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What's New in Laser Technology

Deborah Sarnoff, MD July 2008 issue of Skin Inc. magazine
slim body and yellow towel

This past year has been an exciting one in the world of laser technology. New improvements are being introduced to the market faster than the speed of light. Here are a few highlights from this past year.

Laser hair reduction

Laser hair removal has improved dramatically throughout the past few years. Major breakthroughs include the development of chilling devices to cool the overlying epidermis, as well as longer pulse durations to allow the beam of light to penetrate more deeply into hair follicles without harming the skin. One of the newest developments is a system that combines both an alexandrite 755 nm wavelength with a Nd:YAG 1064 nm wavelength. The alexandrite wavelength is ideal for light-skinned, dark-haired patients, and the Nd:YAG is considered the gold standard when treating patients with darker skin. This type of equipment covers the gamut of skin types. Research is ongoing to develop light-based technology for light-colored hair.

One of the biggest breakthroughs this year has been U.S. Food and Drug Administration (FDA) approval of several home hair removal systems. One such device uses intense pulsed light (IPL) to selectively target unwanted hair. The machine is available by prescription only under the direction of a physician. This type of device complements professional spa treatments, resulting in increased overall client satisfaction.

Laser lipolysis

Saddle bags, tummy bulges, love handles, an aging neck—these areas of unwanted fat can be removed with a new Nd:YAG laser with a 1064 nm wavelength. Imagine a fiber optic wire, thinner than a strand of capellini, with a tiny laser beam at the tip. Now imagine introducing this magic beam of light into those target areas in order to gently melt away the fat. That’s precisely what this laser can do. It’s a world apart from traditional liposuction. The amazing bonus is that the gentle effect of the laser beam on the overlying skin can break the bands that cause dimpling, increase collagen production during the healing period and improve skin tightening after the fat is removed. This capacity to produce skin retraction is very important in the treatment of patients with skin laxity in the submental region (double chin), abdominal region, arms and thighs, as well as cellulite.

Hyperhidrosis, or excessive sweating under the arms, is another condition ideal for this type of laser. The heat from the laser produces a collapse of the sweat glands, resulting in significantly less sweating. This year, several companies have released fat-melting lasers utilizing energy from a 1320 nm wavelength. This energy is absorbed by fat two to three times more readily than from the 1064 nm wavelength, but the jury is still out on whether it will be more effective. Another fat-melting laser system that combines the two beams of light—1320 nm and 1064 nm—in a sequential delivery system for maximal efficacy has recently been introduced, as well.

Lasers for vascular problems

The flashlamp pulsed dye laser (PDL) is still highly regarded for treating broken blood vessels, port-wine stains and various red blemishes. Improvements in cooling the skin have resulted in increased efficacy without significant bruising. One recent newsworthy development is the introduction of a system that employs two lasers in one—a PDL and an Nd:YAG—in a sequential fashion. The PDL is attracted to the hemoglobin in the blood and converts it to methemoglobin, which is the perfect target for the Nd:YAG. Effectively, this delivers a one-two punch to blood vessels, synergistically increasing effectiveness and diminishing side effects.

Lasers for acne

A combination therapy featuring a vacuum and a painless laser is used to deeply cleanse and purify pores from the inside out. The FDA has recently cleared this device to treat pustular and comedonal acne, as well as mild to moderate acne vulgaris. People who have tried the equipment have reported a visible reduction in pore size, improved skin tone and texture, and an overall radiant and healthier-looking complexion.

Another big breakthrough in light therapy for acne has been the FDA clearance of hand-held phototherapy devices for the at-home treatment and prevention of acne and blemishes. The beam of light destroys bacteria that causes acne. One of these systems consists of a blue light (414 nm LED) and a red light (6660 nm LED). The blue light has proven to be effective for acne and blemishes, and the red light promotes skin rejuvenation and collagen formation. These types of devices do not replace professional spa treatments, but are adjuncts for overall better results and increased client satisfaction. It is relaxing, easy to administer, and clients can supplement professional spa treatments in the comfort and privacy of their own homes.

Microablative fractional resurfacing

A decade ago, CO2 laser resurfacing was widely popular for the treatment of acne scars and deep wrinkles. Although it is still highly regarded in tissue tightening and facial rejuvenation, clients pay the price in terms of pain, downtime and wound care. Complications, such as infection, scarring and permanent pigmentation changes, have limited its clinical use. The biggest breakthrough during the last few months has been the introduction of microablative fractional CO2 resurfacing. Using this technique, the laser beam delivers light in a stippled fashion, ablating miniscule areas without damaging the surrounding skin. The laser gently vaporizes the skin in a polka-dot pattern, sparing the bridges of normal skin that lie in between the areas that are zapped by the laser. The bridges of skin that remain untouched by the laser are the key to rapid healing, because the entire epidermis is not ablated by the laser. With one system, clients can see tissue tightening, and textural and pigmentary improvement with only four to five days of downtime. As an added bonus, areas other than the face, such as the neck, décolletage and hands, can be safely treated with no lines of demarcation.

A bright future

Modern laser technology continues to evolve in ways that benefit both professional practitioners and clients. And although most of these devices can only be operated or prescribed by medical personnel in most states, spa professionals need to be familiar with them in order to keep clients informed and help them make educated decisions when it comes to more medically based treatments.

The future seems bright for lasers that utilize improved chilling systems, a combination of wavelengths and offer sequential deliveries of light beams. Moving forward, more and more systems will become available that provide the convenience of at-home laser options to supplement professional treatments.

Access the specific names of the equipment referred to in this article.

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