This procedure is performed at our Gheringhap St, Geelong Clinic
ABOUT GREEN TONING
Green toning is a new method of non-ablative skin rejuvenation, often used for treatment of melasma and other pigmentation conditions. This treatment is performed with low energy level settings on our QX MAX laser using both Q-Switch Nd:YAG 1064nm and KTP 532nm. The Q-Switch Nd:YAG at 1064nm has a deep penetration into the skin and causes deep dermal heating. This leads to the formation of elastin and the shattering of dermal pigmentation. Q-Switch light is unique in that it breaks down pigments and not the cells, allowing pigment destruction without ablating the skin, meaning that there is no downtime. The KTP 532nm frequency is used following the Q-Switch Nd:YAG to help remove superficial pigmentation and assist with the microvascular component of melasma. Results show an improvement in skin texture, tone and pigmentation. Minimal downtime is required for this treatment. Several sessions are required to maximise the effect.
At Body Recon we are industry leaders with our innovative Green Toning treatment. Our treatment findings and parameters were presented at the annual Laser And Health Academy (LAHA) conference in Slovenia in 2013 to medical professionals from all over the world, to showcase the treatment and what types of results can be achieved.
FREQUENTLY ASKED QUESTIONS
This will depend on the strength of the treatment but generally we perform a course of less aggressive treatments, leaving the skin mildly red for the first few hours. This redness dissipates very quickly, usually without any flaking or peeling.
Deeper, more aggressive sessions may result in some downtime with scabbing and flaking of the skin. We generally try to avoid these more intense settings as injury to the skin can often cause re-stimulation of melasma.
For these lower energy treatments, anaesthesia is not required. You will be able to feel Q-Switch Nd:YAG, however at Body Recon we always use a cooling device which blows refrigerated air onto the area and makes the treatment very tolerable. KTP 532nm feels very similar to a pins and needles sensation. Green toning is much more comfortable than IPL therapies and there will be no discomfort post treatment.
Melasma, also known as chloasma, is a form of pigmentation that is stimulated by oestrogen and can result from pregnancy, medication (the contraceptive pill and hormone replacement therapy) or from naturally high oestrogen levels. It is a difficult form of pigmentation to treat and manage as there is no real cure and ongoing maintenance is usually required.
Melasma is the result of an increase in the production of melanin within the skin, resulting in hazy pigment patches. Apart from oestrogen, other factors that are known to contribute include genetics, hormones, sun exposure and skin inflammation. Melasma is a very common skin condition that is characterized by dark pigment with irregular borders, found in the dermal and epidermal layers of the skin. It can be found on all skin types and usually affects the cheeks, upper lip, forehead or nose. Melasma can never really be cured but it can be treated to minimise its effect.
Body Recon is able to offer you a melasma treatment, the first of its kind in Australia, using Green Toning with our Fotona QX MAX laser. Q-Switch laser works on the melasma in a similar way to tattoo removal – using a nanosecond pulse to shatter the underlying pigment in the skin. This creates a photoaccoustic response in the skin, shattering the pigment into particles small enough to be removed by the body’s inflammatory response.
It really depends on the severity and strength of your melasma. We usually begin with a course of 3-4 sessions spaced every 4 weeks. From there we reassess your response to treatment and either cut back to maintenance sessions or begin another course for more severe cases of melasma. It is particularly difficult to predict how melasma will respond to treatment and it can be different in every case.
It is important to try to determine if there are any causative factors that may be exacerbating the pigmentation, for example, the oral contraceptive pill or a hormone imbalance.
The next step is daily sun and UV protection and avoidance – this is paramount in the treatment of melasma. UV radiation is a key factor in exacerbating melasma and it will often appear during or after a summer of significant UV exposure. Using corrective sunscreen on a daily basis is very important as is avoidance of sun exposure.
Topical lightening agents must be used in conjunction with green toning laser to control the melanocyte skin cells that are producing the melanin and creating the melasma. Kligman’s formula is often recommended to help lighten skin pigmentation, as it is a powerful combination of lightening and exfoliating agents. It can be prescribed by Dr Rahdon when required and it contains; hydroquinone, which helps to prevent the production of new melanin (skin pigment), tretinoin, which helps to exfoliate and flush out existing melanin and hydrocortisone, which helps to calm the skin from these active ingredients. Kligman’s formula is not often recommended for long-term use but a short course may be advisable whilst undergoing the green toning treatment.
We also offer other non-prescription types of lightening agents. Lytera is a complete lightening system that is a non-hydroquinone alternative and has been proven to give results equivalent to hydroquinone. Often this will be recommended as a topical maintenance.
Adverse outcomes with laser treatments are undesired outcomes that occur in a small percentage of patients treated. It is very rare to have any adverse outcome when treating with Green Toning.
Adverse outcomes can include:
- post-inflammatory hyperpigmentation – a brown mark left on the skin after treatment that usually takes some months to fade with the assistance of lightening agents.
- Hypopigmentation – loss of pigmentation in the treated area that can be permanent. This is very rare.
- Prolonged redness – sometimes the redness of the skin can take a longer time to fade than expected.
- Bacterial or viral infection – laser treatments can sometimes trigger herpes simplex outbreaks. Any viral or bacterial infection in a wound created by a laser has the potential for scarring. It is important to let your specialist know if you are prone to cold sores or any other viral condition.
- Scarring – a very rare possibility, usually associated with darker skin types, over-zealous energy settings and bacterial or viral infection. For darker skin types, you may be required to have a test patch prior to your treatment.
Fractionated laser is another option for the treatment of different grades of melasma. As the name suggests, fractionated laser only treats a fraction of the skin by firing micro-columns of laser energy into the skin. The fractional nature of the laser allows the melasma pigmentation to break down and be extruded from the skin. For deeper melasma, fractional in combination with Green Toning may be suitable. Usually 2-3 treatments are required and there may be a few days of downtime post treatment.
Other lasers or IPL are often used in the treatment of melasma, however, they are often unsuited to this treatment and can cause worsening of the pigmentation. This occurs when excessive heat/energy is transferred to the skin by the laser/IPL causing inflammation which leads to the formation of extra pigmentation.
Chemical peels can help to speed the process of improvement from melasma by increasing skin turnover and shifting the melanin deposits from the affected area. Light chemical peels are usually used, as the stronger chemical peels such as our medical-grade TCA can often stimulate new pigmentation production so aren’t the best option.
It is important to note that melasma is a chronic skin condition and cannot be cured. The above treatments all help in the management of melasma but it has a strong tendency to return and so maintenance treatments are essential. At Body Recon we aim to get your melasma to a level where you would require 2-4 maintenance treatments a year depending on the severity of the condition.
For the face, a stand-alone Q-Switch laser treatment and KTP treatment are $300 each. However, we are able to package these treatments into a course which will entitle you to considerable savings. Packages can be drawn up at the time of your initial Visia consultation.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.