Speaking at the 2005 American Academy of Dermatology's summer scientific meeting, dermatologist Arielle Kauvar, M.D., clinical associate professor of dermatology at New York University School of Medicine in New York City, discussed how innovative laser and light treatments, used alone or in combination with light-activated skin medications, are advancing dermatologists' ability to treat a variety of skin conditions including acne, rosacea and sun damage.
"In the past, treatments for some skin conditions could be quite involved, leaving the patient with visible side effects and a long recovery time," said Dr. Kauvar. "With today's laser and light treatments, dermatologists can safely and effectively remove the visible signs of a variety of skin conditions with faster results and a shorter recovery time for the patient."
During his presentation Kauvar pointed out that wrinkles, brown spots, loss of elasticity and actinic keratoses (AKs) are all signs of sun damage that can be treated by non-invasive laser and light therapies. For this kind of damage he said that non-invasive lasers that target pigment (KTP, alexandrite, ruby lasers and IPL) or blood vessels (KTP, pulsed dye laser and IPL) are now being used to remove red and brown blotches associated with years of sun exposure. Other lasers (YAG, diode and erbium glass) can stimulate new collagen in the skin, thereby improving fine lines, skin texture and acne scars.
In addition to improving the visible signs of skin aging - red and brown blotches, sallowness and wrinkling - photodynamic therapy can enhance the health of the skin by destroying abnormal growths, Kauvar added. When aminolevulinic acid is applied to the sun damaged skin, the medication accumulates in abnormal cells. Laser treatment activates the medication to destroy these abnormal calls. This treatment, termed "photodynamic photorejuvenation," will rid the skin of early cancerous cells and growths while reducing redness, brown blotches and improving the overall skin texture and appearance.
Another significant area that Dr. Kauvar focused on was acne. With more than 80 percent of Americans affected by acne, there are three major factors causes: the overproduction of oil by enlarged oil glands in the skin; blockage of the hair follicles that release the oil; and a growth of bacteria called P. acnes within the hair follicles.
New laser and light treatments can specifically target two of these factors: excessive oil production by enlarged oil glands and the overgrowth of P. acnes bacteria. Several laser systems, including the diode, YAG and erbium glass, use heat to damage the oil glands. Photodynamic therapy, a treatment that uses the combination of a photosensitizing medication called aminolevulinic acid with laser and light treatment, also targets the oil glands and P. acnes bacteria. Each of these treatments reduce the overproduction of oil and help diminish, and in some cases completely remove, acne.
"The biggest benefit of these laser and light therapies is that they treat the affected area without harming the surrounding skin," said Dr. Kauvar. "Another benefit is they promote collagen formation and renewal which helps diminish acne scarring."
Other light and laser therapies include narrow band blue light, KTP (green light), pulsed dye lasers (yellow light) and intense pulsed light (IPL) devices which destroy the P. acnes bacteria. These treatments are non-invasive, but may leave the patient with mild pinkness that lasts for a few hours.
With an estimated 14 million Americans suffer from the facial redness and swelling of rosacea, this was another focus area for Dr. Kauvar. Rosacea is most common in fair-skinned people and usually begins as a tendency to blush easily. The condition can occur over a long period of time and often progresses to a persistent redness of the face with visible blood vessels, pimples and in its most severe form, enlarged oil glands with thickening of the nose called rhinophyma.
"Depending on the severity of the condition, a series of two-to-five treatments over a period of weeks will cause the redness and pimples to gradually disappear," explained Dr. Kauvar. "Patients may need to return annually for treatment of new blood vessels."
Today new laser treatments, including KTP and pulsed dye lasers, can simultaneously treat the redness and the visible blood vessels with minimal discomfort and bruising. These lasers work by using heat to seal the blood vessels from the inside out, causing the vessels to collapse and effectively prevent the body from producing the excessive facial redness.
"Depending on the technique that is being used, a series of four-to-six treatments delivered at two-to-four week intervals can produce long-term remissions in acne," said Dr. Kauvar.