By: @dermahealthnutrition

 

Laser treatments are widely used in Dermatology for various medical and cosmetic procedures. A laser (which stands for Light Amplification by Stimulated Emission of Radiation) is a device that emits a beam of highly concentrated monochromatic (single-color) light. Every laser has a unique wavelength, which is only absorbed by one specific target in the skin, such as a hair follicle, blood vessel, or pigment, while sparing the surrounding tissue. This basic principle is called selective photothermolysis and explains why there is no single laser that can be used for every treatment.

 

The absorbed laser light creates heat in the skin, leading to thermal damage and destruction or removal of the target tissue. The effects are dependent on several factors, including the wavelength, pulse duration, and energy of the laser. When the laser parameters are chosen correctly for the specific target, the following effects can occur.

 

Selective Inflammatory/Autoimmune Skin Diseases

Lasers that emit a high-intensity beam of ultraviolet B (UVB) light can be used for the adjunctive treatment for psoriasis, atopic dermatitis, vitiligo, lichen planus and prurigo by reducing inflammation, restoring pigmentation, and promoting healing. (e.g. excimer laser).

Scar Revision

Lasers can improve the appearance of scars by breaking down scar tissue and stimulating collagen production. (e.g. (fractional)CO2 laser/Erbium:YAG laser).

Skin Rejuvenation

Laser light can stimulate collagen production and improve skin texture and tone by selectively targeting the dermal tissue. (e.g. (fractional) CO2 laser/Erbium:YAG laser).

 

Vascular Lesions

Laser light is absorbed by the hemoglobin in the blood vessel, causing coagulation and closure of the vessel. This effect is useful for the treatment of spider veins, port wine stains, and other vascular lesions. (e.g. pulsed-dye laser/yellow laser/Nd:YAG laser)

 

Pigmented Lesions

Laser light is absorbed by the excess melanin pigment in the skin, leading to its fragmentation and removal. This effect is useful for the treatment of age spots, sun spots, and melasma. (e.g. rubin laser)

Hair Removal

Laser light is absorbed by the melanin pigment in the hair follicle which leads to thermal damage and destruction of the follicle. This results in long-lasting or permanent hair reduction. (e.g. Diode laser/Alexandrite laser)

 

Tattoo Removal

Laser light is absorbed by the ink particles in the tattoo, causing their fragmentation into smaller particles that can be removed by the body's immune/lymphatic system. The number of treatments required for a complete removal will depend on factors such as size, color, type of ink and skin type. (e.g. Q-switched laser/rubin laser).

 

Warts

Different lasers can be used for different types of warts either vaporizing the tissue or targeting the blood vessels in the wart, causing them to close off and shrink. (e.g. CO2 laser/pulsed dye laser/Nd:YAG laser).

 

Overall, laser treatments are safe and effective when performed by an experienced practitioner. However, there may be risks and potential side effects, such as redness, swelling, scarring and changes in pigmentation. Therefore, it's important to seek a board-certified physician who can determine the most appropriate laser treatment for each individual indication and skin type and minimize the risk of adverse events.

 

References:

Shah VV, Aldahan AS, Mlacker S, Nouri K. The Evolution of Laser Technology in Dermatology. JAMA Dermatol 2016; 152: 199

Conforti C, Vezzoni R, Giuffrida R et al. An overview on the role of CO(2) laser in general dermatology. Dermatol Ther 2021; 34: e14692

Guertler A, Reinholz M, Steckmeier S, Gauglitz GG. Evaluation of a non-ablative, fractional 1565 nm laser for the improvement of striae distensae albae. J Eur Acad Dermatol Venereol 2019; 33: 220-226