Resumo

Objectives: • Diagnosis of skin hyperpigmentation and patient selection. • Individualize treatment plan that includes QS-laser as standalone or in combination with other treatment modalities. • Prevention of treatment adverse events. Introduction: Treating hyperpigmentation disorders is associated with high success rate. Nevertheless, some patients respond well and fast, while others are untreatable or experiencing adverse events. Even within the relatively narrow scope of benign pigmentary disorders, many factors should be considered, and every patient treatment plan must be constructed accordingly. Materials / method: My presentation is based on my experience with QS-laser in the treatment of skin hyperpigmentation disorders in diverse Israeli patients with different skin types and ethnic backgrounds. It also discusses the leading articles in the field of hyperpigmentation, and their treatment with QS-lasers. Results: Benign hyperpigmentation disorders are divided into epidermal (e.g. solar lentigo, etc.), dermal (e.g. melasma, etc.), and mixed. Treatment of every disorder is different and is based on the inherent mechanism that involve its pathogenesis. Moreover, in order to succeed and avoid adverse events, when treating hyperpigmentation, we must respect patient’s skin type, the size and distribution of the lesions, and the quality of the skin in the background. Hence, an individualized treatment plan should be constructed to every patient. Conclusion: In order to construct an individualized treatment plan we must use different modalities aiding in accurate diagnosis (history, physical examination, Wood’s lamp, and dermoscopic features), understand the mechanism of action behind the EBD (different wavelengths, fractioning the beam, different pulse length, and combinations with other modalities), and minimize complications with prophylactic treatment and patient selection.