Using lasers to correct laser and IPL-induced side effects

It might seem counter-intuitive - even scary - but patients and their dermatologists should consider laser therapy as a first-line approach for treating laser and intense pulsed light (IPL)-induced scarring and dyspigmentation.

Even in the best of hands, undesired side effects can result from light-based therapies, says Chicago-based dermatologist Mary C. Massa M.D., who presented on the topic at yesterday’s American Society for Laser Medicine & Surgery 2015 annual conference in Kissimmee, Fla.

“This is true for both lasers and IPL systems. Sometimes, unexpected, undesirable outcomes occur when the treatment was done correctly but the patient’s skin does not respond as well as expected,” she says.

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It’s easy to understand why patients and clinicians would want to steer clear of lasers to treat the very side effects similar technologies created. The concept of treating with laser the very same area - now scarred, persistently red, hypopigmented or hyperpigmented due to lasers - is a bit intimidating.  

“First, we should remember to tell our patients that many of the undesired changes, which can occur with light-based therapy, slowly resolve over time,” says Dr. Massa, professor of dermatology, Rush University Medical Center. “In those patients with persistent, undesirable laser complications… lasers have been used successfully to treat scars, pigmentation issues, erythema and should be considered standard of care.”

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Erythema, according to the dermatologist, can be treated by pulsed-dye, potassium titanyl phosphate (KTP) and long-pulsed (LP) Nd:YAG lasers. Scarring and texture changes can improve with pulsed dye, fractional and combination (quality-switched) QS and LP Nd:YAG lasers. Hyperpigmentation and even hypopigmentation is responsive to low-energy QS Nd:YAG lasers.

“The key to gaining the patient’s confidence is explaining, in detail, the process and the differences in how the laser or IPL was initially used and the current approach,” she says. “Test sites are recommended not only to evaluate safety and efficacy, but also to win over the trust and confidence of the patient to undergo the suggested corrective laser treatments.”

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Dr. Massa and her associates conducted a review of 22 patients who had experienced, through the use of many different types of light systems, persistent side effects. The side effects were textural, pigmentary, persistent erythema and scarring. After laser therapy with various lasers, hyperpigmentation was reduced by 92%, erythema reduced by 80%, scarring, skin texture improved by 86% and hypopigmentation improved by 56%.

Corrective therapy was well tolerated and only transient, anticipated, immediate effects occurred treating these patients, she says.

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