Nonablative laser and light treatments

A variety of noninvasive rejuvenation treatments are based on the use of nonablative lasers or intense light. (Nonablative means that the skin surface does not get burnt off.) These treatments are becoming ever more popular, advanced and ubiquitous. One of the key reasons is that they do not burn off the top layer of the skin (as opposed to ablative lasers), which means no or little downtime and lower risk of side effects and complications. Admittedly, for certain problems, such as moderate-to-deep wrinkles, nonablative laser and light treatments remain less effective that skin resurfacing with alblative lasers. On the other hand, for problems like broken capillaries, redness, facial flushing and certain types of abnormal pigmentation they are now the treatment of choice.

All these methods are based on the same principle called selective photothermolysis. In essence, a targeted beam of light selectively heats up and thereby damages a particular skin structure without damaging the surrounding tissue. Such targeted damage and the resulting healing response may produce cosmetic improvements, such as dissolution of spider veins and age spots, skin tightening, wrinkle reduction and so forth.

Selective photothermolysis is made possible by the capacity of lasers and some other photo devices to produce intense light with a particular wavelength. Wavelength determines how deep a beam of light will penetrate the skin and what structures it will hit. Depending on the wavelength selection, one can target stratum corneum, epidermis, upper or lower dermis. One can also specifically target blood vessels (e.g. to treat spider veins or rosacea), melanin (to treat pigmented lesions), collagen (to tighten skin) and so forth.

Generally, each type of cosmetic laser or photo devices works within a particular narrow range of wavelengths. This allows targeting a particular problem while reducing side effects. For example, green light is absorbed by hemoglobin in red blood cells and causes targeted heating of blood vessels. Hence, it is used for targeted treatment of spider veins, facial flushing (in rosacea) and other vascular conditions.

However, there is an important difference between the light generated by lasers and nonlaser photo devices. Lasers emit the so-called coherent light (synchronized light waves of the same wavelength), providing unmatched targeted energy delivery of unmatched specificity and intensity. Conversely, non-laser photo devices emit a spectrum of different wavelengths. To improve targeting and specificity, such devices often use special filters to remove unwanted wavelengths and keep only those in the required narrow range. Since the same device can be used with different filters, a single such system may be suitable for treating a number of different conditions by using different filter and intensity settings. This makes non-laser photo devices (such as intense pulsed light systems) more versatile and more cost-effective. On the other hand, lasers remain superior when it comes to high specificity and precise targeting of the treatment.

If you are looking at laser and light treatments as a potential solution to your cosmetic needs, the first step is to determine which, if any, of the available systems is the best fit for your specific problem(s). If more than one system seems appropriate, you need to compare the specificity, reliability, cost, and so forth. Remember that providers (surgeons, dermatologists, etc.) may be consciously or unconsciously biased towards the systems they happen to operate. Do your homework: talk to different provides and their patients; read research studies, reviews, industry news and so forth. You can start with the fact-sheets on the most common laser and light treatments provided below.