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Cosmetic Dermatology

Got Melasma? Piqo4, a new laser for unwanted brown spots

Posted on: April 10th, 2018 by Dr. Jennifer Herrmann

Even before laugh lines or deepening forehead furrows, dark spots are often the first sign that we’re not getting any younger. But unlike blemishes, brown discolorations don’t fade away on their own and can be particularly stubborn, if Melasma is their cause.

Melasma is an inflammatory skin condition that causes brown-gray blotches on the forehead, cheeks, and upper lip in people who are genetically prone. Hormones, especially estrogen and progesterone in combination with the sun put your skin pigment cells into overdrive, gradually creating patchy discoloration.

Although topical brightening creams are often first-line treatments, these products typically don’t penetrate deeply enough to really remove pigment satisfactorily. Chemical peels typically fall short, too, and most traditional lasers aren’t good options because they use too much heat, which can paradoxically worsen pigmentation.

So, are there other options? We asked top Beverly Hills cosmetic dermatologist Dr. Jennifer Herrmann what’s new for treating Melasma.

New Treatment Options for Melasma

Treating Melasma typically starts with managing or eliminating risk factors and using topical lightening formulations.

“Daily sun protection is a must because sun is one of the few variables we can better manage,” says Dr. Herrmann.

Controlling hormones is more difficult unless you’re on a birth control pill and can stop it. For topicals, Dr. Herrmann recommends combination creams that target multiple steps in the “pigment pathway,” for better clearance. “It’s a multi-pronged approach,” she relays.  Combinations containing compounds like hydroquinone, arbutin, azeleic acid, or kojic acid may temporarily improve the skin, but pigment often returns when products aren’t used.

What about devices or lasers for treating Melasma?

“We have used light and laser based treatments for several years, but they haven’t been perfect,” explains Dr. Herrmann. “The problem with most lasers is that energy delivered creates too much heat in the skin, which can create additional injury-related pigmentation. This is particularly problematic because pigment is what we’re trying to improve in Melasma, and nothing is more frustrating than worsening it!”

But, there is a newer laser, one that helps circumvent this concern, the piQo4 picosecond laser. According to Dr. Herrmann, “The piQo4 helps solve this problem because it delivers energy so quickly, the skin doesn’t heat up.” How? The piQo4 transfers light energy to brown spots in very short picoseconds, faster than nano and milliseconds. The pigment absorbs it so quickly, that the energy is immediately converted into pressure, not heat. This pressure shatters the pigment particles into sand, which your body eliminates. The end result? Clearer skin without paradoxical darkening.

But, this is not a one-time treatment. To safely clear brown patches, 6-8 weekly treatments are needed. And because of the recalcitrant nature of Melasma, a monthly maintenance treatment is advisable.

“What I really like about the piQo4 treatments is that they are safe on darker skin and don’t require any downtime. Patients are in an out, clearer after each treatment.”

So, with so many less than perfect options, why not give the piQo4 laser a shot? Clearer, brighter skin is your upside. Schedule a consultation with Dr. Jennifer Herrmann at one of our dermatology clinics in Beverly Hills, Encino or Torrance.


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