Lasers Offer Many Options to Improve Appearance

From the WebMD Archives

March 15, 2000 (San Francisco) -- Lasers have taken center stage here at the 58th Annual Meeting of the American Academy of Dermatology, where dermatologists from the world are gathering to discuss the latest medical and cosmetic advances in skin care.

Revolutionary advances in laser surgery have enabled physicians to safely and effectively eliminate a number of skin conditions such as wrinkles, scars, excessive body hair, birthmarks, tattoos, and facial and leg veins. Today's laser procedures produce fewer side effects and offer shorter recovery times than earlier lasers. In addition, recent improvements in laser technology have resulted in more successful outcomes in fair-skinned patients as well as darker skin types.

Described by some experts as "magic bullets of bright light," lasers work by generating heat that tightens the skin. The result is a more uniform, smooth appearance. While laser surgery is generally not painful, patients may experience mild discomfort afterwards.

The best candidates for laser treatments are those with skin that has been damaged by too much exposure to sunlight, according to dermatologist Arielle N.B. Kauvar, MD. "Most wrinkles around the eyes and mouth are associated with sun exposure," she tells WebMD. "[These] include all the changes you'd expect -- wrinkling, brown spots, dryness -- and they all respond well to laser resurfacing." Kauvar is associate director of the Laser & Skin Center of New York and is a clinical associate professor of New York University.

Unwanted, excess hair is a concern for men and women, particularly among ethnic populations. Recently, laser improvements have made it possible to effectively treat patients with darker skin types, such as African-American, Native American, and Asian patients.

"Everybody has the right to be treated for cosmetic reasons," Eliot F. Battle Jr., MD, tells WebMD. "Now, lasers are being introduced to a population that needs the benefits but has been ignored." He stresses that it's important to choose a clinician who is knowledgeable in the use of new lasers for ethnic skin types. Battle is with the department of dermatology at Wellman Laboratories of Photomedicine in Boston, and the Harvard Medical School.

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Until recently, lasers were primarily used for facial veins. Now, leg veins can be effectively -- and comfortably -- treated with a variety of lasers, depending on the size, diameter, and color of the vein, according to Melanie C. Grossman, MD, clinical assistant professor of dermatology at Cornell University Medical School in New York.

New lasers allow more energy to be released into the skin so that the overall treatment is more effective with fewer side effects. "Even larger veins can now be treated, thanks to newer technologies," she says.

Costs for laser surgery range from several hundred to several thousand dollars, and because it is cosmetic, insurance companies generally don't pay for it. Still, insurance coverage varies according to the carrier and the nature of the medical problem. Patients should consult their insurance carrier to determine if a procedure is covered by their policy.

Although new lasers are relatively risk-free and highly efficient, their smaller size and portability mean that many more physicians have access to them. "An increasing number of physicians ... are sharing or renting laser resurfacing machines, and the number of complications ... is increasing," according to presenter Mitchel P. Goldman, MD, associate clinical professor at the University of California, San Diego.

The take-home message for consumers, says Grossman, is "do your homework and become educated before undergoing any procedure."

How do patients feel after their laser surgery? "Patients are uniformly happy," Kauvar says. "Most patients say they look younger and that people ask them what they had done."

In the future, lasers will result in shorter recovery times, fewer side effects, and better patient outcomes. The goal, Kauvar says, is to design lasers that are extremely safe and gentle for the patient.

Vital Information:

  • Advances in laser surgery are allowing physicians to safely and effectively eliminate a number of skin conditions, including wrinkles, scars, excess body hair, and facial and leg veins.
  • Improvements are also being made in laser surgery for different ethnic skin types, a population that used to be difficult to treat.
  • With the increased ease of performing laser surgery, more physicians are doing it, and the rate of complications is going up, so patients should educate themselves before having any surgery.
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