LASERS AND LIGHTS IN DERMATOLOGY: PROGRESS

Although Einstein theorized about laser concepts in 1917, it wasn’t until 1959 that cutaneous applications of lasers pioneered the subsequent rapid development of laser therapies in all aspects of medicine, including dermatology. Now, the technology is sophisticated and the field is highly specialized. Specialists and researchers are linked to practitioners of light medicine by societies and publications. Although the field is still very new, the therapies are increasingly defined by evidence, with enhanced results and safety as desired endpoints. Lasers have revolutionized cosmetic dermatology and the field continues to evolve. The trend has been toward effective treatments of skin pathologies and skin aging, without downtime. Examples of conditions that have been significantly improved by dermatologic laser therapy are exemplified as follows.

Consider the woman who suffers male pattern hair growth. Only affected individuals may understand the humiliation of heavy or coarse facial hair on a woman. For some, only a few conspicuous unsightly hairs might jeopardize self-esteem and concentration in public. For others, the density of hair might rival that of her male partner. She may carry razors and cover heavily with make-up. Often she discusses her “problem” with no one. The depth of her isolation and humiliation becomes evident the day she realizes that true medical laser hair removal relieves her of this burden. Her relief is often very emotional.

Although almost all of us have perceived cosmetic problems, some individuals have appearances that prompt attention and comments by others. The rosacea patient understands this. The gradual development of facial redness with age becomes initially conspicuous in photographs, followed later by questions from well meaning others about the status of the rosacea patient’s blood pressure. There is still a widespread misconception that the redness and facial veins that go with rosacea are due to alcoholism. In fact, most rosacea patients do not touch alcohol because it triggers severe facial flushing, and certain unwanted attention in public. The inflammatory aspects of rosacea resemble acne, and have conventionally been treated by topical products and pills with limited success. But the rosacea patient simply had to accept that the disease was poorly understood and there was little that could be done for the cosmetically embarrassing redness, facial veins, flushing. Then, a serendipitous discovery changed all of that as it was noted that laser and intense light therapy for some unrelated application induced a long lasting remission of rosacea symptoms. Studies ensued and the resulting data has recently prompted the FDA to clear intense light therapy by a powerful medical instrument known as Vasculight as “effective for treatment of the symptoms of rosacea”. The relief for rosacea patients is usually very significant and long lasting, albeit not a cure. Symptoms generally remit for months to years, even without medications. Most regain confidence as their skin is no longer a beacon for attention.

There are many other cosmetic features of the skin that might perturb an individual. A simple light based therapy, or other modern non-surgical intervention might effectively improve appearance, and confidence, without downtime or disclosure. Certainly, skin beauty and health is a concept that will change with the times as technology continues to develop lights, lasers, and other modern strategies to revive and restore skin vitality.

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