LASERS AND LIGHTS—A PRACTICAL UPDATE AND FUTURE CONSIDERATIONS
Light-emitting diode photobiomodulation is the newest category of nonthermal light therapies
to find its way to the dermatologic armamentarium. In this article, we briefly review
the literature on the development of this technology, its evolution within esthetic and
medical dermatology, and provide practical and technical considerations for use in various
conditions. This article also focuses on the specific cell-signaling pathways involved and
how the mechanisms at play can be put to use to treat a variety of cutaneous problems as
a stand-alone application and/or complementary treatment modality or as one of the best
photodynamic therapy light source.
Semin Cutan Med Surg 27:227-238 © 2008 Elsevier Inc. All rights reserved.
Photodamage is one of the most common reasons that patients visit a dermatologist’s
office. Carbon dioxide (CO2) laser resurfacing has always been the gold standard for
reversing photodamage. Because of the relatively high incidence of side effects and the
prolonged downtime associated with CO2 resurfacing, new technologies have emerged to
address photodamage. Portrait skin regeneration (PSR) is a novel device that has been
developed to treat photodamage, and this device yields fewer side effects and downtime
than traditional CO2 laser resurfacing. At our center, we have performed more than 500
high-energy PSR treatments and have developed a unique and highly effective treatment
protocol. In addition, fractional CO2 laser resurfacing has emerged as the latest technology
developed to combat photoaging. This technology yields impressive results and is much
safer and causes less downtime than traditional CO2 laser resurfacing. In this article, we
will review our treatment techniques and protocols as well as address patient selection,
preoperative and postoperative care, and anesthesia.
Semin Cutan Med Surg 27:239-251 © 2008 Elsevier Inc. All rights reserved.
Fractional resurfacing devices thermally alter microscopic treatment columns in the skin,
leaving intervening areas between the columns untouched. Because only a fraction of the
skin is being modified, untreated areas are able to rapidly repopulate the treatment columns
to greatly reduce recovery time and adverse events. Mid-infrared fractional systems have
shown improvement in treating photoaging, scars, rhytides, dyschromia, and textural
disorders. An additional advantage is that they are safe and effective for the treatment of
nonfacial areas such as the neck, chest, and extremities.
Semin Cutan Med Surg 27:252-258 © 2008 Elsevier Inc. All rights reserved.
Liposuction is one of the most popular cosmetic procedures. The advent of laserassisted
liposuction is the next evolutionary step in the market of body contouring. The
goal of laser-assisted liposuction is to facilitate liposuctioning, enhance tissue tightening,
and reduce downtime and morbidity. Several different protocols using different
devices and wavelengths generate variable results. Current laser-assisted lipolysis
technology and techniques are reviewed with respective expectations. As laser lipolysis
technology and coinciding experience grow, so will the ability to achieve the aims of
more efficient, safer, and cosmetically pleasing body sculpting.
Semin Cutan Med Surg 27:259-263 © 2008 Elsevier Inc. All rights reserved.
Superficial venous insufficiency is a common problem associated with varicose veins.
Venous insufficiency and varicose veins can be symptomatic, but more commonly they are
a cosmetic concern. In this article, we discuss the relevant anatomy and pathophysiology
of superficial venous insufficiency, review the current literature for varicose vein treatment,
and cover the technical aspects of diagnosing and treating superficial venous insufficiency.
Saphenofemoral junction incompetence with resultant greater saphenous vein reflux is the
most common cause of varicose veins; because this condition constitutes the majority of
patients encountered in practice, we will concentrate on this area. Endovenous laser
ablation and sclerotherapy are covered, including patient workup and selection, procedure
set-up, and anesthesia.
Semin Cutan Med Surg 27:264-275 Published by Elsevier Inc.