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Lighting the Way to Beautiful Skin

By: Wendy Reichert
Posted: June 24, 2008, from the February 2006 issue of Skin Inc. magazine.

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Lasers (Light Amplification by Stimulated Emission of Radiation). Lasers are high-powered devices that feature one coherent wavelength of light. They are capable of providing significant rejuvenative improvements to the skin, from gentle collagen stimulation to deep laser peels that require weeks of healing.

Different laser wavelengths affect different components of the skin. For example, some are well absorbed by oxyhemoglobin and, therefore, work well to clear telangiectasia, rosacea or diffuse redness. This occurs through a controlled wound-inducing process called selective photothermolysis. Laser wavelengths convert to heat in the skin and are absorbed by a target chromophore—in this case, oxyhemoglobin—that cauterizes blood vessels and eliminates visible redness. Target chromophores can be melanin (brown), hemoglobin (red) or even water. When lasers generate high levels of heat, they can destroy or vaporize tissues, such as when clearing telangiectasia or when utilized for a laser peel. Successive millisecond pulses of extremely high power help to protect the surrounding tissue, or the nontarget areas, by providing a controlled amount of “cool-down” time between pulses.

Some lasers allow pulse duration and pulse delay settings to be adjusted manually, while others only permit the fluence to be changed. Lasers can be used to tone and tighten lax skin, reduce hair growth, help clear acne, diminish hyperpigmentation, remove tattoos, and improve the appearance of fine lines and scars.

There is a nationwide effort to mandate that a physician or a state-approved alternative medical professional, such as a nurse practitioner or a physician’s assistant, must be present when laser treatments are performed. Some states require that they be administered by a physician. All operators must be trained properly, as lasers are capable of inflicting significant damage, including burning, scarring and the possibility of retina damage. However, they are safe and very effective when used by trained technicians. Lasers are classified as Class IV medical devices by the U.S. Food and Drug Administration’s (FDA) Center for Devices and Radiological Health (CDRH). Individual states have varying regulations on who may purchase a laser legally. Check with your state regulatory board if you are considering a laser purchase. This contact information can be found on www.SkinInc.com.

Intense pulsed light (IPL). IPL is broad-spectrum light composed of multiple wavelengths. A cutoff filter usually is used to restrict the bandwidth to a certain range when IPL is used. The shorter wavelengths clear lentigines (pigment spots) and telangiectasias; the longer ones rejuvenate and smooth the skin.