How Do Cosmetic Lasers Work?

Laser, as an acronym, is an abbreviation for “light amplification by stimulated emission of radiation.” A laser is actually a single color of light (one wavelength), which is a high-energy light source that can be concisely directed to focus the light beam on a very small targeted area. In cosmetic laser procedures, two basic varieties of lasers are used—ablative and non-ablative.

The Two Basic Laser Types: Ablative, Non-Ablative and How They Work

In cosmetic laser procedures, the two basic varieties of lasers are used — ablative and non-ablative. While ablative lasers act to vaporize the upper layers of injured or deteriorated skin, non-ablative lasers penetrate deeper into the skin without displacing or causing damage to the upper skin layers. When patients undergo cosmetic laser procedures that use non-ablative laser techniques, there is no actual downtime for the patient due to this procedure.

Since lasers are monochromatic, any laser emits light of just one color, or wavelength. During cosmetic procedures, lasers operate through “selective photothermolysis.” In other words, the laser alters the light frequency (photo) to create heat (thermo) in the exact location of the area (skin or tissue) you plan to destroy (lysis). To accomplish this, the light beam wavelength must be synchronized with the target color, regardless of whether the target is brown spots on the skin or bright red broken capillaries.

The two main kinds of lasers can be subdivided into many other divisions of laser varieties, with hundreds of laser brands and types within these different divisions. Different laser wavelengths, or light colors, are used for treating different skin problems. If you are a patient who has several different skin issues to be treated, your surgeon will recommend different lasers to target the varied skin problems that you need treated.

Recommended Lasers for Various Cosmetic Applications

• Wrinkles and Lines. – For treatment of fine lines and wrinkles, skin procedures to resurface and tighten the skin are used together, and both these treatments can be handled with use of the CO2 (carbon dioxide) laser or Erbium YAG, which are aggressive laser varieties. CO2 lasers are also frequently used to remove skin tags and warts a well as for making incisions in skin during surgeries that are laser-assisted. Pulsed dye lasers can also be helpful in some instances, as are non-laser treatment methods that are light-based, like IPL and LED photofacials. These non-laser treatments are less aggressive than procedures performed using CO2 lasers or Erbium YAG.
• Skin Tightening. – The majority of cosmetic laser treatments include some degree of skin tightening, even if it is superficial, since they create some regulated injury to the skin, which promotes a rise in collagen production in the body. For greater tightening measures, CO2 lasers are most often used. Currently, more procedures of this type are being accomplished with light-based, non-laser treatments like Titan infrared instruments and systems that are based on Thermage radio frequencies.

• Pigmented Lesions. – Examples of these lesions are age spots, sun spots, melasma and other types of hyperpigmentation. The lasers the most frequently used for procedures involving pigmented lesions are the pulsed dye, Nd:YAG and Fraxel (fractional lasers) as well as light-based, non-laser treatment methods such as use of IPL.

• Precancerous Lesions. – Nearly all surgeons concur that cancerous lesions are best removed with a scalpel, in a regular medical surgical procedure. This will ensure clean borders and complete removal of precancerous tissues. This also provides a skin sample for pathologists to examine for further assurance of the nature of the lesion. However, lasers are now in frequent use for removing actinic keratoses, or precancerous growths, before they can become malignant, or squamous cell skin cancers. For this type of procedure, ablative lasers like the CO2 and Erbium:YAG are most often used.

• Vascular Lesions. – These lesions include facial broken blood vessels, spider veins of the legs and ankles, hemangiomas and some birthmarks. IPL is most often used to treat these conditions since it is a minimally invasive treatment mode. In addition, the pulsed dye, Nd:YAG and diode lasers may be used.

• Hair Removal. – The extent of the safety and success of hair removal by laser treatment depends on the pigment of the hair and skin of the patient. For individuals with darker skin tones, the Nd:YAG or diode lasers are usually the best option, while patients with lighter skin tones are best treated with use of IPL.

• Acne Scars. – For deep scars caused by acne, the CO2 laser is the very best choice. Other good choices are the Erbium:YAG as well as the fractional laser and some non-ablative lasers, but these three laser types are usually only effective for treating less severe acne scars. LED treatments have also shown to be effective for treating scars resulting from acne.
• Tattoo Removal. – Both the CO2 laser and the Nd:YAG are the most often used for removing tattoos. In some instances, tattoo removals can also be accomplished with IPL use.

Light-Based Treatment Technologies in Use Today

There are numerous varied types of light-based treatment technologies that are currently in use in the practice of modern cosmetic surgery. Although many of these different treatment modes are frequently referred to as “laser” procedural methods, these treatments are being performed with use of devices and instruments that are not true lasers. The treatment technologies used include LED treatments, IPL, Titan and other infrared methods that are energy-based as well as radio-frequency based modes like Thermage. Although these treatment technologies are very helpful and successful methods of approach for many different cosmetic surgeries, it should be stressed that they are not actually laser treatments.

Laser Surgery Procedures with Optimal Expertise

Dr. Joseph W. Rucker, Jr., completed his medical school training and degree at the College of Human Medicine at Michigan State University in East Lansing, Michigan. After receiving his medical degree, he spent five additional years in general surgery followed by a three-year residency in plastic surgery as well as a fellowship in breast reconstruction.

Since 1984, Dr. Rucker has had a highly successful private practice in the Eau Claire region of west central Wisconsin. He has performed more than 10,000 cosmetic and reconstructive surgical procedures. Dr. Rucker is board certified by the American Board of Plastic Surgery.

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