Features of Our Clinic's Laser Toning

• 1. We aim for sufficient energy delivery of over 2,000 shots. We do not insist on low power or low shot counts for quick procedures. At our clinic, we precisely irradiate with over 2,000 shots, striving to reduce skin irritation while expecting improvement.
• 2. We perform individualized intensity adjustments tailored to the depth and type of pigmentation. Various pigments such as melasma, ABNOM (Acquired Bilateral Nevus of Ota-like Macules), and blemishes have different depths and characteristics. At our clinic, we apply gentle treatment for melasma, more focused treatment for ABNOM, and for complex cases, we adjust the appropriate intensity and parameters for each specific area.
• 3. During the procedure, we check the mirror and adjust parameters in real-time. Instead of simply completing the laser irradiation, our medical staff carefully observes the skin's reaction during the procedure. If necessary, we meticulously adjust the spot size, energy intensity, and even the type of handpiece. Through this process, we strive to provide a more suitable treatment for each individual.
• 4. We utilize a Mark-Vu diagnostic device to precisely diagnose the location and depth of pigmentation. Instead of relying solely on visual inspection, we meticulously confirm the type of pigmentation, its distribution, and its depth using the Mark-Vu diagnostic device. Based on these diagnostic results, we establish and implement individualized treatment plans.
• 5. For complex pigmentation problems, we apply a multi-layered approach. If melasma and ABNOM coexist, treating only one type of pigmentation aggressively may worsen the other. At our clinic, we first stably manage and calm the melasma, then consider a method to more intensively control the ABNOM in the dermal layer.

What are the characteristics of our clinic's laser toning?

Laser toning is a commonly used method for improving various pigmentary disorders. However, treatment results can vary among individuals depending on the equipment used, the number of irradiations, and the intensity applied.

Various pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules) exist at different skin depths and elicit different tissue reactions. Therefore, meticulous planning is crucial for treatment.

1. Sufficient energy delivery of at least 2,000 shots

Many academic sources report that low-power laser toning can show relatively stable and effective improvement within the range of 1,500 to 2,500 shots.

At our clinic, we fundamentally perform over 2,000 shots of irradiation and plan treatments to ensure sufficient improvement while minimizing skin irritation.

It is difficult to expect skin changes simply by operating the equipment.

It is necessary to meticulously adjust the number of irradiations, output intensity, irradiation speed, and even spot size, taking into account the location and distribution of pigmentation, as well as individual skin sensitivity.

2. Individualized toning adjustment by disease characteristics

1) For Melasma

Melasma is one of the common pigmentary disorders that primarily appears on both sides of the face.

Since melanocytes that produce melanin pigment are excessively activated, excessive stimulation carries the risk of worsening the condition.

At our clinic, we meticulously check the extent and depth of melasma using a Mark-Vu skin precision diagnostic device. Subsequently, we perform treatments using a toning laser with a short pulse duration of 5ns.

Our clinic's toning method, which selectively controls only the melanosomes within the cells without stimulating the melanocytes themselves, focuses on reducing the occurrence of side effects.

During the procedure, our medical staff checks the mirror with the patient and adjusts the laser intensity and focal areas. To ensure no area is missed, we replace the handpiece or delicately fine-tune parameters as needed.

Throughout the entire procedure, we check the skin condition together in the mirror, not just before and after, but also during the treatment.

2) For ABNOM (Acquired Bilateral Nevus of Ota-like Macules)

ABNOM, like melasma, is a pigmentary disorder located in the dermal layer. However, it often requires higher energy intensity than melasma.

In complex cases where melasma and ABNOM appear together, contrasting approaches are simultaneously required: lower energy for melasma and higher energy for ABNOM. This demands meticulous adjustment skills from the medical staff.

If a strong procedure is performed without sufficiently considering melasma first, the melasma symptoms may actually worsen.

At our clinic, we aim to minimize side effects through thorough differential diagnosis and personalized planning before the procedure. We adjust the individual intensity during treatment so that ABNOM can also be expected to improve.

ABNOM treatment also involves differential diagnosis with Mark-Vu and then setting parameters suitable for the individual. We meticulously adjust and apply spot size, repetition rate, output intensity, and other settings according to the skin type.

3) Other Pigmentary Disorders

Lentigines, freckles, and blemishes are pigments that can respond relatively quickly to appropriate wavelength selection, leading to expected improvement. However, when accompanied by melasma or ABNOM, the treatment approach needs to be even more delicate.

In such cases, a precise differential diagnosis is required, along with a delicate, individualized approach that includes mirror checks, output intensity adjustments, and laser handpiece changes at each session. Through these processes, our clinic strives to provide melanin pigment management tailored to each individual's condition.

Pico Toning vs. Laser Toning Comparison

Pico toning uses ultra-short laser pulses in picosecond units, which theoretically allows for more precise control of pigmentation.

In contrast, laser toning uses nanosecond pulses, which deliver energy to the skin for a relatively longer duration.

Both toning methods are used to selectively control melanin pigment to improve skin tone and are applied for the alleviation of pigmentary disorders such as melasma, blemishes, and ABNOM (Acquired Bilateral Nevus of Ota-like Macules).

Due to differences in laser irradiation time, there is an opinion that pico toning may have a slightly faster response rate in the initial 2-3 sessions. However, it is reported that both methods can show similar skin tone improvement effects after 10 or more consistent sessions.

Laser toning is a clinically proven treatment method for nearly 20 years. Especially for individuals with sensitive skin or pigmentary disorders like melasma that are sensitive to stimulation, it can be considered a relatively stable procedure.

Due to pico toning's characteristic of delivering high energy in a very short time, there is a possibility of temporary redness or stinging sensations occurring occasionally.

Clinical studies also report many results showing no significant differences in skin brightening, improvement of melasma lesions, or reduction in melanin index when comparing the two methods based on the same 1064nm wavelength.

Considering these points, there are several important factors if one expects similar improvements with laser toning as with pico toning.

For cumulative treatment effects, more than 10 repeated sessions are considered.

It is important to apply an appropriate energy intensity in the range of 1.0~2.0 J/cm² while observing the skin's reaction.

For effective results, a sufficient number of shots, at least 2000, may be required.

If the treatment interval is too long, the cumulative effect may decrease, so maintaining an interval of 1-2 weeks is helpful.

It is advisable to receive treatment from a skilled practitioner who can adjust in real-time according to skin type or reactions during the procedure.

If these conditions are met, according to several research findings, a similar level of improvement can be expected when compared to PICO toning.

All the content mentioned above is based on research papers.

Research materials such as Medicina (Kaunas), 2022, Lasers in Medical Science, 2021, and Journal of Cosmetic and Laser Therapy, 2021 were referenced.

Principle of Laser Toning

Laser toning is a treatment method that gradually breaks down pigment and evens out skin tone by repeatedly irradiating low-power laser energy deep into the skin multiple times.

Unlike high-output treatments that directly burn pigment with strong energy, laser toning consistently provides subtle stimulation to gently remove melanin and induce skin regeneration.

It can be applied to various types of hyperpigmentation such as melasma, freckles, and acquired bilateral nevus of Ota-like macules (ABNOM) without putting significant strain on the skin, and is currently one of the widely used methods for pigment improvement.

1. Type of Laser Used: Q-switched Nd:YAG

Q-switched Nd:YAG lasers are primarily used for laser toning treatments.

The 1064nm wavelength of this laser can reach the dermal layer where melanin pigment is mainly distributed, and it selectively destroys pigment without damaging the skin surface.

By focusing on pigment improvement while preserving the skin barrier intact, it can be considered for sensitive or thin skin types.

2. 'Tone-up' Effect from Low Energy, High-Repetition Stimulation

While conventional pigment treatments aimed to remove pigment in one go using strong lasers, laser toning proceeds by irradiating low-energy lasers thousands of times repeatedly.

This process minimizes skin tissue damage, finely breaks down melanin particles, and the decomposed pigment is absorbed and expelled by the body's immune system (macrophages).

Through this action, the skin tone is expected to gradually become more even and brighter.

3. Destruction of Dendrites within Melanocytes and Melanin Removal

Beyond simple pigment breakdown, laser toning can also play a role in inhibiting the melanin production process itself.

A key mechanism here is the destruction of dendrites (branching projections) of melanocytes.

Dendrites act as pathways that deliver mature melanosomes (melanin carriers) produced by melanocytes to the epidermis, the outer layer of the skin.

When the laser severs these dendrites, melanin carriers are prevented from migrating to the epidermis, thereby preventing pigment formation on the skin surface.

Furthermore, the melanin pigment accumulated within melanocytes can also be directly broken down, which can help improve existing hyperpigmentation.

This action can only be observed with lasers that have short irradiation times, measured in 'nanoseconds' or 'picoseconds'.

Therefore, it is a key mechanism of action primarily seen in treatments such as laser toning or PICO toning.

Three Key Points of Laser Toning

These are the three main treatment principles of laser toning.

Beyond improving existing pigmentation, laser toning is a treatment that controls the entire process from melanin production to its transport.

1. Removal of Already Formed Pigment Particles

For pigmented lesions other than melasma (e.g., freckles, ABNOM), improvement can be expected by removing melanin using appropriately adjusted laser parameters.

However, melasma can react sensitively to stimulation, requiring delicate adjustment, and care must be taken to prevent excessive stimulation from overactivating melanocytes.

2. Destruction of Dendrites (Branching Projections) to Inhibit Melanosome Transport

By preventing melanosomes produced by melanocytes from migrating to the epidermal layer, it can help prevent the progression of hyperpigmentation.

3. Direct Breakdown of Melanin Pigment within Melanocytes

The laser directly destroys melanin pigment inside melanocytes, which can reduce the amount of melanin and promote overall skin tone improvement.

Expected Effects of Laser Toning

• 1. Skin Tone Brightening Effect Subtle laser stimulation gently breaks down melanin pigment, leading to a natural brightening of dull skin.
• 2. Alleviation of Melasma and Pigmentation
• By selectively targeting only melanosomes without stimulating melanocytes, we can help reduce the burden of managing sensitive melasma.
• 3. Improvement of ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• We perform a procedure that carefully approaches dermal pigments with customized intensity, reaching deeper pigment lesions than melasma.
• 4. Reduced Recurrence Burden through Pigment Production Inhibition
• By treating the dendritic sheath, which is the pigment migration pathway, we reduce the outward movement of melanin and contribute to inhibiting pigment regeneration itself.
• 5. Smooth Skin with Improved Fine Lines and Skin Texture
• Laser stimulation promotes the skin's regenerative process, allowing you to expect the additional benefit of overall refined skin texture and reduced fine lines.
• 6. Reduced Irritation, Enhanced Treatment Effects
• The procedure is performed repeatedly with low output, resulting in less irritation to the skin. This allows even individuals with sensitive skin to feel less burdened by the treatment.

Recommended for Laser Toning

• 1. Individuals concerned about dull and uneven skin tone
• 2. Individuals experiencing recurrent or worsening melasma, blemishes, and freckles
• 3. Individuals with dermal pigment lesions such as ABNOM (Acquired Bilateral Nevus of Ota-like Macules)
• 4. Individuals with thin and sensitive skin who still wish to receive pigment management
• 5. Individuals who also want to achieve improvement in fine lines and skin texture
• 6. Individuals who desire consistent skin improvement with minimal irritation

Laser Toning Procedure Steps

• STEP 1. Precise Skin Diagnosis using Mark-Vu
• We meticulously identify the depth and distribution of pigmentation that is difficult to observe with the naked eye.
• STEP 2. 1:1 Consultation with the Director and Customized Treatment Plan Establishment
• STEP 3. Personalized Laser Setting and Toning Procedure
• (Before the procedure, we reconfirm the treatment area with the Director using a mirror.)
• STEP 4. Mirror Check During Procedure and Re-evaluation of Areas Requiring Focus
• STEP 5. Mirror Check After Procedure and Guidance on Expected Progress

Chief Director's Opinion

Many of you may have experienced discomfort for a long time due to pigmentary issues such as melasma or ABNOM.

I understand that you may also have significant anxiety about whether this can truly improve, or perhaps even worsen.

Therefore, when it comes to pigment management, we avoid simply operating machines.

We meticulously check the skin condition and adhere to the important principle of performing the procedure precisely, only as much as necessary.

The approach must vary depending on the type of pigment, as well as the skin depth and sensitivity.

Laser toning is by no means a light procedure. We are doing our best to help you improve through a delicate system.

Post-Procedure Care Instructions

• ㆍWashing your face and applying makeup are possible on the day of the procedure, and it is highly recommended to pay special attention to sun protection.
• ㆍFor temporarily irritated skin, we recommend paying extra attention to soothing and moisturizing care.
• ㆍSwelling or redness may appear after the procedure, but it usually subsides naturally over time. If it persists for several days, we recommend visiting the clinic again for a consultation.