Fractionated lasers, combined-wavelength treatments abound

Las Vegas

- Throughout the next five years, fractionated lasers and combined-wavelength treatments will continue to lead growth in the dermatologic laser surgery segment, says a leading dermatologic laser surgeon.

"Today we treat a variety of dermatologic conditions ranging from vascular and pigmented lesions to unwanted tattoos and hair, and scars and wrinkles," says Tina S. Alster, M.D., director, Washington Institute of Dermatologic Laser Surgery, Washington, D.C.

Among nonablative resurfacing technologies, fractional resurfacing (Fraxel, Reliant Technologies) and plasma skin regeneration (Portrait PSR, Rhytec) provide excellent efficacy on facial and non-facial areas, Dr. Alster tells Dermatology Times. Strictly speaking, these technologies don’t vaporize tissue, but they do achieve desquamation.

Seeking to provide the best of ablative and nonablative technologies, manufacturers more recently have begun introducing fractionated lasers.

To spare patients from having to undergo a series of treatments, Dr. Alster states, "We’ve taken it up a notch and are fractionating our CO2 and erbium systems." Such lasers use a single treatment session as opposed to several required for the Fraxel. "There is some recovery," she says, "but not as much as with the old-fashioned CO2 lasers."

Fractionated CO2 lasers include the Active FX (Lumenis) and the re:pair (Reliant). Conversely, the ProFractional (Sciton) operates at 2940 nm (Er:YAG). Dr. Alster says that such products are safe and effective on facial and non-facial areas (Alexiades MR, Dover JS, Arndt KA. J Am Acad Dermatol. 2008;58:719-737).

Along with increasing lasers’ pulse duration to affect larger vessels (such as perinasal telangiectasis), "We’re combining different wavelengths such as pulsed-dye laser and YAG wavelengths to penetrate more deeply because YAG is a longer wavelength," Dr. Alster says. "In this way, we can improve our ability to treat leg veins and recalcitrant port wine stains."

Plasma skin resurfacing, on the other hand, allows the stratum corneum and epidermis to remain intact, Dr. Alster notes. Non-facial areas in which it has shown efficacy include the neck, chest and hands (Alster TS, Konda S. Dermatol Surg. 2007;33:1315-1321).

Disclosure: Dr. Alster reports no relevant financial interests.