What is Laser?
One of the most common and widely used aesthetic treatments in Singapore, laser, an acronym for Light Amplification by Stimulated Emission of Radiation, means sources of high intensity and monochromatic light, emitting light of only one wavelength or color.
The aim of lasers is to focus on a small area but without harming the surrounding tissue. Different lasers with various wavelengths target different skin concerns. While some lasers focus on melanin (brown pigments) by minimizing the appearance of dark spots, others concentrate on red pigments, penetrating blood vessels, capillaries or acne scars, creating micro-sized wounds in order to stimulate the body’s repair and renewal response to generate new collagen.
How Does Laser Work?
When it comes to applying laser to treat the skin, it is more commonly referred to as laser resurfacing – mainly carbon dioxide (CO2) and erbium with each laser vaporizing skin cells at the surface level. A laser is a focused beam of light that targets a problem area of the skin by “destroying” the specific pigment or tissue by heating the lower layers in the dermis while sparing the skin around it. This will in turn trigger the production of new collagen fibers so that you achieve baby smooth, firmer and younger looking skin as the end result.
What Can Laser Do For You?
Laser therapy can be used for a wide range of skin concerns including fine lines and deep wrinkles around the eyes, mouth or forehead, shallow scars from acne, or a non-responsive skin after a facelift. The main difference between the types of lasers have to do with wavelength, with different laser wavelengths (colors of light) targeting different skin issues.
There are two types of ablative (also more invasive) laser but produce the best clinical results - Carbon Dioxide (CO2) and Erbium or Erbium Yttrium-Aluminum-Garnet (Er:YAG) laser resurfacing which work by vaporizing the outer layers of the skin, penetrating the tissues beneath to create micro wounds, causing the skin to heal and restructure through an increase in collagen production. These lasers are great for treating visible signs of aging such as wrinkles, acne scars, pigmentation irregularities, unwanted lesions, warts, enlarged oil glands on the nose, and the results generally last for a few years. However, a longer recovery and higher degree of risk are expected compared to non-ablative lasers.
The latest version of CO2 uses very short pulsed light energy known as ultrapulse or continuous light beams that are delivered in a scanning pattern to remove thin layers of skin with minimal heat damage. Erbium on the other hand, is designed to remove surface-level and moderately deep lines and wrinkles on the face, hands, neck, or chest, atrophic acne scars, sun-damaged skin, uneven pigmentation, seborrheic keratosis and other benign skin growth with minimal burning of surrounding tissue. Ablative lasers are also generally chosen for removing pre-cancerous growths, such as actinic keratoses, before they have a chance to become malignant, as a preventative measure.
Non-ablative (and non-invasive) lasers also known as pulsed light (Quality or Q-Switched), pulsed-dye (PDL) and fractional (Fraxel) lasers, do not remove any skin layers and are non-damaging to the surrounding tissue. They may be used for mild to moderate age-, sun-, or acne-related skin concerns that aren’t treatable with over-the-counter (OTC) products. They can also be combined with other treatments such as chemical peels and botulinum toxin injections.
A quality-switched laser (Q-Switched) creates high-intensity pulsed beam light that last just a billionth of a second. The energy emitted from this laser is concentrated enough to shatter tiny fragments of pigmentation or ink, kill fungus and stimulate collagen production. Q-Switched are best used for tattoo removal, toenail fungus, freckles, birthmarks, moles, spider veins, angiomas, and port wine stains.
PDL is also useful in the treatment of port wine stains (vascular malformation), superficial haemangiomas, a variety of vascular lesions including telangiectasis and cherry angiomas, as well as non-vascular conditions such as plane warts. Light energy emitted by the flash lamp-pumped PDL is primarily absorbed by oxyhemoglobin within the blood vessels, minimizing thermal damage to other structures.
Procedure and Treatment
Before procedure, your medical doctor will apply a topical anaesthetic or numbing cream to the area being treated to minimize any discomfort. Patients will be required to wear a protective cover over the eyes for the duration of the procedure. Your doctor will direct the laser onto the targeted skin site for treatment. A slight stinging sensation may still be felt but treatment is very well tolerated most of the time, so there is no need for pain killers unless the treatable area is large. The procedure usually takes 30 to 60 minutes, and there may be redness over the treated site post treatment, usually lasting for a few hours. Most of the time, there is no swelling and most patients can return to work almost immediately.
Post laser, skin whitening and rejuvenation may be visible immediately but not so much with lightening of pigmentation. In fact, pigmented spots may even darken for one to two weeks before getting lighter.
Lasers often need to be repeated for several multiple follow-up treatments, spread over a span of a few weeks apart.
Risks and Side Effects
Before procedure, do inform your doctor if you are taking medications such as isotretinoin (Accutane) for acne as it may increase your risk for scars, or even aspirin as it can increase your risk of bleeding.
Know that it is generally safe when handled by a board-certified healthcare practitioner or medical doctor in a proper clinic. However, anyone considering the procedure should be aware that laser skin resurfacing complications such as abnormal healing and infection (though quite rare) can happen. It can cause burns or other injuries due to the heat of the laser. Understand that those who undergo the procedure are also more prone to outbreaks of cold sores or acne, and some itching. There is also a risk of viral, bacterial and fungal infections following the treatment. You need to be aware of such risks even if they are not common and you may not experience any of these complications.
As a general rule, the bigger the area, the deeper the laser, and longer the recovery time. During recovery, your skin may be red and scab over with slight peeling. Ice packs may help to reduce any swelling. While you don’t need to be at home during the entire recovery process, do avoid places like the gym where there is greater risk of infection as there are more germs in such places.
Mild lower powered lasers have fast recovery times, generally a few days as they do not result in any side effects such as peeling or crusting of the skin. However, the more aggressive (ablative) lasers require a longer recovery period, with skin typically experiencing various stages of redness, crusting and peeling for one week. Risk of other side effects include burning, bumps, rash, swelling, infection and scars. After that, the skin may remain pink for up to another one to two weeks.
Who Is Not Suitable For Laser?