| Laser
Surgery
There are a variety of lasers currently available to treat
many conditions of the skin. Lasers create a coherent beam
of light which targets a specific structure in the skin to
improve such things as broken blood vessels, wrinkles, tattoos
and other problems without harming the surrounding skin.
In our practice we currently have five lasers:
V Beam Pulsed Dye
Laser
How this laser works
This laser produces a yellow beam of light which is absorbed
by superficial blood vessels in the skin effectively destroying
them without harming the normal surrounding structures of
the skin.
Uses
This laser can be used to treat broken blood vessels ( telangectasias),
port wine stains, cherry angiomas, acne rosacea, red thickened
scars, stretch marks, and warts.
Side effects
Immediately following laser exposure, the treated areas
may turn black and blue and may swell. This can last 5 to
14 days, but on average lasts about 7 days. Water based cosmetics
can be applied after 3 days. Occasionally a blister, scab
or crust may form over the treated area and polysporin must
be applied to the treated area on a daily basis. Ice head
elevation and Tylenol may reduce this effect.
Other possible side effects
Hyper pigmentation (darkening of the skin's pigment) occurring
in less than 1% of patients is the most common side effect
and is usually temporary. It can be caused or worsened by
sun exposure either immediately before or after your treatment.
For this reason strict sun avoidance and sun screen use is
a must before and after your treatment.
Treatment sensations
The V beam laser can feel like a rubber band snapping. This
brief sting can be warm or hot. After treatment ice or Tylenol
can be used to ease any discomfort which is usually very
transient.
Preparation for treatment
Aspirin and aspirin containing products, certain cough remedies
and ibuprofen (such as Nuprin, Advil, and Motrin) should
be avoided one week prior to surgery. These medications can
thin the blood causing increased bruising and delayed healing
time.
Care after treatment
Avoidance of sun exposure is important immediately after
treatment and reasonable protection from the sun is advisable
for 3 months after treatment. Use of a sunscreen with spf
15 or higher, a hat and general sun avoidance will help protect
you. Your skin will be somewhat fragile in the treated areas
and should be patted dry and not rubbed after washing. Polysporin
can be applied to the treated areas if the dry out and should
be applied to any treated areas that form blisters, scabs
or crusts on a daily basis until the area heals completely.
ND:
YAG Laser
How this laser works
This laser produces a green light which is absorbed by brown
pigment in the skin as well as many colors of tattoo ink
which is broken up and absorbed by the body.
Uses
This laser is used to remove brown lesions including solar
lentigos (age or liver spots) freckles, café -au-lait
spots and Nevus of Ota. It is also designed to remove many
colors of tattoo ink including black, dark green, red, and
blue. Unlike brown spots on the skin which usually only require
one or two treatment sessions tattoo removal requires many
treatments spaced two months apart to completely eradicate
all the ink in the tattoo.
Side effects
Immediately following treatment the area turns ashy grey
and may swell. This whiteness fades in about twenty minutes.
Blisters may sometimes form and are very common after the
first several sessions of tattoo removal. The swelling may
last several days but the skin usually returns to its normal
appearance in 7 to 14 days. For age spots or freckles healing
is much more rapid on the head and neck usually occurring
in about 7 days than areas such as the hand or legs which
may take several weeks to totally heal.
Treatment sensations
The laser feels almost exactly like hot grease splattering
on your skin while cooking bacon. This sensation only occurs
during treatment which is very rapidly completed. There is
sometimes a burning sensation of the treated area which rapidly
subsides within 20 to 30 minutes. A numbing cream such as
EMLA or Elamax can be applied prior to treatment to decrease
this discomfort and ice following surgery is helpful as well.
Care after treatment
Care of treated pigmented lesion of the skin consists of
gentle daily washing with soap and water and application
of Polysporin until the lesions resolve and healing is complete.
For tattoo removal the treated area should be cared for as
above and also covered with a non-stick dressing such as
a Telfa pad for about 7 days.
KTP Laser
Uses
This laser is similar to the V beam pulsed dye laser except
that it only works of fine well defined blood vessels of
the face which are easily traced out by the tip of this laser
which is similar in size to the tip of a pencil.
The advantage of this laser is that there is no bruising
or swelling after treatment and the blood vessels treated
are gone immediately after treatment. The disadvantage of
this laser is its ability to only treat small well defined
blood vessels (ones that look like a road on a map) and the
fact that several treatment sessions may be needed to completely
remove a given blood vessel. Despite its limitations it is
an excellent choice for people with a small number of bloods
vessels or those who cannot tolerate the recovery period
following V beam laser treatment.
Side Effects
The treated areas may be swollen or red following treatment
but this generally resolves within 24 hours. Ice may hasten
the resolution of this swelling and analgesics such as Tylenol
are rarely needed. Since recovery is so rapid sun avoidance
and protection with sunscreen is only required for the first
week after treatment.
Treatment Sensations
The KP laser generally feels like a pinprick or a warm or
hot feeling which only occurs during active treatment which
is accomplished very rapidly. Topical numbing medications
are generally not required.
Care after treatment
Generally no care is required other than sun avoidance and
protection as noted above.
Gentlase
Hair Removal Laser
How this laser works
This laser produces an invisible beam of light that penetrates
through the upper layers of skin without harming them and
is absorbed by the hair root deep within the skin to rupture
it and retard hair growth. This laser is absorbed by dark
structures and is therefore most effective on dark hair on
light skinned individuals. Patients with fair, blond or fine
hair are usually not good candidates for laser hair removal.
Uses
Dark or pigmented hair anywhere on the body can be treated
with this laser; facial hair, underarms, legs, and the "bikini
line" are areas commonly treated with this laser.
Side effects
The laser may produce mild redness and occasional swelling
in the treated areas. There is sometimes a pinpoint redness
or swelling located around each hair follicle and these side
effects usually resolve within 24 to 48 hours. During that
time the skin may be more sensitive to sun exposure and therefore
sun avoidance and sun screen is recommended immediately after
treatment.
Treatment Sensations
This laser is equipped with a cooling system which cools
and protects the skin prior to the delivery of laser energy.
This makes the treatment very tolerable with only a mild
pin-prick-like sensation experienced during treatment.
Results and Limitations
The Gentlase system is one of the safest and most effective
lasers used in hair removal but it still has limitations.
Despite tremendous media and advertising hype the truth is
that there is no laser that permanently removes hair. After
a series of treatments (usually from 3 to 5 spaced one month
apart) patients should experience a significant reduction
in the amount of hair in the treated area but after a period
of months (on average 6) there will be regrowth of some,
and perhaps all of the hair in the treated area. Patients
can achieve long term control of unwanted hair but this may
require ongoing treatment sessions, spaced several months
apart. Despite these limitations many patients find laser
hair removal to be a safe, quick, comfortable way to achieve
long term control over unwanted hair.
Care after treatment
Since immediate effects are so minimal and resolve so quickly
there is little to no after care required other than sun
avoidance, and Ice for any swelling that occurs.
Smoothbeam
Laser
How this laser works
The Smoothbeam is a unique diode laser that targets water
within the skin which stimulates the generation of new collagen
formation. This is accomplished without damaging or removing
the outer layers of skin which greatly adds to this laser's
safety and remarkably decreases healing time after treatments.
Uses
The Smoothbeam laser helps improve the appearance of fine
lines and photoaging, improves the texture of facial skin,
improves some types of acne scarring, and can be used to
treat acne itself.
Side effects
The skin is generally pink to red and may be slightly swollen
following smoothbeam laser treatment but these side effects
generally resolve in 24 to 48 hours. In rare cases there
may be pigmentary changes of the skin (darkening or lightening)
as well but if these occur the skin generally returns to
its normal color over time.
Treatment sensations
During treatment with the Smoothbeam laser you will feel
the light spray of coolant onto your skin just before each
laser pulse. Most patients report the procedure as mild with
little more than a slight snapping or tingling sensation.
Preparation and care after treatment
Sun exposure should be avoided for 4 to 6 weeks before treatments
and 2 to 4 weeks after treatment. Care should be taken in
the first few days following treatments to avoid scrubbing
or rinsing the treated area with abrasive cleansers.
Results
To get the maximum improvement from Smoothbeam laser treatments
3 to 5 sessions at monthly intervals is generally required.
In addition because this laser works by stimulating new collagen
formation, it may take many months to see the maximum benefit
from this laser.
Insurance Coverage
Almost all insurance companies will not cover laser surgery
done for cosmetic or non-medical purposes. Payment for laser
surgery is therefore expected at the time of service.
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