Explains how lasers work in dermatology and other similar areas.
Cosmetic laser therapy
The invention of the laser, which stands for Light Amplification by Stimulated Emission of Radiation, can be dated to 1958 with the publication of the scientific paper, Infrared and Optical Masers, by Arthur L. Schawlow, then a Bell Labs researcher, and Charles H. Townes, a consultant to Bell Labs. That paper, published in Physical Review, the journal of the American Physical Society, launched a new scientific field and opened the door to a multibillion-dollar industry.
What is a laser, and what does it do to the skin?
A laser is a device that produces an intense beam of light.
When laser is applied to the skin it is absorbed either within the skin, or absorbed in haemoglobin, the blood’s natural pigment.
The level of penetration of the skin by the laser depends on the type of laser used.
Many types of laser are used in medical practice, including the argon, carbon dioxide, ruby, etc. Each of these lasers produces a differently coloured beam and pattern of light, and has a specific medical use. It is essential that the right laser is chosen to treat an individual patient's condition, and that the treatment is properly and safely delivered. Apart from its medical uses, lasers are commonly used for skin resurfacing by cosmetologists and cosmetic surgeons.
How can laser treatment improve my appearance?
There are many applications of the use of laser therapy in cosmetic surgery.
These include the removal of:
fine lines, wrinkles and acne scars(resurfacing lasers),
Fine lines, wrinkles and acne scars:
Sun damage and skin ageing combine to produce fine lines and wrinkles in the skin. These can be particularly noticeable on the face around the mouth and eyes.
All resurfacing lasers act in essentially the same way; the laser vaporises the outer layers of skin, new cells are formed during the healing process, and a smoother, tighter skin surface is formed. This type of laser therapy is not a substitute for a facelift procedure during which excess skin is removed and the facial tissues are tightened. Laser treatment cannot remove excess, baggy skin, as it is a surface treatment directed at eliminating fine wrinkles. The carbon dioxide laser is commonly used for resurfacing.
Resurfacing lasers may also help to reduce surface irregularities, such as the pitting resulting from acne, or scars of chickenpox etc..
Removal of excess hair:
Lasers can also be used to eliminate excess body hair.
For this several types of laser are used. The principle is that intense energy has to be transmitted down the hair shaft to destroy the hair at its root.
Common areas for hair removal in women are usually the face, the bikini area, the legs, back and underarms, whilst men may be concerned about hair on their chest and chin.
More than one treatment is usually necessary. This is because the hairs need to be at the correct stage of their cycle of development before the roots, or follicles can be effectively destroyed. Individual hair removal treatments usually last from 15 to 30 minutes. A single treatment usually achieves between 28% to 54% hair removal one year after treatment. After multiple treatments, this increases to 38% to 78% hair removal one year after treatment.(U.S. F.D.A. figures)
Removal of tattoos:
The use of lasers to remove tattoos is gaining popularity, as with the new YAG lasers, there is minimal scarring.
Results are never 100%, and some remnants of the tattoo will always be there.
Birth marks and pigmented skin lesions:
Some birthmarks and vascular lesions can be removed by laser therapy. If treatment is given at an early age, results are excellent.
Will the laser be suitable for me?
During your initial consultation, the cosmetologist/surgeon will examine you and discuss whether laser therapy is able to help you or not.
It is usual to carry out a 'test patch' before subjecting the entire area to laser therapy. This involves using the laser on a small area of skin (usually inconspicuously placed) to test the tissue's reaction of your particular type of skin. If this treatment has been successful, and the area has healed with a good result, then further treatments can be carried out.
What happens when I have laser treatment?
The treatment is carried out in a special room, with screens across the windows and with the patient and surgeon wearing special goggles. (Looking directly into the intense laser beam can cause damage to the eyes). The sensation of laser therapy is rather like being flicked with an elastic band against the skin.
Multiple applications are likely to be needed during the same session if a significant surface area is being treated. The treated area will sting for a short period of time. Most treatments last for about half an hour, during this time you will be awake and fully conscious, and can ask the cosmetologist to stop at any time if the treatment becomes uncomfortable.
The procedure is often performed with some form of skin desensitisation. One common and simple technique is to apply an ice cube directly to the skin area at the time of treatment.
Apart from removing all make-up before the treatment, there are no other special precautions that you need to take.
The treated area will be red and tender for a day or two. (a little like sunburn). If you have had laser treatment for hair removal, it will take some weeks to see how many hairs have been eliminated as the normal cycle of hair growth continues.
What are the possible complications for me?
This is usually brief, and occurs during the treatment. The sensation is rather like being flicked with an elastic band.
b) Damage to the eyes may occur if correct eye protection is not worn.
This is unusual, but can result if large areas are treated at once. If you see blisters, or feel tingling you should contact the cosmetologist, so that you can receive the appropriate treatment.
b) Prolonged healing
This usually occurs because of infection, although occasionally if several applications of the laser have been carried out on a particular area, the wound may be a little deeper.
c) Red or discoloured skin
This is normal following laser treatment, and may last for a few weeks. In some individuals this may be prolonged.
a) Changes in pigmentation
Pigmented skins may react to laser therapy by producing hypo or hyper pigmented change in the skin. Rarely these changes are permanent. To reduce this risk usually the surgeon performing the treatment will carry out a small 'test patch' before treating all the area involved.
b) Burns to the skin
If the laser is not used correctly, then burns to the skin may occur.
This may be the result of inappropriate use of the laser, or infection in the healing wounds.
Are there any alternatives to laser treatment?
This depends on what the laser therapy is to be used for:
a)Wrinkles and fine lines
Possible alternative treatments include use of chemical peels and dermabrasion. The disadvantage with both of these is that it is difficult to gauge how deep the agents penetrate into the skin. (In contrast, the laser penetrates the skin to a known and reproducible depth). This means treatment is more reproducible, and you are less likely to damage the underlying skin and produce scarring. Dermabrasion entails some discomfort
Electrolysis is time consuming, is associated with some discomfort, and is likely also to require multiple treatments. Like laser therapy, the effects on hair removal may not be permanent.
Laser therapy has dramatically improved tattoo removal. However, multiple laser treatments are needed to remove pigment adequately. Previous alternatives have included excision and skin graft or direct closure or dermabrasion. These techniques are more effective at eliminating the original tattoo, because skin is excised, but at the cost of a degree of scarring.