Solar Lentigines Treatment Guidelines - Medsystems

• The fluence setting should be selected to provide the desired treatment without effecting the pigmentation
of background skin.
• Use lower fluences for darker targets, both pigmented and vascular, or over bony areas.
• The potential for overtreatment is greatest with skin type IV and patients with the pigmentary effects of
long-term tanning (actinic bronzing). Begin with low settings for the initial test treatment.
• Fluence settings should not be based on settings used with other pulsed light devices.
RECOMMENDED TECHNIQUE:
• When telangiectasia are present, with or without solar lentigines, apply a thin layer of clear (no color)
ultrasound gel and use standard cooling (5° or 10° C).
• When only solar lentigines are present, use Sun Mode and no gel. This allows use of reduced fluences.
• Place the entire light-emitting window in contact with the area to be treated.
• Activate the light pulse.
• Place the window over the next treatment area and treat in the same manner.
• If treating an area with closely spaced lentigines, place treatment pulses adjacent to one another so that
there is no more than 1 mm overlap between pulses.
• The desired response for lentigines is some darkening of the treated lentigines, and possibly mild erythema.
If a large portion of the treated area darkens or develops significant erythema, the fluence should be
reduced. This effect is often delayed.
• The desired response for telangiectasia treatments immediately is constriction or darkening of the vessel. If
results are not seen at the lower settings, the fluence may be gradually increased as new areas are treated
while watching for the desired endpoint as well as epidermal damage. Treatment may also affect pigment,
which may have a delayed reaction.
• Always observe the epidermis during the treatment, watching for signs of damage (epidermal separation or
gray coloration). If damage is seen, stop the treatment, cool the skin, and reduce the fluence before
continuing.
• Do not “double pulse” or retreat an area within a single visit.
• Ensure that the window remains clean during the treatment. This is especially important when treating over
areas with hair.
POST-OPERATIVE CARE:
• Ice, chilled gel, or hydro-gel pads may be applied post-treatment as needed for patient comfort. The
treatment window can also be used as an effective post-cooling device.
• Treated lentigines usually darken after treatment, and crusting begins to form within a few days. This
crusting usually resolves in 1 to 3 weeks. It should be allowed to naturally flake off for best results.
• The recommended treatment interval is 4 weeks or longer, depending on the rate of clearance.
• Localized erythema may also be present and typically resolves within 24 to 48 hours. If prolonged
erythema occurs, future treatments should be performed at a lower fluence.
• If a wound develops an antibiotic ointment may be recommended.
• Patients should avoid artificial tanning, or sun exposure without sun protection, between treatments.
© November 2006, D0481 Rev. C LimeLight Treatment Guidelines
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