Vascular lasers

Vascular lasers such as pulsed dye lasers are used for the following indications:-

• Rosacea and facial redness
• Spider veins (telangiectasias)
• Port-wine stains
• Cherry angiomas
• Venous lakes
• Poikiloderma of Civatte
• Scars

I will most commonly use Pulsed-Dye Lasers. These emit a yellow light, which is absorbed by the haemoglobin in blood vessels. This light energy causes the blood vessels to coagulate and eventually be reabsorbed by the body. PDLs are particularly effective for treating rosacea, facial redness, spider veins, and port-wine stains.

Long-Pulsed Nd:YAG Lasers: Nd:YAG lasers have a longer wavelength, allowing them to penetrate deeper into the skin. This makes them suitable for treating larger blood vessels, such as those found in varicose veins and deeper vascular lesions, however as they target larger blood vessels, they are associated with a slightly higher risk of complications such as scarring.

Advantages of vascular laser treatments

• Minimally invasive: Lasers offer precise targeting of blood vessels, minimizing damage to surrounding tissue and reducing the risk of scarring.
• Quick: Vascular laser treatments are typically quick, with many procedures taking less than an hour to complete.
• Minimal downtime: Most patients can return to their normal activities soon after treatment, with only minor side effects, such as temporary redness or swelling.
• Long-lasting results: Vascular laser treatments often provide long-lasting improvement in the appearance of vascular skin conditions.

Risks and Side Effects

As with any medical procedure, vascular laser treatments do carry some risks and potential side effects:

• Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical anesthetics or cooling devices.
• Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolve within a few days.
• Pigmentary change: In rare cases, vascular laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones.
• Scarring: Although rare, scarring is a potential risk of vascular laser treatment, particularly if the skin's outer layers are damaged during the procedure.
• Incomplete clearance: Some vascular lesions may require multiple treatment sessions for optimal results, and in some cases, complete clearance may not be achievable.

Questions about vascular lasers

Pigment lasers

I use Q-switched (532nm and 1064nm) lasers to treat a variety of skin conditions. Some common indications for pigment laser treatment include:

1. Age spots (solar lentigines)
2. Freckles
3. Post-inflammatory hyperpigmentation (PIH)
4. Café-au-lait spots
5. Nevus of Ota
6. Hori's nevus
7. Becker's nevus
8. Melasma

Benefits of Pigment Laser Treatment

1. Targeted treatment: Pigment lasers offer precise targeting of pigmented lesions, minimizing damage to surrounding tissue and reducing the risk of scarring.
2. Minimally invasive: Pigment laser treatments are non-surgical and less invasive compared to other treatment options, such as cryotherapy, chemical peels or electrocautery.
3. Quick procedure: Most pigment laser treatments can be completed within half an hour, depending on the size and complexity of the area being treated.
4. Minimal downtime: Patients can typically return to their normal activities soon after treatment, with only minor side effects, such as temporary redness or swelling.
5. Long-lasting results: Pigment laser treatments often provide long-lasting improvement in the appearance of pigmentation issues.

Risks and Side Effects

As with any medical procedure, pigment laser treatments do carry some risks and potential side effects:

1. Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical anesthetics or cooling devices.
2. Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolve within a few days.
3. Pigment changes: Pigment laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.

Due to the potential for complications it is always advisable to attend for a small test patch of treatment prior to treating a larger area.

Questions about pigment lasers

Laser hair removal

Hair removal lasers are a widely used and generally safe method of removing unwanted hair growth. They can cause a long lasting reduction in hair growth, however they are not a permanent treatment and repeat treatments are usually required.

Please note:

• Laser hair removal is only effective for dark hairs and will not work for grey or blond hairs.
• When patients come to me for laser hair removal, it is generally for relatively small areas of treatment since it is much more cost efficient to attend high street laser clinic where large areas need to be treated over multiple session.
• Alternatives to hair removal lasers include electrolysis and topical eflornithine (Vaniqa) cream.
• If you are attending for laser hair removal it is essential that you do not have a tan and are not wearing makeup or anything else on the skin as this increases the risks of treatment. It is important that the hairs to be treated should be shaved close to the skin surface to reduce discomfort and risks during the procedure.

Indications for Laser Hair Removal

Laser hair removal is primarily used to reduce unwanted hair growth on various areas of the body. Some common indications for laser hair removal include:

1. Facial hair, such as upper lip, chin, and sideburns
2. Underarms
3. Bikini line and Brazilian area
4. Arms and legs
5. Chest and back
6. Treatment of ingrown hairs and razor bumps

Types of Hair Removal Lasers

Various types of hair removal lasers are used, each with its specific strengths and target areas. The most common hair removal lasers include:

1. Nd:YAG Lasers: Nd:YAG lasers have a long wavelength and are suitable for treating all skin types, including darker skin tones. They are often used for hair removal on larger body areas and for treating ingrown hairs.
2. Alexandrite Lasers: Alexandrite lasers have a shorter wavelength, making them more effective for treating lighter skin tones. They offer rapid hair removal on large areas, such as the legs and back.
3. Diode Lasers: Diode lasers have a longer wavelength, making them effective for treating a wider range of skin types, including darker skin tones. They are commonly used for hair removal on larger areas of the body, such as the back and legs.
4. Intense Pulsed Light (IPL): While not a true laser, IPL devices emit a broad spectrum of light that targets melanin in hair follicles. IPL is often used for hair removal on various body areas and is suitable for treating a wide range of skin types.

I use the Cynosure Elite device which has both Nd:YAG and Alexandrite lasers enabling treatment of both lighter and darker skin types.

Benefits of Laser Hair Removal

1. Long-term hair reduction: Laser hair removal provides long-term hair reduction by targeting the hair follicle, resulting in slower regrowth and thinner, finer hair.
2. Precision: Lasers offer precise targeting of hair follicles, minimizing damage to surrounding tissue and reducing the risk of scarring or pigmentation changes.
3. Speed: Laser hair removal treatments are relatively quick, with most sessions taking less than an hour to complete, depending on the size of the area being treated.
4. Minimal downtime: Most patients can return to their normal activities soon after treatment, with only minor side effects, such as temporary redness or swelling.

Risks and Side Effects

1. Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with cooling devices.
2. Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolves within a few days.
3. Pigment changes: Laser hair removal may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
4. Burns or blisters: In rare cases, burns or blisters may occur.
5. Incomplete hair removal: Some patients may require multiple treatment sessions for optimal hair reduction and may not fully respond to treatment.

Fractional ablative lasers

Ablative lasers such as the carbon dioxide laser were a major advance in dermatology providing new treatment options for scars, sun damage, fine lines and wrinkles. Ablative lasers remove the surface layer of the skin allowing the natural healing process of the skin to regenerate the skin. I use the Lumenis Ultrapulse (available either at OneWelbeck or Skin55). I will use the laser in full ablative mode for conditions such as keloid scars, rhinophyma or for removal of harmless skin growths however generally for superficial resurfacing and acne scarring I will use in fractional mode.

Fractional mode has faster recovery and significantly lower risks of scarring and pigmentary change. The Lumenis Ultrapulse permits precise control of fractional energy delivery. Fractional ablative lasers have revolutionized the treatment of become an integral part of dermatological treatments, offering impressive results for scarring, fine lines and rejuvenation.

Indications for Fractional Ablative Laser Treatment

Fractional ablative lasers are primarily used to treat skin conditions that require resurfacing or collagen stimulation. Some common indications for this treatment include:

1. Fine lines and wrinkles
2. Acne scars
3. Surgical or traumatic scars
4. Sun damage and age spots
5. Skin texture irregularities
6. Enlarged pores
7. Skin tightening and rejuvenation

What to Expect During Treatment

1. Pre-treatment preparation: Your skin will be cleansed, and a topical anaesthetic may be applied to minimize discomfort during the procedure.
2. Laser treatment: Dr Lynch will use the fractional laser device to deliver controlled pulses of energy to the targeted areas. This creates microscopic columns of thermal injury in the skin, stimulating collagen production and promoting skin resurfacing.
3. Post-treatment care: We will apply a soothing ointment to your skin and provide you with specific aftercare instructions to optimize healing and results.
4. Recovery period: The healing process typically takes 1-2 weeks, during which your skin may appear red, swollen, or crusty. It's essential to follow aftercare instructions, such as avoiding sun exposure and using gentle skincare products, to minimize the risk of complications.

Benefits of Fractional Ablative Laser Treatment

1. Collagen stimulation: The treatment promotes collagen production, which can help improve skin elasticity, reduce the appearance of wrinkles, and tighten the skin.
2. Skin resurfacing: Fractional ablative laser treatment effectively removes damaged outer layers of the skin, revealing a smoother and more youthful complexion.
3. Precision: Fractional ablative lasers minimize damage to surrounding skin reducing the risk of scarring.
4. Long-lasting results: Fractional ablative laser treatment often provides long-lasting improvement in the appearance of scars and skin rejuvenation.

Risks and Side Effects

1. Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical or injected anaesthetic. Pain can persist for a number of days.
2. Redness and swelling: Immediately following the treatment, the surface of the skin will appear red, swollen and inflamed. Some bleeding and crusting may occur.
3. Pigment changes: Fractional ablative laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
4. Infection: Although rare, there is a risk of bacterial or viral infection after the treatment particularly if aftercare instructions are not followed.
5. Scarring: In rare cases, scarring may occur as a result of the treatment.

Questions about fractional ablative laser treatments

Fractional non-ablative lasers

Whilst fractional ablative lasers were a major advance in skin resurfacing and the treatment of scars, the recovery time and risks meant that they were not suitable for all patients. This led to the development of non-ablative fractional lasers, such as the erbium glass laser. Whilst these generally will not achieve the same degree of improvement as fractional ablative lasers they can cause significant improvement with minimal downtime and low risks – even in pigmented skin types. I use the Palomar ICON laser – a 1540nm erbium glass laser available at Skin55 Ltd.

Indications for Fractional Non-Ablative Laser Treatment

Fractional non-ablative erbium glass lasers are primarily used to treat skin conditions that require collagen stimulation or skin resurfacing with minimal downtime. Some common indications for this treatment include:

1. Fine lines and wrinkles
2. Acne scars
3. Surgical or traumatic scars
4. Mild to moderate sun damage and age spots
5. Skin texture irregularities
6. Enlarged pores
7. Skin tightening and rejuvenation

What to Expect During Treatment

1. Pre-treatment preparation: Your skin will be cleansed, and a topical anesthetic may be applied to minimize discomfort during the procedure.
2. Laser treatment: Dr Lynch will use the fractional non-ablative laser to deliver controlled pulses of energy to the targeted areas. This creates microscopic columns of thermal injury in the skin while leaving the outer layers intact, stimulating collagen production and promoting skin resurfacing. Several passes may be required in each area.
3. Post-treatment care: We will apply a soothing ointment or gel to your skin and provide you with specific aftercare instructions to optimize healing.
4. Recovery period: The healing process for fractional non-ablative laser treatment is typically shorter than that of ablative lasers, with most patients experiencing only mild redness and swelling for a day or two.

Benefits of Fractional Non-Ablative Laser Treatment

1. Collagen stimulation: The treatment promotes collagen production, which can help improve skin elasticity, reduce the appearance of wrinkles, and tighten the skin.
2. Minimal downtime: Fractional non-ablative erbium glass lasers offer skin resurfacing and collagen stimulation with minimal downtime, making them an attractive option for those seeking effective results without the extended recovery time associated with ablative laser treatments.
3. Long-lasting results: Fractional non-ablative laser treatment often provides long-lasting improvement in appearance.

Risks and Side Effects

As with any medical procedure, fractional non-ablative erbium glass laser treatments do carry some risks and potential side effects:

1. Pain or discomfort: Some patients may experience mild pain or discomfort during the treatment, which can be managed with topical anesthetics or cooling devices.
2. Redness and swelling: Temporary redness and swelling may occur after treatment but typically resolve within a day or two.
3. Pigment changes: Rarely, fractional non-ablative erbium glass laser treatments may cause temporary or permanent changes in skin pigmentation, particularly in individuals with darker skin tones. Hypopigmentation (lightening) or hyperpigmentation (darkening) can occur in some cases.
4. Infection can occur but is rare.

Questions about non-ablative fractional lasers