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The effect of Enlighton® SR skin treatment and the difference from other pico lasers

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順 菅原
Dr. 順 菅原

JUN CLINIC

Japan Society of Plastic and Reconstructive Surgery (specialist) Visiting Researcher, Plastic Surgery, Yokohama City University Japanese Society of Aesthetic Surgery (JSAPS) Japan Society of Cosmetic Dermatology Anti-aging society Japan Laser Medical Association, etc. Director of Customized Treatment Study Group cutera adovocates cutera advisor enlighten SR technical provider excel V + technical provider CLEVIEL EXPERT

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Jun Sugawara Medical institutions with doctors

JUN CLINIC Contact: 026-225-9191
JUN CLINIC Shirokane Inquiries: 03-6456-4997

The effect of Enlighton SR and the difference from other pico laser machines

In aesthetic medicine, there are options for improving spots, dullness, and bruises, such as internal medicine, topical medicine, phototherapy, and laser treatment.

There are several types of lasers used for aesthetic medicine treatment, but pico lasers are expected to improve symptoms that are difficult with conventional Q-switched lasers, and are said to reduce the risk of pain and pigmentation .

Pico Laser has multiple machines, and Enlighton SR (enLIGHTen SR) is one of them. By knowing not only the features and effects of Enlighton SR, but also the downtime and precautions, you can receive the treatment with peace of mind.

It is also important to know how to choose a medical institution (doctor) in order to obtain satisfactory results with Enlighton SR.

Pico laser that improves skin problems with little damage

A pico laser (picosecond laser / picosecond laser) is a laser that can irradiate in units of picoseconds (one trillionth of a second) .

Pico lasers are said to have a relatively short downtime because the thermal effect is small because the irradiation time is extremely short, so there is little burden on the skin .

Before learning more about the Enlighton SR, let's talk about the pico laser.

Characteristics of lasers used in aesthetic medicine

In aesthetic medicine, lasers such as Q-switch lasers, carbon dioxide lasers, and pico lasers are used to improve spots, dullness, bruises, and remove tattoos.

A laser (Light Amplification by Stimulated Emission of Radiation) is a type of electromagnetic wave. While light is a collection of multiple wavelengths (colors), a laser is a light beam that artificially extracts and amplifies one specific wavelength, and when absorbed by a specific substance, it produces heat and shock waves. I have.

In aesthetic medicine, a laser with a wavelength that is absorbed by the melanin pigment that causes blemishes and a laser with a wavelength that is absorbed by the tattoo pigment is used to destroy the melanin pigment and tattoo pigment with heat and shock waves to remove blemishes. improve or remove tattoos.

The shorter the laser irradiation time, the greater the destructive power.

The time that a single laser shot hits the skin (irradiation time) is called the "pulse width" , and the pulse width of the laser used in laser treatment is shortened to milliseconds, microseconds, nanoseconds, and picoseconds.

millisecond (ms) 1/1,000s (one thousandth of a second): Long pulse
microsecond (μs) 1/1,000,000s (one millionth of a second)
nanosecond (ns) 1/1,000,000,000s (one billionth of a second)
picosecond (ps) 1/1,000,000,000,000s (one trillionth of a second)

The shorter the pulse width, the greater the instantaneous force acting on the substance, and the greater the destructive power .

Lasers with pulse widths of milliseconds, microseconds, and nanoseconds mainly generate heat in the material when irradiated, and the thermal action destroys the target . In this case, if you irradiate with a high irradiation energy (fluence) to increase the destructive power, the heat will be transferred too much to the surrounding cells, increasing the risk of side effects such as post-inflammatory pigmentation and burns.

"Pulse width is short" pico laser

The pico- laser, which has a pulse width of picoseconds, generates little heat due to its extremely short irradiation time, and when irradiated, generates a destructive shock wave in the material, so it does not need to be irradiated with high irradiation energy (fluence). It can efficiently pulverize the target finely .

Pico lasers, which are good at pulverizing small substances, are expected to lead to improvements in thin spots that do not react with conventional Q-switched lasers.

The main mechanism of action of the pico laser is a shock wave that has less impact on the surroundings than heat, and since strong irradiation is not required, unnecessary damage to surrounding cells does not occur , reducing pain during treatment. Side effects such as post-inflammatory hyperpigmentation are less likely to occur .

Pico lasers are not good at targeting large substances

Not all lasers with shorter pulse widths are better.

Opinion that it is difficult to produce effects on dark spots and thick spots because the abnormal keratinocytes (pigment cells with a lot of melanin, the cause of spots) that are originally intended to be destroyed cannot be damaged by the action of the laser. There is also

If the object is large, it is more likely to be destroyed by photothermal action such as a Q-switched laser than by crushing it finely with a shock wave such as a pico laser .

For example, the laser used for hair removal, which targets the melanin pigment in the hair root, and red face (telangiectasia), which targets the red pigment of hemoglobin in the blood vessels, has a pulse width of millisecond (1/1000). As with long pulse lasers in seconds, long pulse widths are effective when targeting large targets such as hair roots and blood vessels.

Picolaser Enlighton SR that can be expected to have a skin regeneration effect

The Enlighton SR is a pico laser machine developed by Cutera. It is a medical device that has been approved by the Ministry of Health, Labor and Welfare, and has been recognized for its effectiveness and safety in treating spots and bruises and removing tattoos, and in some cases it is covered by insurance.

Approval number 22800BZX00138000
Sales name enLIGHTen

Case covered by insurance

  • Nevus of Ota
  • Ectopic Mongolian spot
  • traumatic pigmentation

Note) Infant addition Note) Insurance calculation as YAG laser radiation therapy with Q switch

Laser wavelength selected according to skin concerns

Electromagnetic waves, including lasers, have waveform energy that repeats crests and troughs, and the length from crest to crest (or trough to trough) of the waveform is called the wavelength.

Wavelengths are expressed in units of nanometers (nm), which is one billionth of a meter. Lasers are named according to their wavelengths, such as Nd:YAG (Neodymium YAG) laser for a wavelength of 1064 nm and KTP laser for a wavelength of 532 nm. are categorized respectively.

There are various types of lasers used in aesthetic medicine, and the substances absorbed by the skin differ depending on the wavelength of each laser. Therefore , the appropriate laser for treatment is selected according to the causative agent of the targeted skin problem .

Up to a certain point, lasers with shorter wavelengths act on the skin surface, and longer wavelengths act deeper into the skin. This is called the "depth of penetration" and is used as an indicator of each laser irradiation effect.

Wavelength of Enlighton SR Responsive color tone adaptation
1064 nm black, brown, purple Deep (dermal) melanin pigment, removal of color tattoo
532 nm red, orange, yellow Removal of superficial (epidermal) melanin pigment and color tattoos

Skin beautifying effect of Enlighton SR

Enlighton SR's SR is an abbreviation for Skin Revitalization, which means "skin regeneration". The pico laser "Enlighton SR", which causes less damage to the skin than conventional lasers, is said to be a laser suitable for skin rejuvenation treatment, which is in high demand in Japan.

Enlighton SR not only removes pigments such as blemishes, dullness, permanent makeup, and color tattoos, but also enables detailed settings suitable for improving skin quality such as fine wrinkles, pore opening, texture, skin gloss, and acne scars . being developed.

In order to achieve therapeutic effects for various skin concerns, it is necessary to have a technology that effectively combines parameters such as the irradiation energy level (fluence) and spot size in addition to the appropriate wavelength and pulse width.

Enlighton SR has two wavelengths, excellent specifications, and comfortable operability, making it easy to set the appropriate settings for skin treatment, allowing you to approach benign pigmented lesions such as blemishes and bruises more safely and effectively.

Difference between Enlighton SR and conventional Enlighton

  • Even lower fluence irradiation is possible
  • Allows for finer spot size and fluence settings
  • Expansion of treatment safety margin, etc.

The Enlighton SR can quickly convert a wide range of parameters via the touch panel. The fluence can be freely adjusted over a wide range for each spot size, enabling detailed settings suitable for skin treatment and realizing comfortable operability.

For details, see [Doctor Only] Product Catalog and Case Photos

Symptoms that can be expected to improve with Enlighton SR

  • Superficial pigmented lesions such as age spots and freckles
  • Deep pigmented lesions such as ADM (dermal melanocytosis)
  • chloasma
  • Improvement of post-inflammatory pigmentation (pigmentation after inflammation due to redness of acne scars and scars)
  • Removal of tattoos and permanent makeup
  • open pores
  • Fine wrinkles
  • Decline in skin firmness and elasticity

Superficial pigmented lesion

The skin is layered with the epidermis and dermis from the outside , but melanin pigment is present in the epidermis in the symptoms generally referred to as age spots (senile pigment spots, solar pigment spots) . The following symptoms, including age spots, are called "superficial pigmented lesions" and can be expected to improve with Enlighton SR.

  • Blemishes (sun pigmentation, senile pigmentation)
  • freckles
  • flat nevus (brown birthmark without elevation)
  • overall dullness

deep pigmented lesions

Enlighton SR is also expected to be effective in improving "deep pigment lesions" where melanin pigment exists in the dermis layer . Symptoms of deep pigmented lesions include:

  • ADM (acquired dermal melanocytosis, gray to bluish birthmark)
  • Nevus of Ota (a birthmark that appears on one side of the face)
  • Pigmented nevus (mole)
  • Ito nevus (a birthmark around the shoulder)
  • Traumatic tattoo (traumatic pigmentation, pigmentation due to foreign matter contamination in accidents or injuries)
  • Ectopic Mongolian spots

Permanent makeup and color tattoos

Enlighton SR can also be expected to be effective in removing permanent makeup that puts pigments in the epidermis and color tattoos that put pigments in the dermis .

Skin troubles caused by depletion of skin cells

In the dermis layer, there are components such as hyaluronic acid, elastin, and collagen that are the source of skin firmness and elasticity, and fibroblasts that produce these.

With Enlighton SR, the stimulation of laser irradiation can be expected to activate fibroblasts and regenerate capillaries.

Three types of irradiation methods that can be used depending on the purpose

With pico lasers including Enlighton SR, treatment is performed by using three irradiation methods separately or in combination.

Irradiation method adaptation
toning irradiation A 1064nm Nd:YAG laser is applied to the entire skin at a low fluence Uneven skin tone, dullness, melasma
Fractional irradiation Attach the "MLA lens" that can irradiate in dots and irradiate the entire skin Open pores, acne scars, fine wrinkles
spot irradiation High fluence for pinpoint irradiation on blemishes and tattoos Blemishes, freckles, tattoos
Combined irradiation Irradiation by combining the above three methods Uneven skin tone, dullness, liver spots, open pores, acne scars, fine wrinkles, age spots, freckles

Toning irradiation for a wide range of dullness and freckles

Toning irradiation is a method of irradiating the entire skin with a low fluence laser, and the toning irradiation using a 1064 nm long-pulse Nd:YAG laser by Enlighton SR is called “PICO Genesis™”.

By stimulating and discharging melanin pigment with PICO Genesis™, you can expect the effect of brightening the skin tone . In addition, when the dermis layer is stimulated, fibroblasts that produce hyaluronic acid, elastin, and collagen are activated. As a result, the texture of the skin is improved, and fine wrinkles are improved and pores are tightened .

Fractional irradiation aiming to improve fine wrinkles and open pores

Fractional irradiation is a method of irradiating the entire skin by attaching an "MLA lens" that can irradiate a laser in a dot shape, and by Enlighton SR, fractional irradiation using 532 nm and 1064 nm is also called "PICO Genesis™ FX". .

When fractional irradiation is performed, a large number of fine spherical cavities are formed, which can be expected to reconstruct the dermis layer due to the effect of wound healing.

Similar to PICO Genesis™, it can be expected to improve texture, fine wrinkles, and open pores, as well as improve acne scars with crater-like unevenness .

Spot irradiation that focuses on worrisome blemishes

Spot irradiation has a higher irradiation output than toning irradiation and fractional irradiation, and it is possible to irradiate spots and tattoos with pinpoint accuracy .

Due to the high output of the irradiated laser, it is said that the pain felt like being flipped with a rubber band during the treatment.

Differences between Enlighton SR and other pico laser machines

Besides the Enlighton SR, Pico Laser has multiple machines. Machines that can irradiate lasers in picosecond units have different wavelengths and pulse widths for each machine, and each has different characteristics.

* ps: picosecond (one trillionth of a second)

machine name wavelength pulse width
enLIGHTen SR 532 nm
1064 nm
750ps
PicoSure 532nm
755nm
1064 nm
550ps-750ps variable type
PicoWay 532nm
730nm
1064nm
294ps
246ps
339ps
Discovery Pico Plus 532 nm
694nm
1064 nm
370ps
30ns
450ps

Enlighton SR can be expected to moderately adjust energy and destroy pigments

The Enlighton SR can emit 532nm and 1064nm lasers with a pulse width of 750 picoseconds. Compared to other pico laser machines, it can be said that the pulse width is long even though it is in picosecond units .

In the case of superficial blemish treatment that uses relatively low energy (fluence), a pico laser with a short pulse width can treat dark blemishes and thick blemishes by destroying abnormal keratinocytes (having a lot of melanin) that are originally intended to be destroyed. However, with Enlighton SR, which has a relatively long pulse width of 750 picoseconds, by appropriately adjusting the energy (fluence), it is possible to treat abnormalities. It is possible to easily damage keratinocytes, so it can be used to treat various pigmented spots .

Also, in the case of tattoo removal that uses relatively high energy (fluence), the shorter the pulse width for the same amount of energy, the higher the destructive power and peak power, but the energy is concentrated on the skin surface, The energy may not reach the pigment in the back. In Enlighton SR, a relatively long 750 picosecond pulse width is set so that the energy reaches the dye without weakening as much as possible even in such cases.

Enlighton SR treatment frequency and cost

Recommended number and frequency of treatments

Regarding the number and frequency of treatments, if irradiation is applied to local spots, improvement can be expected even once, but for treatment of spots on the entire face and treatment to improve skin quality, treatment should be performed once every one to two months. It is recommended to do this multiple times .

Tattoo removal requires multiple treatments once a month. The number of treatments varies depending on the state of the tattoo pigment, so please consult a medical institution.

In addition, since the pigment of the tattoo may fade with the interval between treatments, if it is performed once every 2 to 3 months, the treatment period will be longer, but the number of treatments may be reduced.

Cost of Enlighton SR

Treatment for cosmetic purposes is not covered by insurance and is a free medical treatment, and the cost varies depending on the medical institution.

Irradiation of the entire face is about 10,000 yen to 50,000 yen when using one irradiation method, and when using multiple irradiation methods, it varies depending on the number of irradiation methods combined, but it is about 30,000 yen to 100,000 yen. there is.

Some medical institutions set the initial fee or the fee after the second time at a low price. Prices for spot spot treatment and tattoo removal may differ depending on the size of the target area, so please check with the medical institution where you will receive the treatment for details.

Medical institutions may be covered by insurance for traumatic pigmentation, Ota's nevus, and ectopic Mongolian spots. Please consult

Enlighton SR downtime and precautions

Enlighton SR Downtime, Pain, Risks and Side Effects

redness

Immediately after the treatment, redness may occur at the laser irradiation site, but it is said to calm down in about 2 to 3 days.

Blistering and post-inflammatory hyperpigmentation

If blistering or post-inflammatory hyperpigmentation occurs, use ointment or whitening topical medicine according to the doctor's instructions. The blisters become scabs and peel off in about a week, and the post-inflammatory hyperpigmentation subsides in about 3 to 6 months.

crusting

When spot irradiation is performed, a thin scab may form, but it will fall off in about 5 to 10 days. If you force it off, it may cause post-inflammatory hyperpigmentation, so wait for it to peel off naturally. Unlike Q-switched lasers, the color does not darken to a scab-like dark brown color, and it is said that tape protection is unnecessary.

petechiae

When fractional irradiation is performed, petechiae may appear for about 2 to 5 days, but it can be made less noticeable with makeup.

pain

When spot irradiation is performed, there are individual differences in how pain is felt, but it is said that the pain is repelled by rubber. Some medical institutions prepare anesthetic creams and local anesthesia, so if you are worried about pain, please consult with the medical institution.

depigmentation

Depigmentation may occur due to high output and high frequency irradiation. In this case, improvement may be expected by fractional irradiation.

Precautions after Enlighton SR treatment

You can shower from the day of the treatment , but avoid long baths, saunas, and strenuous exercise as they may promote swelling and redness . Since the skin is sensitive after the treatment, it is recommended to properly moisturize and protect against UV rays .

Also, if you have had a tattoo removed, you will need to apply an ointment and protect it with a case for about a week.

Those who cannot receive Enlighton SR

  • Those with skin cancer or precancerous conditions
  • Those who are tanned or who are likely to get sunburned after the treatment
  • Those using steroids
  • Those who are pregnant, may become pregnant, or are breastfeeding
  • Those with photosensitivity, those taking orally or externally using drugs that increase photosensitivity
  • People with keloid constitution
  • Those with a history of epileptic seizures
  • Those with inflammation or scars at the treatment site

Enlighton SR treatment flow

(1) Examination/Counseling

A doctor will examine you and decide on the treatment. Tell your skin concerns and hopes, and if you have any concerns or worries, ask the doctor at this time and resolve them.

(2) Face washing/anesthesia

Remove make-up and wash your face to cleanse your skin.

(3) Taking pictures and changing clothes

Depending on the medical institution, a photo will be taken to check the condition of the skin before the treatment. In addition, in the case of body treatment, change into special clothes for treatment.

(4) Treatment

In order to protect the eyes from laser irradiation, a shield is worn before irradiation. Treatment time is about 10 to 20 minutes depending on the content of the treatment.

(5) Termination

Finish by cooling the treatment area.

How to choose a doctor to receive satisfactory treatment

For example, if you want to improve blemishes, there are various types of blemishes. Senile pigment spots (solar pigment spots) that tend to appear with age and are caused by ultraviolet rays, chloasma that is thought to be related to female hormones, and ADM (acquired dermis) that is considered to be a kind of bruise rather than age spots. melanocytosis), etc.

In many cases, it is difficult to distinguish between bruises and chloasma, which are thought to be so-called ordinary spots (senile pigment spots). Without proper treatment for each symptom, the results will be unsatisfactory.

First of all, it is most important to consult a doctor who has extensive knowledge and experience in treating dark spots and improving skin quality, and selecting the appropriate treatment method .

Treatment with Enlighton SR is delicate, with different effects depending on the distance from the skin surface to the target and the irradiation method. The doctor's skill is required to optimally combine the appropriate wavelength, spot size, and irradiation energy level (fluence) for the treatment target .

Therefore, it is important to choose a medical institution that has a wealth of experience in pico laser treatment, including laser treatment and Enlighton SR, and has a doctor who is familiar with the features of the machine .

Enlighton SR Q&A with Professor Sugawara

Professor Jun Sugawara, who supervised the article, taught me about Enlighton SR.

KIREI
How is the Enlighton SR different from other pico laser machines? Please let me know if there are any advantages or disadvantages.
Dr. Jun Sugawara
Among the pico lasers, Enlighton SR has a long irradiation time, so it can destroy not only thin stains, but also thick stains by strongly irradiating. In addition, pico toning is a pico laser that makes it easy to restore the firmness of the skin as well as light spots by making use of its high output. However, there is a possibility that pigmentation is likely to occur if you irradiate light spots too strongly.
KIREI
How painful is the procedure? Do you use anesthesia?
Dr. Jun Sugawara
During the procedure, you will feel pain like being snapped with a rubber band. If you are not good at pain, you can reduce the pain by applying topical anesthesia with cream for about 30 minutes in advance.
KIREI
Will my blemishes fade in one session? Is there a guideline for the number and frequency of treatments?
Dr. Jun Sugawara
There are different types of blemishes, but Nikko lentigines and freckles are highly likely to fade even once. Depending on the lesion, usually one or two treatments are required. The treatment interval is at least one month, and the skin condition is judged.
KIREI
Is there a difference in the effect depending on the practitioner? If so, why?
Dr. Jun Sugawara
The difference between pico lasers is very large depending on the practitioner. More delicate irradiation is required than Q-switched lasers so far, and it is easy to make a big difference depending on experience.
KIREI
I would like to receive picolaser treatment such as Enlighton SR, but I am wondering which doctor (medical institution) to choose. Please tell me how to choose a doctor (medical institution).
Dr. Jun Sugawara
First, look at the websites of several clinics and find a clinic or doctor that seems to suit you. It is recommended that you receive counseling from several clinics and find the clinic that suits you.
KIREI
Thank you very much, Dr. Sugawara!

Introduction of supervising doctor

Dr. Jun Sugawara, who is well versed in both surgical and laser fields, has obtained a doctorate in medicine for his research on laser treatment of melasma. Through the Customized Treatment Study Group, which serves as a director, and the "enLIGHTen Training Program" at the first laser training facility for doctors certified by Cutera in Japan, the original irradiation method "Multipass Technique™" that controls the risk of pigmentation that occurs in blemish treatment. We are energetically engaged in enlightenment of

Jun Sugawara Medical institutions with doctors

JUN CLINIC Contact: 026-225-9191
JUN CLINIC Shirokane Inquiries: 03-6456-4997

[Only for Doctors] Enlighton SR Q&A with Dr. Sugawara

We asked Professor Jun Sugawara about Enlighton SR.

  • What is the multipath technique advocated by Dr. Sugawara?
  • A blemish treatment method that focuses on reducing the risk of PIH
  • Indicator of spot treatment by multipass technique
  • Is pico toning superimposed immediately after pico spot irradiation?
  • How long does it take to tone after a multipass? Such
KIREI
What kind of method is the blemish treatment using the multipass technique that the teacher is doing?
Dr. Jun Sugawara
It is a spot treatment that focuses on reducing the risk of PIH, and it is a method of hitting multiple passes with a fluence that is not too strong until there is a change in skin tone. I think it's a very good way to get used to it, and the stain treatment will be easy.
Dr. Jun Sugawara
The pico laser makes it easier to remove light spots, but there are many spots that cannot be removed, and PIH appears when the fluence is increased. Therefore, we devised the multi-pass technique, an original irradiation method that makes use of the destruction range of the pico laser.
Dr. Jun Sugawara
Pigment spot treatment with sub-nanosecond-level picosecond lasers has a smaller destruction range than Q-switched lasers. As a result, the effect on the area around the lesion was reduced, and pigmentation became less likely to occur. On the other hand, as the destruction range becomes smaller, the problem of leftovers is more likely to occur, so techniques associated with irradiation are required.
Dr. Jun Sugawara
Increasing the irradiation fluence is a common way to reduce the risk of residue left behind, but since the absorbance at 532 nm is also high, simply increasing the output tends to cause pigmentation.
Dr. Jun Sugawara
The multipass technique, which is frequently used at our hospital, reduces the damage of a single irradiation and destroys the entire lesion with multiple irradiations (multipass), so the risk of pigmentation is low and the risk of leftovers is reduced. I think it is a useful irradiation method that can be done.
Dr. Jun Sugawara
In the past, most cases were treated with an irradiation diameter of 4 mm, but in cases with large lesions, the irradiation diameter was increased to 5 mm to 6 mm, which not only enabled the removal of lesions to deeper areas, but also improved efficiency. I can do it well. The end point is that IWP (immediate whitening) does not occur, and it takes some getting used to, but once you get used to it, you can treat pigmented spots that are less prone to pigmentation.
Dr. Jun Sugawara
However, depending on the case, we also provide treatment that focuses on removing blemishes with spot irradiation using IWP as an index.
KIREI
Does the transpiration sound, which is an indicator of blemish treatment using the multipass technique, mean that the treatment ends when the "clap" sound becomes "ton, ton"?
Dr. Jun Sugawara
Transpiration sound is also one of the indicators, but it may not be heard due to the patient's skin condition or environment. If the sound of transpiration is used as the first indicator, it may result in excessive irradiation, so it is better to avoid it. The first indicator is the skin reaction. The optimal skin reaction varies depending on the skin type, irradiated area, color tone of spots, etc.
KIREI
Is it necessary to repeat pico toning every time immediately after removing spots with pico spot irradiation?
Dr. Jun Sugawara
Immediately after removing the stain, the irradiated area is damaged, so additional toning may cause further damage and increase the risk of PIH (post-inflammatory hyperpigmentation). Pico toning was not performed immediately after stain removal by pico spot irradiation.
KIREI
How long do you wait between toning sessions after multipasses? You say that you are doing it one month later, but even if you have PIH with residual inflammation, would you still do it?
Dr. Jun Sugawara
Usually after 1 month. Even if the inflammation remains, if the output is not too strong, there should be no problem. In cases where inflammation remains after one month, there is a high possibility that PIH will occur, so if PIH appears after monitoring the progress while toning, I think it would be a good idea to deal with it.
KIREI
In the case of SK (seborrheic keratosis), which is already mildly raised on the face, is it possible to go only with Pico? Use with CO2?
Dr. Jun Sugawara
If it is mild, treatment with a multipath technique while causing IWP is also effective. However, I think that it is better to shave off the ones with strong bumps. I try to irradiate something that can be done with multiple passes, and when I see the reaction and think it's tough, I sometimes shave it as it is.
KIREI
I have the impression that PIH often appears strongly in patients who usually have VISIA and have a bad score for UV spots, so I try to have them start with toning without suddenly doing Pico Spot. Even if the VISIA score is bad, do you ever use multi-pass and hit the pico spot from the beginning?
Dr. Jun Sugawara
I also use VISIA images, but in most cases irradiation is performed from the first time. It's a multipath that uses IWP as an index, so it doesn't cause much of a problem. After that, I often do some training.

[For doctors only] Enlighton SR product catalog and case photos

Product catalog and case photos provided by the manufacturer.

Enlighton SR Product Catalog

Enlighton SR Catalog

Enlighton SR Catalog

Enlighton SR Catalog

Enlighton SR Catalog

Enlighton SR case photo

Enlighton SR case photo

Enlighton SR case photo

Enlighton SR case photo

Enlighton SR case photo

Enlighten SR case photo tattoo

Enlighten SR case photo tattoo

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