Laser Treatment The Risks, and How To Be Safe

By Asmaa Chaudhry, MD

Dermatology Associates of NOVA

. http://www.dermdocs.com/

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Laser Treatment The Risks, and How To Be Safe

As we bask in the glory of a much anticipated summer, dermatology offices are filled with patients undergoing or inquiring about laser treatments. From laser hair removal to the treatment of spider veins, lasers have numerous applications in dermatology. This is an exciting time to be a dermatologist as lasers have expanded our treatment arsenal, but this excitement must be coupled with a thorough understanding of their limitations and dangers.

The term “laser”is an acronym that stands for “light amplification by stimulated emission of radiation.” Essentially, all lasers have a medium (a solid, liquid, or gas, depending on the specific laser) which is “pumped.” This pumping causes the release of energy in the form of light energy, or photons. The specific wavelength (color) of the photons is what gives each laser its unique properties. Indeed many industries have benefitted from these properties from tech industries to entertainment to medicine, the impact of lasers can be seen everywhere.

Dermatology is no different. Lasers have become part of our growing arsenal in the treatment of various skin disorders and in improving cosmesis. Lasers are now routinely used for hair removal, tattoo removal, skin resurfacing, scar treatment, removal of vascular birthmarks and pigmented lesions, spider vein treatment, and treatment of stubborn or localized psoriasis plaques. This wide spectrum of skin related uses as well as the relative abundance of new laser 'providers' necessitates a thorough examination of the risks of lasers and how to mitigate those risks.

Laser hair removal is the most common laser treatment for patients. Several different lasers can be used to successfully provide long-lasting hair removal. The ideal candidate was once considered to be a fair skinned individual with dark hair, but recent understandings and improvements in lasers have made laser hair removal more accessible to different skin types.

Risks include dyspigmentation (either hyper- or hypo-pigmentation), burning, paradoxical hypertrichosis (increased hair growth by using suboptimal settings), scarring, pain, and incomplete hair loss (usually due to incomplete overlap of treated areas). These risks may be decreased significantly by choosing an experienced board certified dermatologist or plastic surgeon to perform or directly oversee the procedure.

Skin resurfacing lasers, particularly ablative lasers, can achieve stunning results but again, must be used with the utmost caution. Improper technique can result in scarring, ocular injury, dyspigmentation, pain, infection, reactivation of HSV (the virus that causes cold sores), crusting, inadvertent tattooing due to incompletely removed makeup, and serious burns. The use of protective gear (metal eyeshields), coverings for any reflective surfaces (mirrors) in the examination room, and the utilization of a “test spot” on the patient's skin to avoid adverse events on a larger skin area are some safety measures that must diligently be employed when indicated.

Alongside a firm grasp of laser physics, a healthy respect for their advantages as well as dangers is crucial to their safe operation. Lasers can achieve remarkable and long lasting results when performed by or under the direct supervision of a board certified dermatologist or plastic surgeon with extensive laser experience.