By Dr Leow Aik Ming
Lasers have revolutionized the treatment of various skin conditions. The term “laser” stands for light amplification by stimulated emission of radiation. Laser light has a specific wavelength and it is produced by the stimulated emission of photons from the lasing medium. Lasers may be classified according to the lasing medium employed, the wavelength of the emitted light and the pulse duration. It is focused in a narrow beam and creates a very high-intensity light. Because lasers can focus very accurately on tiny areas, they can be used for very precise and specific treatment.
Conditions that are commonly treated by lasers include:
Scars from acne or chickenpox
Enlarged oil glands or large pores on the face or nose
Non-responsive skin after a facelift
Fine lines or wrinkles around or under your eyes, forehead or mouth
Aged or sun-damaged skin
Improve your complexion if you have yellowish or grayish skin tones
Birthmarks such as linear epidermal nevi
Removal of tattoo or unwanted hairs
Types of Lasers Used in Plastic Surgery:
A. Laser Skin Resurfacing by (Carbon dioxide) CO2 Laser
Laser skin resurfacing is a procedure that uses light beams to treat facial scars, wrinkles and blemishes. This technique is also known as a laser peel, laser vaporization or lasabrasion. Laser devices send short, concentrated pulsating beams of light at irregular skin. This removes unwanted, damaged skin in a very precise manner one layer at a time. This targeted approach means there are fewer problems with hypopigmentation especially when used for acne scar removal. Newer laser technologies give your plastic surgeon a new level of control in laser surfacing, permitting extreme precision, especially in delicate areas.
B. Laser Removal of Birthmarks or Pigments by NdYAG Laser (1064nm)/ Flashlamp Pumped Pulse Dye Laser (585nm)
Laser treatment for pigmented conditions have been widely used in conditions such as Becker’s nevus, cafe-au-lait macules, Nevus of Ota, nevocellular nevi, lentigines, tattoos, melasma, and post-inflammatory hyperpigmentation (PIH). It works by selective photothermolysis by targeting on different tissue components namely the pigmented cells. In other words, when the laser light is absorbed by the melanin or pigment cells within the skin, it will cause overheating of the cells resulting in cellular destruction. These damaged pigment cells will eventually be removed naturally by our immune cells. The pigment appears to darken as the pigmented cells are lifted to the surface and in some cases forming a very light scab. This is then naturally shed after a few days one to two weeks and the pigmentation underneath is removed or lightened.
C. Laser for Hair Removal
Laser hair removal is accomplished through follicular unit destruction. The ability to remove hair without damaging the surrounding skin is based on selective photothermolysis—the theory that at a particular wavelength, pulse duration, and fluence, thermal injury is confined to a target that contains a light-absorbing molecule called a chromophore. Laser-assisted hair removal is the most efficient method of long-term hair removal currently available. Several hair removal systems have been shown to be effective include: ruby laser (694 nm), alexandrite laser (755 nm), diode laser (800 nm), intense pulsed light source (590 to 1200 nm), and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (1064 nm), with or without the application of carbon suspension.