Published: Tuesday, May 14, 2013

Beauty dissected

Lasers, lasers, and lasers

By Dr Firdous Quader Minu,
M.B.B.S, D.L.O ENT, Head-Neck
& Cosmetic Surgeon, Phone: 01199845531

Lasers seem to be the word now for any kind of aesthetic treatment. Patients with all sorts of problems walk into my chamber and ask, “Will you treat this with lasers?” So, this gives me an idea of all the myths and misconceptions that exist about lasers. I would like to clear some of that and give you an understanding about lasers.

First I think it’s important to know what a laser is. Laser stands for Light Amplification by Stimulated Emmission of Radiation. Laser instruments amplify light into different kinds of energy waves and radiation which penetrate body tissues at different levels. These energy waves are then absorbed by the target tissue and are used to treat various problems.

Lasers can be used all over the body, and doctors of all specialisation are using them for different kinds of treatment. Cosmetic surgeons use lasers for treatment of different aesthetic problems. The advantage of lasers is that treatment can be given very accurately and precisely to the area needed without disturbing the surrounding tissues.

Many types of lasers are available for use. Each is used in a specific way for specific problems, according to the depth and type of tissue that needs to be treated. There are ablative and non-ablative lasers. Ablative meaning it will cut the tissues and non-ablative ones emit rays that penetrate the skin but do not cut it.  The CO2 laser is an ablative laser and the NdYag laser is a non-ablative laser.

CO2 lasers are used for excision of skin lesions as well as resurfacing of skin in cases like, acne scars, freckles, or   rejuvenation. If used properly with proper calibrations, scarring does not occur. There are different wavelengths and energy that need to be used at different depths for the treatment of various lesions.

Skin tags, warts, small moles, some keratotic lesions etc. can be easily treated with CO2 lasers. Also small tumors can be excised with the help of this laser. Some redness and swelling may appear after the procedure but that subsides in a few days.

Non-ablative lasers are used for treatment of lesions deep to the skin. Here the target tissue absorbs the laser light without causing any open wound on the skin.  Some non-ablative lasers are NdYag laser, Q-switch laser, Pulse dye lasers, Fractional laser etc.

Each laser is used to treat different problems according to the site, type of tissue, and diagnosis. Treatment for unwanted hairs, vascular lesions, some pigmentations, and removal of tattoos, hair growth stimulation etc, can be done by these lasers.

Unwanted hairs in some young girls and postmenopausal women can be a big aesthetic as well as psychological problem. These can be treated very easily and successfully with NdYag laser.  Here the hair follicles in the unwanted area are destroyed or reduced in size so that the hair growth stops or reduces, the hair follicles becomes thin and so does the hair, which is not visible any more.

Different wavelengths are used on each individual, according to colour of hair and skin type. Here there is no effect on the surface of the skin, as the target tissue is the hair bulb and melanin present under the skin, so, there is no scarring. The treatment takes 6-8 months, 1 session per month. It is a painless procedure, so, no anesthesia is needed.

Some pigmented lesions are treated with Q-switch lasers. Care must be taken when choosing laser treatment for pigmentation, as not all pigmentation goes away, some, like melasma will only become lighter but will not disappear. It usually has a tendency to come back. But if the pigmentation is for other reasons then it may give good results. So each case is treated differently, by different wavelengths and energy. Removal of tattoos can also be done by Q-switch lasers.

Pulse dye lasers are used to treat vascular lesions, which target the blood cells and the size of the lesion is reduced gradually.

Lasers are also used to stimulate hair growth in some cases. The blood supply of the scalp is stimulated and this helps in hair growth. But it is important to note that if hair follicles are not present to be stimulated lasers will not work.

Besides these treatments, lots of centers are offering Laser treatments for fat reduction. Before venturing into these treatments it is best to know what is being used and how much fat will be reduced. If the patient has a slight bulging abdomen, that may be reduced by lasers.

An abdomen which has a huge bulge will not be benefited by lasers. Also the hip area, thighs or arms where there is a lot of excess fat will not benefited by lasers. Here the conventional treatment by liposuction or tummy tuck surgery will be beneficial.

When deciding on laser treatment it is important to go to well reputed centers where the doctor are trained. It is very important that proper diagnosis is done, as in all these treatments, precision is very important as to the dose of energy as well as wavelengths that needs to be used. Also patients should be aware of the type of lasers being used.

Usually there is no side effect but if not done properly scarring and burning of skin may occur. In some centers IPL or VPL machines are used for skin treatments, which also give good result, but patients should be aware of what is being used, as it will avoid misunderstandings.

Lasers are a wonderful invention as it has made treatment easy by being precise, accurate and safe, almost without any side effects. But the patient needs to be aware that lasers cannot do everything and that it does have limitations. The biggest dilemma arises when both surgical and laser treatments are available as treatment options for a condition.

It is best to let your doctor explain the treatments to you and then decide what to do. Browsing through the internet may also give you a better understanding of your treatment choice.