Cosmetic Surgery Laser Skin Resurfacing

Lasers offer new medical and cosmetic treatment options for patients with skin of color

CHICAGO (July 27, 2003) – Lasers are becoming one of the most versatile treatment options for everything from leg veins to birthmarks. However, the first generation of laser treatments was not appropriate for use on darker colored skin because they could result in loss of pigment and scarring. As a result of the research and development conducted by dermatologists, advances in laser technology have made treating conditions that affect even the darkest skin safe and effective.

Speaking today at ACADEMY ’03, the American Academy of Dermatology’s summer scientific meeting in Chicago, Ill., dermatologist Min-Wei Christine Lee, MD, Clinical Instructor, Department of Dermatologic Surgery, University of California, San Francisco, Calif., discussed the use of lasers for both medical and cosmetic procedures on patients with skin of color.

“New laser treatments, when used by dermatologists who are skilled in both their use and in treating skin of color, can successfully improve a variety of conditions that affect patients with darker colored skin,” said Dr. Lee.

Medical Uses of Lasers in Ethnic Skin

Acne affects 80 percent of both ethnic and Caucasian patients, but its treatment has only recently benefited from advances in laser, light and radiofrequency technology. While lasers can thermally reduce the oil production of the sebaceous glands and light sources can destroy acne bacteria itself, it is the use of radiofrequency in combination with these other treatments that has recently been studied.

Radiofrequency energy effectively tightens the skin by delivering heat directly into the dermis, deep below the skin surface. The heat causes subsurface tissue to immediately contract, and then gradually tighten. Dermatologists began to explore the uses of radiofrequency specifically for acne when patients noticed clearer complexions after treatments.

“The use of a light and radiofrequency combination to treat acne can greatly benefit patients with skin of color who can develop disfiguring complications following conventional treatment, such as acne scarring and keloids, or post-inflammatory skin discoloration,” said Dr. Lee.

A recent study evaluated the safety and efficacy of this combined treatment for inflammatory acne lesions in patients with a variety of skin colors. Patients received 10 weekly treatments with a device that produces an intense optical light burst followed by a radiofrequency wavelength which was calibrated depending on the skin color and severity of the acne. After two weekly treatments, 80 percent of patients noted reduced inflammation of their lesions and this improvement continued following subsequent treatments.

Another treatment that has recently been studied for the control of existing acne in both light and dark skin is the variable-pulsed KTP laser, which is currently used to treat vascular lesions including those on the face. Following treatment of facial veins, many patients noted a decrease in the severity of their acne. A recent study of 175 patients with mild to moderate acne on the face, chest, back and arms, showed that this laser has the potential to clear acne as well as reduce sebum, the oily substance made by the sebaceous glands. After one treatment with this laser, which is passed over the skin a number of times depending on the skin type and severity of acne, improvement was evident in 80 percent of patients.

“These new treatments are promising for patients with skin of color because they have few side effects and prompt a faster decrease in the severity of acne lesions than oral antibiotics,” said Dr. Lee.

Another condition that can occur in both Caucasian and ethnic populations is vitiligo, in which there is complete loss of pigment in localized areas of the skin. Advances in laser technology have led to new treatment options that can induce repigmentation of the skin by stimulating the production of melanin in the skin, the natural substance that gives color, or pigment, to hair and skin.

New research has examined the use of long-pulsed infrared lasers to treat vitiligo. These lasers penetrate deeper into the skin than UV light treatments, reaching dormant melanocytes, the cells located in the epidermis that produce melanin. “A preliminary study showed that the use of the long-pulsed infrared laser produced 50 to 70 percent repigmentation for all of the patients,” said Dr. Lee. “This new laser treatment also has the additional benefit of not exposing the patient to ultraviolet light which may have long-term cumulative carcinogenic effects.”

Another recent study of patients with vitiligo, hypopigmented or lightened scars, and striae, or stretch marks, showed promise for the treatment of these skin conditions. Using a high-intensity, light source that emits in the wavelength range of 290 to 320nm, areas of affected skin can be selectively targeted with small doses of UVB light, sparing the surrounding healthy skin from unnecessary ultraviolet light exposure. Patients in this study received 15 treatments and every patient showed some degree of repigmentation in a fraction of the time conventional treatment requires. However, after six months, half of the patients demonstrated regression of repigmentation.

Cosmetic Uses of Lasers in Ethnic Skin

No matter what their skin color, patients are often concerned about the obvious signs of aging, caused by years of sun exposure, such as wrinkles, deep skin furrows and discoloration. One of the most effective treatments to turn back the hands of time is CO2 laser resurfacing which uses short bursts of extremely high-energy laser light to vaporize the skin tissue one layer at a time, revealing fresh skin underneath.

While the laser’s highly focused beam enables the dermatologist to gently remove the skin’s surface with a low risk of scarring and other complications, recovery time for patients with skin of color can be long since there can be residual redness and hyperpigmentation. However, a recent study has shown that the use of nonablative laser treatments following CO2 laser resurfacing can shorten recovery time for darker skinned patients by more than 50 percent.

“By following a CO2 laser treatment with nonablative lasers to decrease hyperpigmentation and discoloration, patients with darker skin greatly reduced their downtime,” stated Dr. Lee. “In addition, these patients demonstrated better skin tone and tightness, and maintained wrinkle reduction under the eyes a year after the procedure, versus patients who only received the CO2 laser procedure,” stated Dr. Lee.

“Whether patients are looking for the treatment of a medical condition or for cosmetic improvement of their skin, it’s important to ask their dermatologist if laser treatment is right for them,” said Dr. Lee. “However, since skin treatments using lasers can carry potential side effects, especially for patients of color, they should be performed by a qualified physician or under direct physician supervision.”

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of over 14,000 dermatologists worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care for a lifetime of healthier skin.


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