Laser technology has certainly advanced the quality of medical care in a variety of specialties. Plastic surgeons and dermatologists have been among the leaders in developing more useful and safe lasers every day.
However, many think that a “laser” can cure just about anything. This mythical perception of a magical cure is far from the truth. In truth, lasers are just tools to help doctors of all specialties perform procedures that usually can be performed in other ways. Intuition would tell you that this is an “advance” and that this technology makes things easier and better; however this is not always the case. There can be devastating side effects when used inappropriately.
There many different types of lasers, all of which have distinct characteristics and properties. A laser used for eye surgery cannot be used by plastic surgeons and vice versa. Not all cosmetic lasers are the same, and there are different indications for their use. Lasers are essentially concentrated light and can have very powerful effects depending on the type of light emitted.
Types of Lasers
For the most part, cosmetic lasers can be grouped by their functions: hair removal, skin resurfacing, vascular, tattoo removal, and facial rejuvenation. All lasers have a particular affinity for a type of substance within the skin. The light is attracted to either water, pigment, or blood vessels. Skin darkness is one major factor in determining safety and what laser to use. Darker skin types, either naturally or artificially (through tanning), are not good candidates for many lasers because of the risk of having pigmentation problems (white spots). Skin darkness is rated on a six point scale with 6 being the darkest (black) and 1 being the lightest (Caucasian). Asians and Hispanics fall somewhere between 3 and 4, with some falling into the 5 range. Most lasers are safe to use for skin types 1 through 4, though extreme caution should be taken for those that fall in the 4 to 5 range.
Hair removal lasers (Alexandrite or YAG) focus on the pigment located in the hair follicle. The laser delivers energy, bursting the pigment. “Removal” is a bit misleading and should be considered “reduction.” Multiple treatments are required for optimal effect, and the goal is to reduce the quantity of darker hairs and to lighten the remaining hairs – it is NOT permanent. However, this is a great alternative to waxing or constant shaving. The most common hair laser works best for darker hairs in lighter skinned patients, thus Asians are prime candidates for this.
Resurfacing lasers (Erbium or CO2) essentially “burn” away the superficial layers of skin, creating a raw surface. By removing the aged and irregular outer layer, a new layer of skin can grow in. This “new” skin has fewer wrinkles, dark spots, and veins, and overall appears tighter, smoother, and refreshed. Darker skinned patients (including many Asians) are not good patients for this laser as it can cause white spots that are worse and more visible than the wrinkles that are being treated. Other complications can occur such as permanent redness or scarring from burns. Laser resurfacing and chemical peels work similarly. Lighter (more superficial treatments) can often be performed under local anesthesia; deeper treatments require general anesthesia. Despite what may be said, the “Day Spa” lasers are not equivalents substitute for the deeper resurfacing lasers. The latter provides a more significant improvement, but does require more recovery (up to 3 weeks).
Facial Rejuvenation Lasers
Facial rejuvenation lasers such as the “Fotofacial” or “Fraxel” provide smaller and more incremental improvements in skin color, texture, and wrinkles. These can be done in the office with minimal recovery (1 to 3 days). Multiple treatments are required for optimal results.
Tattoo Removal lasers
Tattoo removal lasers can be effective in all skin types. The light “sees” the tattoo specifically and bursts the pigment, causing it to be absorbed. Some tattoo colors, such as yellow and green, do not respond well to laser treatment; darker colors are more easily eliminated. This can lead to partial removal, depending on the color combination within a particular tattoo.
Vascular lasers are utilized for unwanted veins, broken blood vessels, and red or blue birthmarks. These are some of the most dangerous and difficult lasers to use and requires physician expertise. The laser light “sees” the blood vessels and coagulates or “burns” them shut. The skin overlying the vessels is left unaffected.
Cosmetic lasers are very powerful tools that do amazing things for skin quality when used properly by people with expertise. A consultation with Dr. Ha can help determine your skin type and if you are a good candidate for laser therapy. Safety is paramount and the consequences of inappropriate treatment can be devastating.