What is laser therapy?
Laser stands for Light Amplification by the Stimulated Emission of Radiation. Lasers work by producing an intense beam of bright light that travels in one direction. The laser beam can gently vaporize and/or ablate skin tissue to improve wrinkles, scars and blemishes, seal blood vessels or cut skin tissue.
The laser has the unique ability to produce one specific color (wavelength) of light, which can be varied in its intensity and pulse duration. The newest laser systems have become remarkably precise and selective, allowing treatment results and safety levels not previously available. Broad spectrum, or Intense Pulsed Light (IPL), has the ability to specifically treat blood vessels and pigmentation. The wavelength and power output of a particular laser or IPL typically determines its medical application.
Learn more about specific conditions where laser therapy can be used
What is skin resurfacing?
Laser resurfacing to improve cosmetic flaws – such as wrinkles, acne scars and aging or sun-damaged skin – is the latest scientific breakthrough in skin rejuvenation.
Using a wand-like laser handpiece, undesired skin cells and wrinkles literally disappear in a puff of mist and are replaced by fresh skin cells. One of the laser's most significant advantages over traditional techniques for skin resurfacing is that treatment is relatively bloodless. The procedure also offers more control in the depth of penetration of the skin's surface, allowing an increased degree of precision and safety in treating delicate areas.
Who is qualified to perform laser surgery?
Dermatologic surgeons have extensive experience with laser surgery and were among the first specialists to use lasers for skin renewal and treating a variety of skin disorders. Since results are technique-sensitive and entail an artistic component, it's important to select a dermatologic surgeon with demonstrated laser expertise
What conditions can laser resurfacing treat?
Laser resurfacing is performed in the dermatologic surgeon's office to help:
- Erase fine lines and wrinkles of the face
- Smooth and tighten eyelid skin
- Improve crow's feet around the eyes
- Soften pucker marks and frown lines
- Remove brown spots and splotchy, uneven skin color
- Improve and flatten scars
- Repair smoker's lines
- Improve skin tone and texture
What can be expected during and after treatment?
Discomfort is usually minor during the procedure, and your dermatologic surgeon can discuss the administration of any pain medication prior to treatment.
Following skin resurfacing, the treated areas usually are kept moist with ointment or surgical bandages for the first few days. The skin is typically red or pink and may be covered with a fine crust. The treated sites must be protected from sunlight after the procedure. Once healing is completed, sunblock lotion should be applied. In some cases, a pink surface color may remain for several days to several months. Make-up can be worn after about seven to 14 days.
Are there side effects or complications?
Each year, thousands of laser resurfacing procedures are performed successfully. Significant complications are rare, and the risk of scarring is low. Some patients may be at risk for varying degrees of pigmentation loss, particularly with the CO2 laser. Common minor side effects may include crusting, mild swelling, redness or brown discoloration at the treatment sites. These are usually minimized by surgical techniques and pre- and post-operative regimens.
What are the limitations of laser resurfacing?
Laser resurfacing is not a substitute for a facelift nor can the procedure eliminate excessive skin or jowls. However, by tightening loose skin, laser resurfacing can improve certain folds and creases. Laser resurfacing offers an alternative to traditional resurfacing methods such as dermabrasion and also can work well in conjunction with or as an additional treatment to other cosmetic skin procedures such as chemical peels, blepharoplasty (eyelid surgery) and liposuction of the face and neck.
For more information and referrals
For more information on skin conditions and treatments, along with a list of ASDS members in your state, please visit the Find a Dermatologic Surgeon section of our website.
What are the benefits of laser and/or IPL surgery?
Your dermatologic surgeon may choose a laser for you for the following general benefits:
- Improved therapeutic results
- Reduced risk of infection
- "Bloodless" surgery with most lasers
- An alternative to traditional scalpel surgery, in some cases
- Less scarring, in most cases
- Precisely controlled surgery, which limits injury to normal skin
- Safe and effective outpatient, same-day surgery for many skin conditions
What type of laser or IPL should be used?
Different types of lasers and IPL are used to treat a variety of skin conditions, birthmarks and growths and cosmetic complaints. Presently, no single laser or IPL is capable of treating all skin conditions, but certain lasers can be tuned to a variety of colors of light or coupled to a robotized scanning device to expand their clinical effectiveness. Your dermatologic surgeon will carefully evaluate your individual condition and suggest the appropriate type of laser and/or IPL system to achieve the best results.
What are the common lasers used in dermatologic surgery?
Carbon Dioxide (CO2) laser
The CO2 laser system can be used in three ways: "focused" for cutting skin without bleeding; "defocused" for superficially vaporizing skin; and "ultra pulsed" for facial resurfacing.
First, by delivering very powerful, rapid pulsing or scanning of the latest generation of CO2 lasers (known as focused), dermatologic surgeons are able to resurface the skin for cosmetic improvement. This technique removes fine lines and wrinkles of the face, smoothes acne scars, and rejuvenates aging and sun-damaged skin as it contours the skin surface.
Second, when the CO2 laser's energy is defocused and not continuous (pulsed), the dermatologic surgeon can treat warts, shallow tumors and certain precancerous conditions.
Third, when the CO2 laser energy is continuous and focused into a small spot of light, the beam is able to cut the skin. It is used in this way to remove skin cancers, to treat a variety of nonvascular and pigmented lesions and for eyelid operations. This technique is also used to remove warts and for some surgical incisions.
Erbium (Er):YAG laser
The high-powered erbium:YAG (Er:YAG) laser produces energy in a wavelength that gently penetrates the skin, is readily absorbed by water and scatters the heat effects of the laser light. These properties enable dermatologic surgeons to remove thin layers of aged and sun-damaged skin tissue with exquisite precision while protecting healthy surrounding tissue. The Er:YAG laser is commonly used for skin resurfacing to improve moderate facial wrinkles, mild surface scars or splotchy skin discolorations. Skin rejuvenation with the Er:YAG laser offers the advantages of reduced redness, decreased side effects and rapid healing compared to some other laser systems. Newer Er:YAG lasers have an extended pulse duration that allows them to act in a similar manner to the CO2 laser. Your dermatologic surgeon is best able to determine which of these lasers, alone or in combination, is best suited to correct your specific concern.
How do non-ablative lasers work?
Unlike laser resurfacing technologies that heat and remove the top skin tissue, non-ablative (or non-wounding) lasers actually work beneath the surface skin layer. This novel approach appears to stimulate collagen growth and tighten underlying skin to improve skin tone and remove fine lines and mild to moderate skin damage. It offers the patient the benefits of few side effects and rapid healing with virtually no "downtime."
Yellow light lasers
Through the use of an organic dye, short pulses of yellow-colored light are produced. A popular yellow light laser is the pulsed dye laser. Because yellow light is more precisely absorbed by the hemoglobin than other colors, these lasers are effective in the treatment of blood vessel disorders such as port wine stains, red birthmarks, enlarged blood vessels, rosacea, hemangiomas and red-nose syndrome. Certain yellow light lasers may also be used to treat stretch marks and are safe and effective for infants and children. The krypton and Nd:YAG lasers are dual light systems. The uses of the yellow light are similar to those already described.
Green light lasers
The green light, in contrast, is used for the treatment of benign brown-pigmented lesions such as café-au-lait or age spots, the "old age" spots commonly found on the backs of the hands and lentigines or freckles. Green light lasers also are used for the treatment of small blood vessels on the face and legs.
Red light lasers
The red light spectrum produced by the ruby or alexandrite light laser is emitted in extremely short, high-energy pulses due to a technique known as Q-switching. The Q-switched ruby or alexandrite laser systems were initially used to remove tattoos, but are now commonly used to treat many brown-pigmented lesions such as freckles or café-au-lait spots. When the pulse duration of the ruby or alexandrite lasers is lengthened, it is effective in removing unwanted hair for long periods of time, sometimes even permanently.
Q-Switched Neodymium YAG (ND:YAG)
Delivering infrared light, it is used to remove tattoos and deep dermal pigmented lesions, such as nevus of Ota. This laser can also be tuned to produce a green light for the treatment of superficial pigmented lesions such as brown spots as well as orange-red tattoos.
The KTP emits a green light and is capable of treating certain red and brown-pigmented lesions. When the pulse duration is lengthened, the Nd:YAG laser is also effective in removing hair and an inflammatory condition termed pseudofolliculitis barbae for months and sometimes permanently. This is particularly useful in the treatment of dark-skinned patients.
New technologies: Light sources
Light-based devices that produce a broad spectrum of light (wavelengths) with computer-controlled parameters of energy delivery (Intense Pulsed Light, or IPL) can be adjusted according to a patient's skin type and condition. This technology is primarily used for the treatment of benign red and brown lesions, hair removal and facial skin rejuvenation.
Other applications: Hair removal and leg veins
Laser technology is presently being utilized for efficient and long-lasting body hair removal. The laser energy causes thermal injury to the hair follicle, stunting hair growth. Several laser hair-removal systems, including the diode laser, the long-pulsed alexandrite and Nd:YAG lasers and the IPL, are being used successfully with long-lasting results.
Until recently, lasers were used primarily for superficial facial veins. Thanks to the newest technologies, leg veins may be effectively treated with a variety of lasers and intense pulsed light systems.