Turn your laser into a Swiss Army knife!

WAILEA, HAWAII – Laser manufacturers want to convince dermatologists to buy a different device for every application. Nothing doing: With an understanding of laser physics and the laser/tissue interaction, a dermatologist can coax a laser to perform a variety of tasks, according to Dr. E. Victor Ross.

"Making the lasers you already have smarter can really save you money. The critical thing, especially if you’re in a private practice, is to take three or four lasers, or maybe just one or two, and make those lasers do as many things as they can. Play to their strengths. Take the tool you have and make it like a Swiss Army knife. You want a multiple-trick pony, not a one-trick pony," he said at the Hawaii Dermatology Seminar sponsored by the Global Academy for Medical Education/Skin Disease Education Foundation.

©Crisma/iStockphoto.com

It’s all about knowing the laser energy’s relative absorption by blood, melanin, and water, according to Dr. Ross, director of the laser and cosmetic dermatology center at the Scripps Clinic, San Diego.

Armed with this understanding, here is some of the multitasking that popular dermatologic lasers are capable of:

• 810-nm diode laser: A popular device for hair removal, it’s also effective in treating deeper venous lakes and reticular facial veins with the handpiece placed against the skin and cooling turned on. With the cooling off, the 810-nm diode laser is also useful in treating various epidermal pigmented lesions.

• Nonfractional CO₂ laser: An old dog capable of many new tricks, according to Dr. Ross. Among them are treatment of seborrheic keratoses, skin tags, nevi, hidrocystomas, and lyomas and lasering and curettage of basal cell carcinomas. With several treatment sessions, roughly 90% of the ink in red lip-liner tattoos can be eliminated.

"I use this laser every day. I’m still a big fan," the dermatologist said.

• Pulsed-dye laser: This laser have been typecast for years as a tool for removal of port wine stains, but it can be applied to anything that’s red and inflammatory. It works particularly well for red striae on fair-skinned patients, scars, warts, sebaceous hyperplasia, lentigo, and red fibrous papules. Dr. Ross said he’s had mixed results with pulsed dye laser therapy for granuloma annulare. He has even used the laser to treat superficial basal cell carcinomas.

"You have to hit them hard, with stacked pulses at about 14 Joules/cm², no cooling, at a duration of 1.5-3.0 millisec. But I have to say, I think excision and curettage works about as well," the dermatologist continued.

• KTP laser: The potassium titanyl phosphate laser is among the devices Dr. Ross turns to most often. It’s the best laser out there for vascular lesions. But it’s well suited for any red or brown lesions, including seborrheic keratoses, red fibrous papules, leg veins, poikiloderma, warts, and dermatosis papulosa nigra.

• Q-switched YAG: Often employed for tattoo removal. But it can also be utilized for treatment of scars, Hori’s nevus, melasma, and for laser skin toning. In addition, it works very well for compound nevi.

"Hit them multiple times with 10 Hz at about 12 Joules/cm². After two or three treatments, they’re gone," according to Dr. Ross.

• Long-pulsed alexandrite laser: It’s normally used for hair removal. But it’s also excellent for epidermal pigmented lesions. In addition, it can provide good single-treatment results for venous lakes, telangiectasias, vascular lesions, seborrheic keratoses, and port wine stains.

"Put numbing cream on about 45 minutes beforehand, turn the cooling off, and blast away," the dermatologist advised.

• Nonfractional erbium YAG: A good laser in addressing stucco keratoses, flesh-colored fibrous papules on the nose, large sebaceous hyperplasia lesions, and seborrheic keratoses.

• Intense pulsed light devices: Lots of applications for these, including activation of photodynamic therapy, removal of port wine stains, and eradication of warts. Templates can be used to mask the beam, allowing high-energy treatment of focal lesions while sparing normal skin.

The SDEF and this news organization are owned by the same parent company.

Dr. Ross reported financial relationships with Alma, Lumenis, Miramar Laboratories, Palomar, and Synernon.

[email protected]

WAILEA, HAWAII – Laser manufacturers want to convince dermatologists to buy a different device for every application. Nothing doing: With an understanding of laser physics and the laser/tissue interaction, a dermatologist can coax a laser to perform a variety of tasks, according to Dr. E. Victor Ross.

"Making the lasers you already have smarter can really save you money. The critical thing, especially if you’re in a private practice, is to take three or four lasers, or maybe just one or two, and make those lasers do as many things as they can. Play to their strengths. Take the tool you have and make it like a Swiss Army knife. You want a multiple-trick pony, not a one-trick pony," he said at the Hawaii Dermatology Seminar sponsored by the Global Academy for Medical Education/Skin Disease Education Foundation.

©Crisma/iStockphoto.com

It’s all about knowing the laser energy’s relative absorption by blood, melanin, and water, according to Dr. Ross, director of the laser and cosmetic dermatology center at the Scripps Clinic, San Diego.

Armed with this understanding, here is some of the multitasking that popular dermatologic lasers are capable of:

• 810-nm diode laser: A popular device for hair removal, it’s also effective in treating deeper venous lakes and reticular facial veins with the handpiece placed against the skin and cooling turned on. With the cooling off, the 810-nm diode laser is also useful in treating various epidermal pigmented lesions.

• Nonfractional CO₂ laser: An old dog capable of many new tricks, according to Dr. Ross. Among them are treatment of seborrheic keratoses, skin tags, nevi, hidrocystomas, and lyomas and lasering and curettage of basal cell carcinomas. With several treatment sessions, roughly 90% of the ink in red lip-liner tattoos can be eliminated.

"I use this laser every day. I’m still a big fan," the dermatologist said.

• Pulsed-dye laser: This laser have been typecast for years as a tool for removal of port wine stains, but it can be applied to anything that’s red and inflammatory. It works particularly well for red striae on fair-skinned patients, scars, warts, sebaceous hyperplasia, lentigo, and red fibrous papules. Dr. Ross said he’s had mixed results with pulsed dye laser therapy for granuloma annulare. He has even used the laser to treat superficial basal cell carcinomas.

"You have to hit them hard, with stacked pulses at about 14 Joules/cm², no cooling, at a duration of 1.5-3.0 millisec. But I have to say, I think excision and curettage works about as well," the dermatologist continued.

• KTP laser: The potassium titanyl phosphate laser is among the devices Dr. Ross turns to most often. It’s the best laser out there for vascular lesions. But it’s well suited for any red or brown lesions, including seborrheic keratoses, red fibrous papules, leg veins, poikiloderma, warts, and dermatosis papulosa nigra.

• Q-switched YAG: Often employed for tattoo removal. But it can also be utilized for treatment of scars, Hori’s nevus, melasma, and for laser skin toning. In addition, it works very well for compound nevi.

"Hit them multiple times with 10 Hz at about 12 Joules/cm². After two or three treatments, they’re gone," according to Dr. Ross.

• Long-pulsed alexandrite laser: It’s normally used for hair removal. But it’s also excellent for epidermal pigmented lesions. In addition, it can provide good single-treatment results for venous lakes, telangiectasias, vascular lesions, seborrheic keratoses, and port wine stains.

"Put numbing cream on about 45 minutes beforehand, turn the cooling off, and blast away," the dermatologist advised.

• Nonfractional erbium YAG: A good laser in addressing stucco keratoses, flesh-colored fibrous papules on the nose, large sebaceous hyperplasia lesions, and seborrheic keratoses.

• Intense pulsed light devices: Lots of applications for these, including activation of photodynamic therapy, removal of port wine stains, and eradication of warts. Templates can be used to mask the beam, allowing high-energy treatment of focal lesions while sparing normal skin.

The SDEF and this news organization are owned by the same parent company.

Dr. Ross reported financial relationships with Alma, Lumenis, Miramar Laboratories, Palomar, and Synernon.

[email protected]

WAILEA, HAWAII – Laser manufacturers want to convince dermatologists to buy a different device for every application. Nothing doing: With an understanding of laser physics and the laser/tissue interaction, a dermatologist can coax a laser to perform a variety of tasks, according to Dr. E. Victor Ross.

"Making the lasers you already have smarter can really save you money. The critical thing, especially if you’re in a private practice, is to take three or four lasers, or maybe just one or two, and make those lasers do as many things as they can. Play to their strengths. Take the tool you have and make it like a Swiss Army knife. You want a multiple-trick pony, not a one-trick pony," he said at the Hawaii Dermatology Seminar sponsored by the Global Academy for Medical Education/Skin Disease Education Foundation.

©Crisma/iStockphoto.com

It’s all about knowing the laser energy’s relative absorption by blood, melanin, and water, according to Dr. Ross, director of the laser and cosmetic dermatology center at the Scripps Clinic, San Diego.

Armed with this understanding, here is some of the multitasking that popular dermatologic lasers are capable of:

• 810-nm diode laser: A popular device for hair removal, it’s also effective in treating deeper venous lakes and reticular facial veins with the handpiece placed against the skin and cooling turned on. With the cooling off, the 810-nm diode laser is also useful in treating various epidermal pigmented lesions.

• Nonfractional CO₂ laser: An old dog capable of many new tricks, according to Dr. Ross. Among them are treatment of seborrheic keratoses, skin tags, nevi, hidrocystomas, and lyomas and lasering and curettage of basal cell carcinomas. With several treatment sessions, roughly 90% of the ink in red lip-liner tattoos can be eliminated.

"I use this laser every day. I’m still a big fan," the dermatologist said.

• Pulsed-dye laser: This laser have been typecast for years as a tool for removal of port wine stains, but it can be applied to anything that’s red and inflammatory. It works particularly well for red striae on fair-skinned patients, scars, warts, sebaceous hyperplasia, lentigo, and red fibrous papules. Dr. Ross said he’s had mixed results with pulsed dye laser therapy for granuloma annulare. He has even used the laser to treat superficial basal cell carcinomas.

"You have to hit them hard, with stacked pulses at about 14 Joules/cm², no cooling, at a duration of 1.5-3.0 millisec. But I have to say, I think excision and curettage works about as well," the dermatologist continued.

• KTP laser: The potassium titanyl phosphate laser is among the devices Dr. Ross turns to most often. It’s the best laser out there for vascular lesions. But it’s well suited for any red or brown lesions, including seborrheic keratoses, red fibrous papules, leg veins, poikiloderma, warts, and dermatosis papulosa nigra.

• Q-switched YAG: Often employed for tattoo removal. But it can also be utilized for treatment of scars, Hori’s nevus, melasma, and for laser skin toning. In addition, it works very well for compound nevi.

"Hit them multiple times with 10 Hz at about 12 Joules/cm². After two or three treatments, they’re gone," according to Dr. Ross.

• Long-pulsed alexandrite laser: It’s normally used for hair removal. But it’s also excellent for epidermal pigmented lesions. In addition, it can provide good single-treatment results for venous lakes, telangiectasias, vascular lesions, seborrheic keratoses, and port wine stains.

"Put numbing cream on about 45 minutes beforehand, turn the cooling off, and blast away," the dermatologist advised.

• Nonfractional erbium YAG: A good laser in addressing stucco keratoses, flesh-colored fibrous papules on the nose, large sebaceous hyperplasia lesions, and seborrheic keratoses.

• Intense pulsed light devices: Lots of applications for these, including activation of photodynamic therapy, removal of port wine stains, and eradication of warts. Templates can be used to mask the beam, allowing high-energy treatment of focal lesions while sparing normal skin.

The SDEF and this news organization are owned by the same parent company.

Dr. Ross reported financial relationships with Alma, Lumenis, Miramar Laboratories, Palomar, and Synernon.

[email protected]