When is laser used and what for?

Pigment changes

Skin imperfections

Couperose

Wrinkle treatments

How are laser techniques used?

Q-switched lasers to treat pigment changes.

Q-switched lasers are used to bleach and remove pigments, for instance, age spots or others on our skin, caused by scarring or colouring agents that penetrated from outside, e.g., from tattoos or injuries. The designation “Q-switched” means that the laser pulse lasts only billionths of a second and thus, only the concerned pigment is heated, and the surrounding tissue spared. Once heated, it shatters into very fine particles which will be carried away by the body’s own cleansing cells.

We can treat various pigments with the two most-used available wavelengths: the ‘neodymium/YAG’ laser 1064 nm, in the near-infrared range, and 532 nm for yellow colours. When tattoos need to be removed, we can treat all colours.

Ablative lasers to treat and smooth out skin unevenness.

Ablative lasers can remove tissue by vaporisation, with highest precision. The laser light is absorbed by the water between and within the cells, causing the water to vaporise immediately. This happens so swiftly that the vaporisation momentum is completed before the heat can spread to the surrounding area. This method is known as “clean ablation,” i.e., the ablation takes place without carbonisation or other heat damage to the adjacent tissue.

In dermatology, we use two types of lasers for such purposes: the CO2 laser, with a wavelength of 10,600 nm, and the Erbium YAG laser, with a wavelength of 2,940 nm.

When used individually, these devices have specific advantages and disadvantages: the CO2 laser triggers the body to generate better collagen, is suitable for deeper wrinkles, but requires a longer healing time. The Erbium YAG laser can also be used superficially on darker skin types, the recovery time is shorter, but it is less effective in terms of skin remodelling (neocollagen synthesis) and less efficient when deeper wrinkles and scars are concerned.

A whole range of skin imperfections can be treated with these lasers.

585 nm solid-state laser (yellow) to treat vascular and pigmentary changes.

This laser can be used to achieve optimal results for vascular and pigmented skin lesions. It minimises the risk of side effects such as purpura and minimises downtime. Thanks to the scanner technology, large areas can be treated very precisely, safely and quickly. The accuracy of the scanner ensures precise and even results while limiting unnecessary heat to unaffected areas. The treatment is suitable for all skin types and is well tolerated.

Fractional laser to treat wrinkles, scars, enlarged pores, pigmentation changes and stretch marks.

The term “fractional” means in part, partially. With this technique, the laser beam is fractionalised, that is, divided into a bundle of 100 miniature laser beams per cm2. Thus, the skin area to be lasered is not treated completely as only a pattern of fine dots will penetrate the skin. The untreated skin “in between” remains intact, the healing process generated from the preserved cells taking place in one to three days.

Compared to past laser skin resurfacing procedures, the healing time of this procedure is significantly shorter. After a superficial fractionated CO2 laser treatment (the so-called CO2 cool peel), the skin will be reddened, slightly swollen and scaly for a few days, an appearance which can be easily concealed with special make-up. After deep fractional CO2 laser treatments, oozing and reddening of the skin will last longer; therefore, it must be well lubricated with a special antibiotic ointment during the next three days. In most cases, normal activities can be resumed after four to five days with a little concealing make-up.

Frequent questions and answers

Is the treatment painful?

As the laser pulses last only a fraction of a second, one feels different sensations of the heat (hence sometimes intense) which can occasionally persist for a while after the treatment. This feeling can be lessened with simple means (ice packs, cold water, cooling gels or, as in the laser practice, with a special cooling device). For treatments with the CO2 and the Erbium YAG laser, local anaesthesia is often applied with creams or injections.

How is the treatment carried out?

The skin is often precooled before a laser treatment, with a blower or an ice pack. The skin structures to be treated (blood vessels, pigment, water in the cells) determine which type of laser will be used. Some lasers are silent, others produce some noise or odours: such vapours are extracted with a suction device.

Are follow-up treatments necessary?

After various types of laser treatments, crusts will form, and it is important that you do not remove them in any way. Keep crusts moist with creams and water. After they disappeared (count a few days to a few weeks), new skin will appear, pink-coloured. You can now apply and wear make-up again, but please make sure that you use products that you can remove easily and without rubbing.

What about tanning beds and sun?

Many laser treatments are less successful or can have stronger side effects if they are carried out on tanned skin, obtained by exposure to either the sun or in a solarium. Therefore, after the treatment, we recommend avoiding both for some time. Remember that applying sunscreen products can protect you against sunburns but not against tanning, sun creams alone not sufficient in this case. To guarantee a full protection against tanning, you will need to use a thick, fully covering make-up or apply plasters.

Results: when, and in which form?

Each result depends on the type of skin changes asked for, and the laser device used. Often, a series of the treatments are necessary, for instance in case of vascular changes (couperose, port-wine stains) and tattoos. The approximate number of sessions needed can only be determined based on objective criteria relating to the wished changes, your skin type, and other factors. See and read the legends of the pictures for more information.

Can relapses occur?

Depending on individual factors, relapses are possible. However, once skin changes have been removed by laser, they usually disappear for good. Whether and what can be done to prevent the same changes occurring again is, of course, the subject of each dermatological consultation with you.

Are side effects to be expected?

All laser devices that we use are recognised by the FDA, the American regulatory authority (Federal Drug Administration), considered to be particularly critical. Provided that the indication and the treatment technique are correct, permanent side effects are altogether very rare. However, in addition to redness, crusts or haematoma may occur, but these are harmless and temporary. In some cases, the skin pigmentation (colour) appears stronger or weaker after a laser treatment. Taking individually adapted measures and avoiding UV light until the skin has returned to its normal colour is then essential.

Will you be able to resume work after a treatment?

Generally, from a purely medical point of view, you will be fit for work after a laser skin treatment. However, after certain laser treatments, it may be advisable to take a week or so off work, for cosmetic and aesthetic reasons.

Treatments

Fat Transfer Treatment – Microfat & Nanofat
Platelet-rich plasma (PRP)
Thread lifting
Wrinkle treatment with botulinum toxin
Laser
Microneedling
Chemical peelings