Cosmetic Lasers: An Overview

The word ‘laser’ conjures up very strong emotions in many of my patients: ranging from pure elation to extreme aversion. This comes from a lack of understanding of the very concept of laser, not to mention the fact that many have strong misconceptions about lasers.

Quite a few think they are a cure-all, while others tell stories of someone who was sidelined for weeks to nurse scarring from a laser blast.

What is LASER?

The truth is, Lasers are not at all that magical. They are, simply, machines which emit light.

The difference is that unlike conventional light sources, lasers emit intensely bright light of a fixed wavelength, which is in phase. (Think of a scenario where 3 children are on swings in a playground. If all of them are moving in tandem, they are in phase. If they way they move bears no relation to each other, they are out of phase).

By using different materials, the wavelength of the light emitted can be controlled. You have heard terms like Ruby Laser, Nd:Yag Laser, etc. These refer to the laser medium which is housed in the laser machine. They are the ones which determine the wavelength of the emitted light.

Now why is the wavelength important?

Different lasers target different skin component

Our skin has different components and each of these components absorb light in different ways with different wavelengths. By using different lasers and the appropriate settings, different structures in the skin can be targeted and selectively destroyed. One can target the melanin (pigmented component), the haemoglobin (in blood vessels), the hair follicles, or the water in the skin with different lasers.

With this simple yet important principle, lasers have become an important tool in cosmetic dermatology. Pigment Lasers target pigment in the skin to break down the melanin and lighten pigmentation. Similarly, vein removal lasers target the hemoglobin in the blood, to cause the veins to coagulate and be removed from the skin. Rejuvenation lasers target the water and collagen in the mid layer of the skin – the dermis – to induce new collagen formation.

It is important to remember, however, that lasers are not a cure all. Many a time, alternative treatment methods may actually be superior to lasers. You should consult your doctor for more information.

Common cosmetic uses for lasers today include:

Treatment of small blood vessels on the surface, such as spider veins

Treatment of birthmarks associated with abnormal blood vessel formation (e.g. port wine stains)

Treatment of pigmentation

Treatment of acne

Removal of tattoos

Hair reduction

Skin resurfacing for wrinkles, scars, and rejuvenation

Post treatment downtime

The downtime associated with each laser is also different. This can range from none (just mild redness of skin) with non-ablative lasers, to 4 weeks with ablative laser resurfacing. Scabbing and pinpoint bleeding of the skin sometimes occur with some laser treatments, and these usually resolve very soon after (less than a week). Newer fractional lasers, commonly used for treating acne scars, are in between – the downtime usually ranges from 1 to 2 weeks.