The laser, which is an acronym for light amplification by the stimulated emission of radiation, is an extremely important scientific innovation that is used in many industrial, commercial, military, and medical applications. High intensity lasers create light with the following features:
These important properties contribute to the strength of a laser light and its ability to be concentrated into specific spots at a high energy level. In aesthetic dermatology, the usage of a laser is commonplace and is constantly being refined and researched. While carbon dioxide and argon-based lasers were first used over 40 years ago to treat various skin conditions like birthmarks, their use resulted in a high rate of scarring. Nowadays, more innovative and effective laser and light technologies are available for treating a wider range of skin problems.
Lasers used in aesthetic dermatology can be categorized into two main classes: ablative and non-ablative lasers, depending on the mechanism of action. As the name suggests, ablative lasers, such as carbon dioxide and erbium-doped yttrium aluminum garnet (Er:YAG) lasers, are used to ablate the skin surface so as to trigger a wound-healing response. High intensity heat energy from the laser is directed onto skin in a controlled and precise manner in order to rejuvenate the superficial skin layer. Dead and keratinized cells are eliminated to give way for new skin cells to grow and mature. Signs of photoaging like wrinkles; lines; hyperpigmentation on the face, neck, and body parts can be effectively erased, and treated skin appears smoother, more elastic, and younger. Non-ablative lasers—such as pulsed-dye, neodymium-doped yttrium aluminum garnet (ND:Yag), and Alexandrite lasers—have lower energy levels than ablative lasers. Non-ablative lasers work by simply heating deeper layers of skin without removing the epidermis in order to stimulate the production of stronger collagen fibers. Since it does not ablate the skin, non-ablative laser treatment results in a lesser degree of discomfort and shorter downtime than treatment with an ablative laser.
Just like any other aesthetic treatment, the physician usually commences laser therapy by assessing the patient’s skin condition and skin type to determine the most appropriate type of laser to use. Initial discussion is also important to outline the treatment goals. The patient’s consent should be obtained once he or she has been educated about the potential benefits and risks of the therapy. The time taken for the aesthetic laser treatment depends on the severity of the skin condition and the type of laser device/system being used. Nevertheless, the proposed treatment area should be cleaned and sanitized prior to the start of the procedure.
Patients who have undergone laser therapy may be advised to follow some important aftercare methods. First, they should maintain the hygiene level of the treated area(s) to reduce the risk of infections and other skin complications. Patients should also reduce their exposure to sunlight and practice tried and tested methods of sun protection (e.g. applying sunscreen, wearing protective clothing, etc.) after their treatment procedure to prevent complications. Patients may also be advised to follow a cosmeceutical skincare regimen for better skin rejuvenation.
After treatment with a laser, patients may experience undesirable skin reactions such as weeping burns, pain, swelling, redness, and pigment changes on the treated area(s). Other more serious yet rare skin reactions like scarring, infections, and pus may also occur. It is imperative that physicians educate their patients about the signs and symptoms of adverse skin reactions so that swift medical attention can be obtained.
Laser accessories are products that make an aesthetic laser system complete. The accessory or accessories that need to be used depend on the laser device being used. For example, a Thermage CPT device, a skin rejuvenating device that incorporates patented Comfort Pulse Technology (CPT), uses the following accessories:
The accessories above are important to ensure that treatment with the Thermage CPT system can be conducted safely and effectively. Disposable laser accessories like applicator tips and temporary stencils are meant to be used only once, after which they must be discarded. Reusing these single-use accessories will only increase the risk of infections and cross-contaminations.