The continuous evolution in the field of laser technology has enabled practitioners to provide the best treatments for specific conditions, ensuring greater efficacy and safety.
FREMONT, CA – Light-based technologies have witnessed a phenomenal growth in the field of dermatology over the last few years. The development of laser and pulsed lights have enabled the effective and safe treatment of various conditions such as vascular and pigmented lesions, tattoos, scars, and so on. Although dermatologists have long used artificial light sources for the treatment of skin diseases, the evolution of laser systems has paved the way for its applications in therapeutics.
The use of lasers in dermatology is gaining popularity all around the world, with its robust therapeutic applications in cosmetic rejuvenation and other conditions. The demand has boosted laser-based innovations, leading to the development of improved therapeutic outcomes with better safety profiles.
Surgical lasers are the most leveraged in dermatology, especially the CO2 laser. Its specific wavelength, variable nature, and duration of output have made it optimal for the treatment of a range of skin and mucosal diseases. The development of dye laser has brought greater efficacy and safety in the treatment of conditions such as facial telangiectasias, spider veins, pyogenic granulomas, rosacea, and cutaneous vascular ectasia.
The laser can be absorbed, reflected, scattered, and transmitted when applied to the skin. The clinical treatment depends on the absorption of the concentrated light by the tissue. The target molecules in the skin have specific wavelength absorption profiles which determine the effect of laser. The primary molecules include water, melanin, and hemoglobin. The absorption of the laser may cause either photothermal, photochemical, or photomechanical effects.
The cutaneous depth of penetrations depends on the absorption and scattering. Light undergoes minimal scattering in the epidermis, whereas the high concentration of collagen fibers causes significantly greater dispersion in the dermis. The amount of scattering depends on the wavelength of light.
The theory of selective photothermolysis by Anderson and Parrish has played a crucial role in the evolution of laser surgery. It has enabled the controlled termination of the cutaneous target with minimal injury to the surrounding tissue. When conducting laser treatment, an appropriate wavelength is maintained for the preferential absorption by the targeted tissue. The pulse duration of the laser is kept shorter than the relaxation time of the target molecules. Also, the energy of the laser pulse is enough to destroy the target molecules within the required time interval.
Several factors decide the selection of lasers and pulsed light systems appropriate for the treatment of specific skin conditions. Continuous-wave (CW) lasers produce a continuous beam of light with more prolonged exposure durations which is suitable for nonselective tissue damage, whereas Quasi-CW mode lasers produce interrupted emissions of laser energy by shuttering the beam into shorter intervals.
Intense pulse light (IPL) is a filtered flashlamp system which emits polychromatic, noncoherent, and noncollimated light with varying pulse durations. It can be absorbed by a broader range of target molecules, making it less selective than conventional laser systems. IPLs are also used to treat vascular lesions due to their capability of targeting intravascular oxyhemoglobin.
The utilization of vascular lasers leads to inhomogeneous heating in the dermal blood vessels. However, it enables effective treatment of small and large blood vessels. The most commonly leveraged vascular lasers include pulsed dye laser (PDL), potassium titanyl phosphate (KTP), alexandrite, neodymium-doped yttrium aluminum garnet, and diode.
The incorporation of lasers in dermatology has led to excellent results. The technology is in the process of continuous innovation and evolution, and will inevitably lead to better outcomes and applications. New laser devices are being developed to treat specific conditions, leading to enhanced security and effectiveness. The continued innovation in the field will expand the use of lasers, empowering practitioners to deliver improved treatments for a broader range of conditions.