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How Dermatologists Use Lasers and Other Light-Based Devices

Rocket projected onto the Washington Monument during the celebration of the 50th anniversary of Apollo 11.

As we celebrate the spectacular achievement of the moon landing 50 years ago, we can reflect on the technological advances that have had an impact on dermatology. In the half century since Dr. Leon Goldman pioneered the medical application of lasers, they have become integral to state-of-the- art dermatology practices. So how do dermatologists use lasers and other light-based devices?

Uses for Laser, Light and Energy-based Devices

Remove unwanted hair

Lasers remove unwanted hair from the face and body by targeting the pigment of the hair and damaging its follicle so that hair growth is slowed. In order for lasers to be effective, the hair must be treated while in its “active growth” phase. This is why multiple (usually six to eight) treatments, spaced four weeks apart on the face, and as much as eight weeks apart on the body, are needed to achieve good results. The same lasers are also effective for excessive sweating or hyperhidrosis. Note: Only specific lasers are appropriate for darker skin types, and those with tanned skin should avoid the treatment.

Do away with those age spots

Sun damage and aging can result in unwanted brown spots, called lentigines, on sun-exposed areas such as the face, chest and hands. Those spots can successfully be treated with Q-switched lasers and IPL (Intense Pulsed Light) devices. Several treatments may be required to achieve optimal results.

Treat redness and broken blood vessels

Lasers are effective at treating skin redness from conditions such as rosacea as well as benign vascular growths such as angiomas and broken blood vessels that can occur from sun damage. The treatment works because lasers at certain wavelengths can target hemoglobin that is found in blood. Typically one to a few treatments may be needed for optimal results. It is important to use a broad-spectrum sunscreen after the treatment.

Banish those breakouts

Lasers and light-based devices can successfully treat mild to moderate acne. While conventional methods to get rid of acne include topical and oral medications, such as antibiotics and retinoids, the use of photodynamic therapy can be effective in achieving long-lasting clear skin. Photodynamic therapy combines the use of a photosensitizing chemical that is absorbed both by the oil glands and the bacteria that produce acne – followed by a light source or laser to activate the chemical. This results in shrinkage of the oil glands and killing of the bacteria.

Refresh and rejuvenate

A newer generation of devices today allows for skin resurfacing that removes the top layer of skin to eliminate signs of aging and photodamage such as fine lines, wrinkles, crepiness and brown spots as well as reducing enlarged pores – all with minimal downtime.

Soften the look of scars

Lasers can improve the appearance of scars – whether they were caused by acne, trauma or surgery. Some devices – like the pulsed dye laser – can help reduce the redness associated with scars. Fractional resurfacing lasers can successfully improve a scar’s texture and tone. Depending on which device is used, there may be a period of downtime following the treatment and a need for several treatments.

Take care of that ‘turkey neck’

With age comes a loss in collagen, which can result in loose skin on the neck and under the chin – affectionately known as “turkey neck.” Fortunately, there are non-invasive technologies that utilize ultrasound and radiofrequency to stimulate collagen production – resulting in skin tightening and lifting. These treatments also can be used for wrinkles on the décolletage, that crepe-paper look on the upper chest.

Rethink the ink

Fortunately there are options for those 20 percent of people who experience tattoo regret. Q-switched lasers have been used for decades to heat up and destroy the tattoo ink particles, usually over multiple treatments. Newer technology using ultra-short bursts of energy can achieve the same results in fewer treatments.

If you think one of these treatments could be right for you, contact us to schedule a consultation. Located in Chevy Chase, MD, our dermatology office serves the greater Washington D.C. area.

excessive sweating

Hyperhidrosis Could be the Cause of Too Much Sweat

hyperhidrosis

Hyperhidrosis is a medical condition that causes excessive sweating that is not necessarily related to heat or exercise. Messages from your brain usually tell your body when to produce sweat, either to keep you cool in warm temperatures or as a reaction to anxiety. However, with hyperhidrosis, excessive sweating occurs regardless of the physical or emotional environment. This excessive sweating may interfere with daily activities and can cause significant social anxiety and embarrassment. Fortunately, several treatment options are available to help with this condition.

Treatments for Excessive Sweating

    • Antiperspirants: Antiperspirants are the most common treatment for hyperhidrosis and may be purchased “over-the-counter” at your local drugstore or with a prescription from a medical professional. They work by plugging your sweat ducts so that the sweat does not reach the surface of your skin.
    • Iontophoresis: This treatment uses a mild electrical current in a shallow tray of water to reduce excessive sweating of the hands and/or feet. It has been shown to reduce sweating by 81%1,2. Prescription iontophoresis machines cost under $1000 and insurance may cover some of the cost.
    • Botox: Botox is a natural, purified protein that, when injected, can temporarily block the secretion of a chemical in your body that controls your sweat glands. When used to treat excessive underarm or hand sweating, it has been shown to reduce sweating by 80-90%, with improvement lasting from 4-12 months. The cost of Botox varies depending upon the size of the body area treated and whether insurance covers any of the cost.
    • Oral medications: There are several classes of medications that may be used to treat excessive sweating, each having different side effects and precautions. Insurance usually covers the cost of this type of therapy.
    • Laser therapy: A laser can be focused into a narrow beam of energy in order to target, heat, and destroy sweat glands in the underarm area. Side effects may include swelling, bruising, and numbness, but usually resolve after 1-2 weeks. In studies, 82% of patients receiving laser treatment for hyperhidrosis said their results were “good” or “excellent”3. Insurance may not cover the cost of laser treatment, which can be up to $3000.
    • MiraDry: This device is used by a doctor to deliver microwave energy to the underarm skin, effectively destroying sweat glands. In research studies, MiraDry was shown to reduce underarm sweat by 90%4. Common side effects include swelling, redness, and tenderness lasting for several days. Best results are seen when two treatments are performed three months apart.
    • Obrexza: This non-invasive FDA-approved treatment is intended to treat axillary hyperhidrosis (underarm excessive sweating). One wipe is applied topically to both underarms once per day. It is approved for patients 9 years old and older.

    Other Causes of Excessive Sweating

    Hyperhidrosis may be caused by an underlying medical condition such as menopause, diabetes, Alzheimer’s, tuberculosis, or cancer. Certain medications, such as antidepressants or anti-anxiety medications may also cause excessive sweating.

    When sweating is caused by an underlying medical problem, this is called secondary hyperhidrosis. Unlike secondary hyperhidrosis, which has a sudden onset, primary hyperhidrosis tends to be a longstanding medical condition that typically begins prior to age 25 with no underlying cause.

    If excessive sweating is a problem for you, consult with your physician.

    Contact us with questions and to book your appointment.

     

     

     

     

    1. Karakoç Y. Safe control of palmoplantar hyperhidrosis with direct electrical current. Int J Dermatol. 2002;41:602-605.
    2. Bouman HD, Grunewald Lentzer EM. The treatment of hyperhidrosis of hands and feet with constant current. Am J Phys Med. 1952;31:158-169.
    3. Leclere FM, Moreno-Moraga J, Aleolea JM, Vogt PM, Rovo J, Corenjo P, Casoli V, Mordon S, Trelles MA. Efficacy and safety of laser therapy on axillary hyperhidrosis after one year follow up: a randomized blinded controlled trial. Lasers Surg Med. 2015; 47(2): 173-9.
    4. Lupin M, Chih-Ho Hong H, O’Shaughnessy KF. A multi-center evaluation of the Miradry system to treat subjects with axillary hyperhidrosis. Am Soc for Laser Med and Surg. 2011; 79.