Fractional resurfacing C02 and Er:YAG lasers have traditionally been used in ablative resurfacing procedures. They target tissue water and non-especially ablate layers of skin to varying depths. Important improvements can be obtained with these lasers in the therapy of scars (like those from acne vulgaris), cutaneous growths and photodamaged skin. Even so, recovery can be protracted and numerous side effects are recognized, including dyspigmentation, scarring and prolonged erythema. A new laser technologies, fractional photothermolysis, has recently been introduced to particularly overcome the drawbacks of conventional resurfacing. As an alternative of making a single beam that causes uniform thermal harm to tissue in its path (as with conventional resurfacing lasers), the output from fractional resurfacing devices consists of thousands of microscopic columns, which each make thermal harm to a tiny volume of tissue).

As ablation is non-confluent, the danger of scarring is decreased and recovery is fast, with epidermal healing taking only 24 hours by means of keratinocyte migration.

Side effects last 24 to 48 hours, and consist mainly of erythema and oedema. The procedure can be performed under topical anaesthesia with slight discomfort.

Although promising, this technologies is still in its infancy and optimum remedy frequency and parameters remain to be defined. The original fractionated laser Fraxel (Reliant Technologies, Mountain View, CA, USA) was a non ablative strategy, interest is increasing in the delivery of ablative wavelengths in this way with fractionated Er:YAG and CO2 laser sources.

Pneumatic suction devices

Pneumatic suction devices are a current enhancement to existing lasers and IPLs. A adverse pressure is applied to the skin ahead of the light pulse is delivered. This gently pulls and stretches the skin so as to thin the epidermis, lessen the density of epidermal melanin and bring the dermis closer to the light supply. As a outcome, reduced energies are needed, and there is theoretically a reduce propensity for side effects. The vacuum also activates sensory fibres, thereby lowering the transmission of discomfort and treatment becomes more comfy. Negative stress could also enhance the volume of dermal vessels.

Expanded vessels concentrate laser energy much better as they include much more blood this could be of assistance in treating therapy resistant lesions such as PWS. Pneumatic suction devices may be integrated into the laser or IPL handpiece (e.g. Aesthera PPx, Pleasanton, CA, USA) or as a separate attachment that can be used with existing systems (e.g. Inolase, Candela Corp, Boston, USA). Investigative clinical makes use of contain hair removal, acne and analgesia in a variety of procedures.

Optical clearing agents

A important proportion of the light emitted by lasers is scattered by the epidermis.

Non-human and laboratory information have shown that hyperosmotic chemical substances such as glycerol and propylene glycol boost penetration of light to dermal targets by reducing scattering in the epidermis. This has the possible of improving the efficacy of lasers and reducing unwanted epidermal injury. Optical clearing agents are at the moment impractical to use in the clinical context, and refinements in the epidermal delivery mechanism of these agents are awaited. 

Dr Sean Lanigan -Consultant Dermatologist – skin was established in 1990 and is the UK’s leading provider of skincare circumstances treatment options such as: laser hair removal &amp laser tattoo removal.