Clinical Studies

History of lasers in dermatology.

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Overview of lasers.

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Lasers in dermatology

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Laser treatment for skin problems.

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History of Lasers.

 

Laser technology has considerably expanded therapeutic modalities in dermatology and aesthetic medicine. In addition, lasers have broadened the spectrum of diagnostic and therapeutic options in many other medical fields. Dermatologists, especially Dr. Leon Goldman, played an important role in the evolution and use of medical lasers. There was a long way from the concept of stimulated emission as the fundamental idea of laser technology by Albert Einstein in 1917 to the practical use of the laser today. We review the development of laser technology from the early days through the latest advances.

What is a laser?

 

The word ‘LASER’ stands for light amplification by stimulated emission of radiation. A laser works by emitting a wavelength of high energy light, which when focused on a certain skin condition creates heat and destroys diseased cells. Wavelength is measured in nanometres (nm). 

 

Various kinds of lasers are available; they are differentiated by the medium that produces the laser beam. Each of the different types of lasers has a specific range of utility, depending on its wavelength and penetration.

CO2 - laser»

 

Fractionated or "pixilated" carbon dioxide (CO2) lasers are one of the latest advances in non-surgical skin rejuvenation treatments. The CO2 has the longest wavelength of all the lasers on the market and can be used safely on darker skin types with appropriate adjustments in the settings.

 

 

Fractionated CO2 lasers excel at treating deeper wrinkles, more severe textural changes from sun damage, wrinkles, blotchiness, acne scars, and surgical or traumatic scars. It can be used on the delicate eyelid skin and around the mouth. It is also a very effective treatment for sun damage and precancerous growths (actinic keratoses – note that insurance will not cover this).

It can be used to improve texture, wrinkles, and blotchiness on the neck, chest, arms and legs but this should only be done by experts because the risk of complications, including scarring, is higher in these areas.

 

WORKING PRINCIPLES

 

The treatment is a fractional treatment that produces thousands of deep, tiny columns in your skin, called, microscopic treatment zones. 

 

The system is in that it intensively treats old epidermal pigment cells without affecting any of the surrounding tissue, which reduces healing time (about 24 hours) and promotes the skin’s natural process for creating new, healthier tissue to replace the damaged cells. 

 

It is a safe, non-invasive procedure that allows you to rediscover the fresh, healthy skin of your youth.

 

TREATMENT:

 

  • Acne scars

  • Actenic keratoses

  • Basal cell carcinoma

  • Burn debridement

  • Laser skin resurfacing

  • Eliminate the scar: traumatism, operation

  • Improve texture tone and pore size

  • Erase unwanted brown spots

  • Smooth wrinkles around the eyes and mouth

  • Rejuvenate your neck, chest and hands etc

  • Skin whitening and tightening, wrinkle removal

  • Pore shrinking 

  • Striae gravidarum removal, tone and texture improvement 

  • Syringoma and steatoadenoma removal

  • Treatment of actinic keratoses and seborrheic keratosis

     

Nd: YAG - laser

 

Nd:YAG (neodymium-doped yttrium aluminium garnet; Nd:Y3Al5O12) is a crystal that is used as a lasing medium for solid-state lasers. The dopant, triply ionized neodymium, Nd(III), typically replaces a small fraction (1%) of the yttrium ions in the host crystal structure of the yttrium aluminium garnet (YAG), since the two ions are of similar size.  It is the neodymium ion which provides the lasing activity in the crystal, in the same fashion as red chromium ion in ruby lasers.

 

APPLICATION IN MEDICINE

 

Nd:YAG lasers are used in ophthalmology to correct posterior capsular opacification, a condition that may occur after cataract surgery, and for peripheral iridotomy in patients with acute angle-closure glaucoma, where it has superseded surgical iridectomy. Frequency-doubled Nd:YAG lasers (wavelength 532 nm) are used for pan-retinal photocoagulation in patients with diabetic retinopathy.

 

Nd:YAG lasers emitting light at 1064 nm have been the most widely used laser for laser-induced thermotherapy, in which benign or malignant lesions in various organs are ablated by the beam.

 

In oncology, Nd:YAG lasers can be used to remove skin cancers. They are also used to reduce benign thyroid nodules, and to destroy primary and secondary malignant liver lesions.

 

To treat benign prostatic hyperplasia (BPH), Nd:YAG lasers can be used for laser prostate surgery—a form of transurethral resection of the prostate.

These lasers are also used extensively in the field of cosmetic medicine for laser hair removal and the treatment of minor vascular defects such as spider veins on the face and legs. Recently used for dissecting cellulitis, a rare skin disease usually occurring on the scalp.

 

Using hysteroscopy the Nd:YAG laser has been used for removal of uterine septa within the inside of the uterus.

 

In podiatry, the Nd:YAG laser is being used to treat onychomycosis, which is fungus infection of the toenail.The merits of laser treatment of these infections are not yet clear, and research is being done to establish effectiveness.

 

TREATMENT:

 

  • Vascular lesions: spider / thread veins, varicose veins, facial veins (telangiectasis)...

  • Pigmented lesions: brown age spots, frackels, naevus of ota, naevus of ito, mongolian spots...

  • Hair removal

  • Improve wrinkles in photo-aged skin

DIODE 808nm - laser

 

Laser hair removal technology emerged and proliferated in the past decade to become the “gold standard” for the treatment of unwanted/excessive hair.And clinically proven,laser technology for permanent hair reduction has yet to achieve good safety and efficacy standards.There is a widely recognized need for an improved method for hair removal which heats the hair follicles to a sufficient temperature for hair removal while delivering a minimal amount of thermal energy to the epidermis.

 

The Tissue Penetration illustration shows the depth of penetration emitted by various laser devices used for laser hair removal. The diode laser penetration is able to surpass that of an ND:Yag due to its ability to be compressed onto the skin causing the waves emitted to penetrate deeper (an ND:Yag cannot be compressed and must sit directly on top of the skin). The Diode is capable to effectively treat all depths of hair, from your head down to your toes.

 

WORKING PRINCIPLES

 

Diode Laser 808nm working principle is based on the photothermic theory. There is plenty ofmelanin in hair follicles and hair shafts. Melanin scatters among hair bulbs and hair shaft structure(like medullary substance,cortex and cuticula pili). Diode Laser 808nm targets on melanin and treat selectively in a precise way. Melanin could absorb the energy from the laser, which would result in temperature rapid increase, to destroy surrounding hair follicles, and finally remove hair.

 

 

TREATMENT:

 

  • Hair removal