At one time, people who underwent laser surgery for wrinkles, scars or other skin problems faced a
significant risk for burning and scarring.
These risks have been mostly eliminated, thanks to a new generation of "smart" lasers--each designed to
treat a specific set of skin problems.
Laser surgery typically involves less pain--and a faster recovery--than chemical peels, dermabrasion,
cryotherapy (freezing) and other, more invasive techniques that have long been used by dermatologists.
BROWN PROBLEMS
Age spots (also called liver spots or sun spots) are caused by long-term exposure to sunlight. They appear
most commonly on the hands, face, neck and shins.
Newly formed spots can often be lightened with a bleaching cream containing hydroquinone... or with the
prescription drug tretinoin (Renova).
To get rid of larger, darker "mature" age spots, dermatologists have long relied on cryosurgery. But this
technique typically leaves white spots behind, since it affects all skin cells in the treated area.
Better: The Q-switched ruby laser. It eliminates spots with minimal risk of whitening, since it targets only
pigmented skin cells.
The treatment causes little pain. Patients report that each split-second pulse of laser light feels like a rubber
band being snapped against the skin.
Anesthetic--typically a cream known as EMLA or an injection of lidocaine--is usually needed only if numerous
spots are to be treated at once.
Healing takes one to three weeks. During this time, treated skin appears sunburned.
People usually have all their spots done in a single session, then come in one month later to take care of any
spots that were missed.
Each treatment lasts 10 to 30 minutes, depending on how many spots are removed. Cost: $500 to $1,000
per treatment.
Q-switched laser treatment works best for people with light skin. If you have a dark complexion, treated skin
may turn even darker--especially if it's exposed to sunlight during the first month after treatment.
To keep this from happening, use sunscreen consistently... and keep the treated area covered during this
period.
Good news: Such discoloration usually clears up on its own within three months. If not, it can be bleached
away.
The Q-switched ruby laser can also be used to eliminate dark circles under the eyes. One to three sessions
are typically necessary, each costing $500 to $1,000.
Caution: Dark birthmarks and moles should be removed via traditional "scalpel" surgery--then biopsied to
determine whether they're cancerous.
RED PROBLEMS
Port-wine stains can be removed with the help of a laser that selectively targets and destroys the blood
vessels that make up these marks.*
In children, the pulsed-dye laser works best. Adults should be treated with a long-pulsed dye laser or a
laserlike device known as a PhotoDerm-VL.
Six to 10 treatments are typically needed. Since port-wine stains vary in size, each treatment can last
anywhere from one minute to 25 minutes. Local anesthetic may be necessary.
Cost: $500 per treatment for a small stain... $2,500 per treatment for a large one.
Pulsed-dye lasers are also effective at eliminating reddish facial discoloration associated with rosacea, an
often-embarrassing condition caused by broken blood vessels in the face.
Other red problems treatable with the pulsed-dye laser include certain strawberry birth-marks
(hemangiomas), surgical scars, stretch marks and small spider veins in the face. Large, disfiguring marks
generally do not respond to laser treatment.
For deep-lying spider veins in the legs, doctors typically use a long-pulsed dye laser.
EXCESSIVE HAIR
Tweezers, bikini waxes, depilatories and electrolysis are giving way to hair removal with a laser or a
pulsed-light device called Epi-Light. These approaches are much faster and far more effective.
To date, two different lasers--the long-pulsed ruby laser and the Q-switched Neodymium:YAG laser--have
FDA approval for use in hair removal. These work by targeting pigmented cells on the "bulbs" of hair follicles,
temporarily disabling the follicles but not killing them.
Treatment time varies. A woman's upper lip or chin might take a few minutes, a man's back or a woman's
legs 30 to 60 minutes.
Cost: $250 for a lip or chin... $500 for underarms... $1,000 to $1,500 for a back or legs.
Hair generally stays away for several months. The actual time depends on the individual and the body part.
A woman's underarms may not require another treatment for two years, while her bikini line may need
treatment every two months.
WRINKLES AND SCARS
With acne scars and deep wrinkles around the eyes and mouth, the carbon dioxide (CO2) laser is
supplanting dermabrasion and chemical peels.
Besides being less painful, CO2 laser surgery improves skin texture and pigmentation in a way that these
older techniques do not. It leaves skin smoother and "tighter" as well.
The region to be treated is numbed first with EMLA, and in some cases supplemented with lidocaine
injections. The patient may also be given an intravenous sedative such as midazolam (Versed).
Healing takes two weeks. With good skin care, the results should last for years.
A full-face peel runs $3,500 to $5,000. Localized peels--around just the mouth or eyes, for example--cost
about $2,500.
The CO2 laser can also be used to eliminate warts and raised scars. It can even be used to tighten droopy
eyelids.
CHOOSING A LASER SURGEON
Laser treatments should be administered only by a physician--ideally a dermatologist or plastic surgeon. For
laser surgeons in your area, contact the American Society for Laser Medicine and Surgery at 715-845-9283.
The surgeon you pick should have significant experience treating your specific problem.
Helpful: Ask to see "before" and "after" photos of other patients who have had the procedure you're
considering. If possible, speak with one of these patients.
Laser Hair Removal: The Best Solution?
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