Laser - Use of Laser in Hair Removal and Cosmetic Surgery

Due to technological advances, the use of professional lasers for skin-care improvement has mushroomed from its beginning twenty years ago, and many laser systems are now available.

What is Laser?

Laser stands for "light amplification by stimulated emission of radiation." A laser beam is a uniform, unidirectional beam of only one wavelength of light energy, created when gases (such as carbon dioxide) or crystals (such as ruby) are stimulated with electricity. The light emitted through these gases and crystals carries a specific, single wavelength of light energy that can target its object. Typically, lasers in use today get their name from the element that is used, such as Ruby, Alexandrite, Erbium:Yag, and Neodymium:Yag. Medical lasers work in a unique way: coherent light Waves specifically target certain components of the skin and leave surrounding skin components unharmed. In this context, the "surrounding skin" includes the layers above and below the area of skin the dermatologist wants precisely improved or eliminated.

Today, the laser system a dermatologist selects is driven by the need for a particular wavelength of light, which will effectively destroy only the target area on or underneath the skin. Laser researchers soon realized that a specific wavelength of light energy could be absorbed uniquely by one component of the skin but not another. This means that the laser may not touch the surface of the skin, but will reach below it. The pulse dye, or vascular, laser reflects this principle. It emits a single wavelength of light visible as yellow light that is toxic to components of the blood; if you were to point a laser beam made of one wavelength of yellow light at a container holding some blood, only the blood will be destroyed, not the container. Because yellow light does not destroy parts of the skin that do not have blood, it will travel harmlessly through the skin cells and .tissue above and around the blood.

Dermatologists can treat any blood-filled spot with this laser, such as broken blood vessels, spider leg veins, spider veins on the face, cherry angiomas, hemangiomas, and other unwanted red-colored spots on the skin. Similarly, there are now lasers that can target the pigment cells in the skin in an attempt to remove unwanted pigmented spots without harming the surrounding skin. This technique is a little more challenging, however, because all skin has some degree of pigmentation. Thus, occasionally the laser can remove too many pigmented cells in a brown spot, and leave it as a white spot. This is especially true for darker-skinned people.

The Neodymium:Yag, Alexandrite, and Ruby lasers are used to remove unwanted pigmented spots (pigmentation after a rash has healed, sun freckles, melasma), unwanted tattoos, and unwanted hair. These lasers remove excessive hair by targeting the pigment cells that are near that part of the hair where growth occurs. By contrast, the wrinkle-removing lasers, namely the superpulsed CO2 and Erbium:Yag lasers, emit a single wavelength of light that destroys anything with water in it. The superpulsed CO2 laser is an advanced form of the older, original CO2 laser. The Erbium:Yag laser is a variation of the Neodymium:Yag laser but does not target pigment cells because the addition of the element erbium changes the laser's wavelength to target water. As the skin has water in it, these lasers vaporize and remove targeted wrinkled skin on contact. These two lasers are different from the original CO2 laser, which also targeted water, because they emit very precise, short pulses that allow skin removal to occur rapidly, but still virtually eliminate collateral damage to surrounding skin. The Erbium:Yag laser does not penetrate or remove skin as deeply as the superpulsed CO2 laser, and hence it is used to remove more superficial wrinkles. Risks are specific to the type of laser used, but may include prolonged redness and scarring as with the CO2 laser, or blotchy brown pigmentation as with the

Alexandrite and pulse dye lasers. What lies in the future for laser technology? In the upcoming decade, dermatologists will have a "tunable" laser, where all of the lasers we use will be combined into one unit. On entering a specific colored wavelength, a physician will be able to eliminate the target area of skin that needs to be altered, whether it is a blood-colored growth, or the top layers of facial skin.

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