laser toning. The cell is still alive, but appears to have undergone a dendrectomy Journal of Electron Microscopy, 2011; 60: 11 18

30 Why QS 1064nm Nd:Yag?

31 Why QS 1064? Appropriate wavelength Anderson RR, Margolis RJ, Watenabe S, et al. Selective photothermolysis of cutaneous pigmentation by Q-switc hed Nd:YAG laser pulses at 1064, 532, and 355 nm. J Invest Dermatol 1989;93:28 32.

32 Appropriate wavelength Pigments absorbs light over wide range of light spectrum, including 1064nm

33 Appropriate wavelength Increasing the power of delivered laser produces deeper SP. Anderson RR, Margolis RJ, Watenabe S, et al. Selective photothermolysis of cutaneous pigmentation by Q-switc hed Nd:YAG laser pulses at 1064, 532, and 355 nm. J Invest Dermatol 1989;93:28 32.

34 MECHANISM OF ACTION Q-Switched Nd:YAG Laser Macrophage Pigment or ink particles Explosion Absorption and drainage by human immune system

35 In Simple Summary Laser Skin Treatment Technique Uses Light (Q/S 1064nm Nd:YagLaser) Selectively heat & destroy specific structure in ski n (pigmented cosmetic blemishes as shown) Limit collateral damage or surrounding structures (without major skin complications)

36 In Simple Summary: 3 essential Laser variables needs to be corrected: Pulse Duration: Duration of laser exposure has to be short longer the dur ation more collateral damage Appropriate wavelength for: Maximal selective optical absorption of desired skin structu re Determine tissue depth at which SP occurs Appropriate power Enough to shutter the pigments Some effect on the depth of SP

37 Is it effective in Asian Skin? AUTHOR TITLE JOURNAL Outcomes of 52 patients with congenital melanocytic naevi treated with UltraP ulse Carbon Dioxide and Frequency Doubled Q-Switched Nd-Yag laser. Al-Hadithy N Al-Nakib K Quaba A Journal of Plastic, Reconstructive & Aestheti c Surgery: JPRAS. 65(8): , 2012 Aug. Kar HK Gupta L Kim SD Kim SW Huh CH Suh DH Eun HC 1064 nm Q switched Nd: YAG laser treatment of nevus of Ota: an Indian open label prospective study of 50 patients. Changes of biophysical properties of the skin measured by non-invasive techni ques after Q-switched Nd-YAG laser therapy in patients with nevus of Ota. Indian Journal of Dermatology, Venereology & Leprology. 77(5):565-70, 2011 Sep-Oct. Skin Research & Technology. 7(4):262-71, Nov. Li Y Yang K Treatment of recalcitrant-pigmented flat warts using frequency-doubled Q-swit ched Nd-YAG laser. Lasers in Surgery & Medicine. 29(3):244-7, Peach AH Thomas K Kenealy J Ogata H Colour shift following tattoo removal with Q-switched Nd-YAG laser (1064/532).British Journal of Plastic Surgery. 52(6):482-7, 1999 Sep. Evaluation of the effect of Q-switched ruby and Q-switched Nd-YAG laser irrad iation on melanosomes in dermal melanocytosis. Keio Journal of Medicine. 46(4):188-95, Dec. Kilmer SL, Wheeland RG Treatment of epidermal pigmented lesions with the frequency-doubled Q-switc Archives of Dermatology. 130(12):1515-9, 19 Goldberg DJ, Anderson RR hed Nd:YAG laser. A controlled, single-impact, dose-response, multicenter trial. 94 Dec. Anderson RR, Margolis RJ, Selective photothermolysis of cutaneous pigmentation by Q-switched Nd: YAG Journal of Investigative Dermatology. 93(1):2 Watenabe S, Flotte T, Hruz laser pulses at 1064, 532, and 355 nm. 8-32, 1989 Jul. a GJ Dover JS

38 Is it effective in Asian Skin? AUTHOR TITLE JOURNAL Outcomes of 52 patients with congenital melanocytic naevi treated with UltraP ulse Carbon Dioxide and Frequency Doubled Q-Switched Nd-Yag laser. Al-Hadithy N Al-Nakib K Quaba A Journal of Plastic, Reconstructive & Aestheti c Surgery: JPRAS. 65(8): , 2012 Aug. Kar HK Gupta L Kim SD Kim SW Huh CH Suh DH Eun HC 1064 nm Q switched Nd: YAG laser treatment of nevus of Ota: an Indian open label prospective study of 50 patients. Changes of biophysical properties of the skin measured by non-invasive techni ques after Q-switched Nd-YAG laser therapy in patients with nevus of Ota. Indian Journal of Dermatology, Venereology & Leprology. 77(5):565-70, 2011 Sep-Oct. Skin Research & Technology. 7(4):262-71, Nov. Li Y Yang K Treatment of recalcitrant-pigmented flat warts using frequency-doubled Q-swit ched Nd-YAG laser. Lasers in Surgery & Medicine. 29(3):244-7, Peach AH Thomas K Kenealy J Ogata H Colour shift following tattoo removal with Q-switched Nd-YAG laser (1064/532).British Journal of Plastic Surgery. 52(6):482-7, 1999 Sep. Evaluation of the effect of Q-switched ruby and Q-switched Nd-YAG laser irrad iation on melanosomes in dermal melanocytosis. Keio Journal of Medicine. 46(4):188-95, Dec. Kilmer SL, Wheeland RG Treatment of epidermal pigmented lesions with the frequency-doubled Q-switc Archives of Dermatology. 130(12):1515-9, 19 Goldberg DJ, Anderson RR hed Nd:YAG laser. A controlled, single-impact, dose-response, multicenter trial. 94 Dec. Anderson RR, Margolis RJ, Selective photothermolysis of cutaneous pigmentation by Q-switched Nd: YAG Journal of Investigative Dermatology. 93(1):2 Watenabe S, Flotte T, Hruz laser pulses at 1064, 532, and 355 nm. 8-32, 1989 Jul. a GJ Dover JS

39 Advantages of using QS Nd:Yag Laser: Quick, no down time Minimal discomfort (no need anesthetic oint) Good result (progressive improvement) Very low risk of complications

40 HYUNSAE KIM MD,Ph.D Peter Kim FACCS Slim-Korea lipoplasty network

41 1064 QS Nd:YAG Laser is effective in Asian Skin Pigmentation Now I am Happy, I have good teeth and GOOD SKIN!