28 Aug Demystifying the Laser
By Naseem S. Miller
AUGUST 18, 2017, 1:12 PM
DEMYSTIFYING THE LASER
A serious talk with doctor and patient on laser skin procedures
Orlando-native Peggy Rex is somewhat of a pioneer among her friends when it comes to using laser treatments as an anti-aging tool. It was 12 years ago when she heard about lasers at her hairdresser’s in Winter Park. “It was very new,” said Rex on a recent afternoon. “So I guess I was the guinea pig,” she joked in her warm Southern accent. She was 54 and had never done anything to her face, but this new tool caught her attention. So she made an appointment with Dr. J. Matthew Knight, who’s one of the first dermatologists in Central Florida to sub-specialize in laser skin procedures.
She now swears by it. “It solves a lot of skin problems. My husband had rosacea and had laser treatment. It completely disappeared,” Rex said. She and her husband moved to New Smyrna Beach shortly after her first skin resurfacing procedure, but that hasn’t stopped her from driving to Orlando — despite having had to put up with I-4 traffic — to see Knight at least once a year for a treatment.
Since the days when Rex took a leap of faith and tried laser treatment, cosmetic laser procedures have become more popular every year. From 2000 to 2016, the number of laser skin resurfacing procedures performed in the United States increased by more than 240 percent, the third largest increase in a minimally-invasive procedure, behind Botox and fillers, according to data reported by the American Society of Plastic Surgeons.
Just between 2015 and 2016 light-based procedures used for rejuvenating the skin increased 36 percent, the highest increase among nonsurgical procedures, according to the American Society for Aesthetic Plastic Surgery.
Laser is actually an acronym. It stands for Light Amplification by the Simulated Emission of Radiation. It’s a mouthful. In simple terms, lasers are man-made beams of energy that are very bright and can travel long distances.
Lasers were first developed in the 1960s for the military — and not for cosmetic reasons. They were used as weapons and guidance systems for planes and rockets, according to the American Society for Laser Medicine & Surgery. They then entered the civilian world as precise cutting tools. And eventually, after further advancements, they were brought into the world of medicine.
Today, they’re used in a wide range of medical specialties, ranging from oncology and ophthalmology to medical and cosmetic dermatology.
There are different types of laser devices, which are usually named after the material that laser passes through before it hits the skin.
Lasers get absorbed by a target in the body, be it the prostate or age spots, acne, scars or hair. When lasers are “pulsed,” they create a shock wave effect that breaks up the targets like bladder stones and tattoo ink.
Depending on the device and the setting, the laser beam targets a different area and at an intensity chosen by the provider.
A lot of math, physics, science and medicine goes into making that decision. That’s why choosing a provider who has experience with laser devices is crucial.
For instance, if not calibrated correctly, the laser that’s supposed to target hair pigments for hair removal can also destroy the skin pigments of individuals with darker skin. And the damage is not reversible.
“Lasers are not toys,” said Knight, who has several laser devices in his practice, Knight Dermatology Institute in downtown Orlando, and is a well-known expert in laser treatment. “They’re powerful devices.”
Adverse outcomes from laser procedures are less common today than a decade ago. Technology has improved, so has the providers’ experience. Still, consumers should do their research before making an appointment with a provider. Be a smart consumer.
“Use word of mouth. Ask around. Get a second opinion. If there’s something that’s bothering you, ask about it,” advised Knight. He’s not a big fan of online reviews, finding them more misleading than helpful. But you can visit the websites of professional dermatology and surgery societies, which have consumer information and physician-finders.
As for Rex, she’s sticking with Knight. “I trust him with my skin,” she said. “He’s very conservative and I’m really appreciative of that.” During the past 12 years, Rex has had three laser resurfacing procedures with Knight. She’s had another laser treatment, twice, to get rid of broken capillaries on her cheeks.
The more intense resurfacing comes with about a week of downtime as the skin heals. Other less invasive procedures may cause a little redness and swelling, but overall have no downtime. “It’s nothing you can’t put makeup on,” said Rex about the aftereffect.
About once a year, Rex also gets Botox and fillers — just enough to keep wrinkles at bay — and has a microdermabrasion or chemical peel with the aesthetician at Knight’s practice. It’s diligent work. “I have people say to me all the time, Your skin is amazing.’ and I say, “Well, I work on it enough,” Rex said.
WHAT’S RIGHT FOR YOU? Here’s a primer on common aesthetic procedures
LASER RESURFACING – It’s also called fractionated resurfacing therapy and is mainly used to provide a fresher, more youthful appearance. The process is also thought to stimulate collagen production. Changes and improvements to the skin may continue for several months as the skin continues its healing process.
• Types – There are two types of laser resurfacing: ablative and non-ablative. Ablative, as the word indicates, can result in a wound on the outer layer of the skin and can take a few days to heal.
• Treatments -The two most common fractionated ablative lasers are Carbon Dioxide (CO2) and Erbium YAG (these names refer to the medium through which laser travels.) They create channels in the skin, prompting the skin to start a healing process. More devices can be used for non-ablative therapy, including infrared lasers, high-impact light sources and radiofrequency devices. The skin may appear red and swollen after the treatment, but recovery is quicker than ablative procedures.
SKIN TIGHTENING – Several non-invasive tools can help you combat wrinkles, bags, droopy jowls, and loose skin on the thighs, knees, arms and back of the hands.
• Treatments – The ultrasound treatment heats up the lower layers of the skin to stimulate collagen production while killing fat cells. Ultrasound is particularly a good option for consumers with darker skin. Many times this treatment is bundled with other therapies such as fillers and Botox.
NECK REJUVENATION – If you have loose or hanging skin on your neck and under the jaw, some non-invasive options may help you get rid of some of that looseness.
• Treatments – Controlled radiofrequency energy heats the inner layer of the skin and helps tighten it. This treat ment usually involves the injection of a local anesthetic. The ultrasound therapy uses sound waves to heat, tighten and lift the skin, without disturbing the top layer of the skin.
LASER HAIR REMOVAL – This procedure is ideal for those who are tired of waxing, shaving, plucking and threading.
• Treatments – Several lasers, including Nd:YAG and intense pulsed light devices, are used. The laser is absorbed by hair pigments, super-heating the hair follicle and killing its cells. The laser doesn’t directly target the hair follicle because the follicle has no pigment (melanin).
Source: American Society for Laser Medicine & Surgery
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