How to treat PIGMENTATION - Part 2 

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How to treat pigmentation - Part 2
Thanks for all you subscribers over the last 2 years. This channel is growing, and I cannot thank you enough for all your support. Who thought a Brisbane Dermatologist using a phone to shoot all his videos can nearly reach 200,000 subs. Thanks guys! So, here are the technical details of how to treat dermal pigmentation.
1. Melasma - This can be epidermal, dermal but most commonly mixed dermal and epidermal. I see 5 to 6 melasma cases a daily. This is because Brisbane, Australia has a high amount of UV radiation. 95% of melasma can be successfully managed with lasers, creams, sun protection and tablets that have an effect on the blood vessels. Melasma is a medical condition and should be treated by specialists only. Incorrect treatment will make this worse. I prefer Revlite or Nano lasers, or the new Picosure,- Picoway - Enlighten laser. Laser parameters, coupled with tyrosinase inhibitors and SPF are critical to getting a good outcome. It is more about the end point settings and wavelengths than the brand of the laser. IPL should never be used to treat melasma as this results in a thermal burn and rebound. If you have had IPL treatment for melasma, see a laser dermatologist to write a medico-legal report. To use IPL to treat mixed melasma can be considered as legally negligent.
2. Birthmarks can be epidermal or dermal. Dermal birthmarks include Ota naevi, and are very common. They occur mostly in Asian and ethic skin types. Hori’s naevi are also commonly seen in Asian women and present on the cheeks- the laser of choice is a Q switch laser. Picoway, or Enlighten over Picosure. Picosure made one of the worse 1064 filtered handpieces that is virtually useless. Older tech such as C6 or RevLite will outperform Cynosure’s Picosure in this context.
3. Traumatic tattoos due to accidents, falls, pencil wounds, or explosions are very common. Depending on the size of particles, I use everything from erbium lasers for large ‘pebbles’ to Picosure -Picosecond lasers. 2-3 sessions, 2-3 months apart will treat the majority of these tattoos.
Thanks for viewing, I do one fun, education video on laser and aesthetic dermatology every week. Will be doing more VLOGs in the future. Please share, comment, like and by all means SUBSCRIBE. See you next week, Dr Davin Lim. Brisbane. Australia