C6 Q-Switched Nd:YAG Pigmentation Removal

C6 Q-Switched Nd:YAG Pigmentation Removal

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What causes brown spots?

Brown spots result from the irregular production and deposition of melanin by melanocytes (pigment making cells) in the skin. Some lesions are present at birth (café au lait patches, Nevus of Ito, Nevus of Ota), but most occur with age or as a result of overexposure to the sun (age spots, freckles, lentigines). Although most pigmented lesions are harmless, they can detract from your skin’s natural beauty. Thanks to specialized technology, most of these lesions can be effectively faded with lasers.

What laser is recommended, and how does it work?

The C6 Laser is a Q-switched laser that creates a high-powered beam of light energy that pulses at a billionth of a second. When the beam of light hits your skin, the melanin is fractured into tiny pieces that are easily carried away by your immune system or peeled off from the skin surface. As a result, the brown pigment is removed.

Are there any pre-treatment considerations?

If the lesion(s) is (are) deemed benign during consultation, laser treatment can be attempted. We do not use lasers to treat cancers or suspected cancers. If in doubt, we will biopsy any suspicious lesions to make sure there is no skin cancer.

Beginning 2 weeks prior to your treatment, sunblock before and after treatment is recommended. It is also wise to stay out of intense sunlight (or tanning beds) during this time. If working around the mouth, we may prescribe an antiviral medication to minimize the risk of cold sores. Aspirin, ibuprofen, vitamin E, fish oil and Aleve should be avoided for 2 weeks before treatment to minimize bruising. No other preparation is needed.

Is the laser treatment painful?

The C6 laser emits light in very short pulses. The impact of the energy from the pulse of light feels like the snap of a rubber band. Afterwards, the area will feel similar to a mild sunburn, and it might be red and swollen for the rest of the day.

Most patients do not require anesthesia, but ice packs, anesthetic creams or local anesthetic can be used if necessary. If there is a large or sensitive area to be treated, Tylenol can be taken to raise your pain threshold before laser treatment.

What can I expect to see during the treatment, and is there any downtime after treatment?

When the skin absorbs the laser energy, it will turn gray or white for a few minutes. There will be bruising in areas where there is a lot of pigment. Over the next several days, shallow blisters or crusting may develop. The skin heals within 7-10 days, usually without wound care. The healed skin is initially pink but regains pigmentation and blends into the surrounding skin over time. Occasionally, if there is significant sun damage, the treated area may remain somewhat pink for two to four weeks, and there may be some flaking or peeling during this time. This is a normal process as the body removes the pigment from the skin. There may be some lightening or darkening of the treated area for several months after laser treatment. This is usually temporary and subtle.

How long are treatments?

Depending on the size and numbers of lesions, treatments usually take 10 to 45 minutes.

How many treatments will be necessary?

Some types of pigmentation will respond better than others. Superficial brown marks caused by age and sun can resolve with 1-2 treatments, while deeply pigmented birthmarks may require multiple treatments or may not disappear completely. Because there is a great deal of variability in the size, depth and darkness of brown spots, and in a person’s natural ability to clear away pigment after laser treatment, it is not possible to predict results after a fixed number of treatments. If an additional treatment is required, it is best to wait at least 8 weeks between treatments so that the maximum fading can occur.

What are the risks of treatment?

In most cases, the laser treatment leads to satisfactory fading or complete removal of pigmented lesions without significant side effects. Scarring is very rare. Lightening or darkening of the skin is quite infrequent, and are almost always temporary.

How much will it cost?

The cost of laser treatment of pigmented lesions varies from a couple of hundred to several hundred dollars per treatment depending on the size of the area being treated. You will be given a written estimate of the cost after your consultation.


Pre-Laser Preparation

  1. Avoid having a tan around the treatment area before the procedure
  2. Avoid Aspirin-containing products for 2 weeks before treatment
  3. If a topical anesthetic is recommended:
    Apply a thick coat of the topical anesthetic over the treatment area and cover with plastic wrap for 2 hours before your appointment. Leave the plastic wrap in place until it has been removed by the nurse just before the procedure.

Post-Laser Wound care

  1. The bruising should resolve within a few days and the fine scabs that look like a darker version of the brown spot should peel off within 10-14 days.
  2. You can apply make-up to the treated area. Just be gentle when removing the make-up.
  3. Avoid sun exposure to the treated area until healing is complete.

For emergencies at night or during the weekend, call (314) 878-3839, leave a message and the doctor will contact you shortly thereafter.