The word LASER is an acronym formed from the first letters of the English phrase Light Amplification by Stymulated Emission of Radiation and means light amplification by stimulated emission of radiation. The light emitted by the laser is monochromatic (with the same wavelength), coherent, targeted (issued in parallel and does not tend to be rozbiegania). The laser light is transmitted through the fiber tissues. The skin is radiated with the tip kept in the hands of the operator. Laser light can be emitted in a continuous, nearly continuous and pulsed.
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Principles of operation of the CO2 laser
CO2 laser emits a laser beam of wavelength 10 600 nm, which has an affinity for water, which allows for this type of laser mainly to evaporation and coagulation of tissue. Initially, the CO2 laser used during surgery due to Its closing of tiny blood was used for tumor removal procedures, treatment of burns and bedsores. In 1993, the use of CO2 lasers have been introduced high-energy, equipped with a scanner, a short pulse, which significantly reduced the number of the most common complications - scarring.
The impact of the laser beam on the skin
A key condition for the creation of the effect of the laser light on the skin is absorbed by tissue water, resulting in conversion of Electromagnetic energy into thermal energy. The temperature rise relates to a small area of tissue covering the treated spots around. Pitch is the area of a circle whose center is part of the beam axis. Focused radius allows precise removal of tissue by cutting. In a distributed radius and less energy per area is obtained as a result of evaporation of surface skin lesions (such as viral warts, skin growths, some signs of przydatkowych, fibromas and warts).
CO2 lasers of new generation (superpulsacyjny, ultrapulsacyjny) produces pulses lasting from 250 ĩS to 1ms. This allows you to control the depth of the evaporation of the skin without damaging surrounding tissue. The advantage is the short CO2 laser pulse duration compared to the thermal relaxation time of the skin, resulting in a reduction of potential scarring and satisfactory therapeutic effect and beauty.
Dermatological Indications
Ablative laser (CO2 laser) is used in the removal of many lesions, such as:
- adenoma of sweat,
- seborrhoeic warts,
- soft fibromas,
- vessel Warts,
- viral warts,
- actinic keratosis,
- basal cell carcinoma - some figures
- genital warts ,
- nasal protuberance in the course of rosacea.
Contraindications
Absolute contraindications to surgery, laser irradiation are:
- the use of medicines to lower blood clotting,
- generalized cancer,
relative contraindications to laser ablation procedures include: the tendency to form hypertrophic scars and colloids, currently ongoing treatment isotretinoin, tan.
Side effects
Adverse reactions may be severe and rely on the occurrence of edema, erythema and pain. In the later period may develop a bacterial or viral infection. The most common side effect is staining or discoloration of the skin in place of removed lesions.
Local anesthesia
Leseroterapii ablation procedures may be preceded by the use of local anesthesia. A frequently used formulation is the anesthetic cream EMLA, which applies to the occlusion of at least 1 hour before surgery. Another type of anesthesia is local anesthetic: 1% or 2% lidocaine.
Laser removal of soft fibroma
Fibroids are small, soft uszypułowanie eruptions usually located on the skin of the neck, near the armpits, skin folds (eg, groin). Ablative laser treatment is short, painless - carried out under local anesthesia. Healing time after surgery is a few days.
Laser removal of sweat gland
Adenomas are benign sweat appendages śródnaskórkowej derived from sweat glands, conductor ekrynowych. The clinical picture is usually dominated by a number of skin color papules located on the lower eyelids. Most of the individual changes is applied to suturing surgical excision, and CO2 laser ablation is recommended in case of multiple lesions. Because the most common location on the lower eyelid, cheek, neck treatment is preceded by the use of local anesthesia. Time wound care after surgery is 2-3 days. It is recommended to avoid exposure to ultraviolet radiation and the use of preparations fotoprotekcyjnych a high protection factor sunscreen to 4 weeks after surgery.
Laser removal of seborrheic keratoses and seborrheic warts
Seborrheic keratoses are benign verrucous, lightly pigmented skin changes around the torso, back pain, facial skin, which usually occur with age. Good cosmetic results can be achieved by removing the laser ablation. Seborrhoeic warts are single, often uszypułowane changes of brown, rough surface is usually located on either side of your body, within the scalp, external genital area. During surgery, the doctor will use a local anesthetic skin lesions by laser evaporation. Wounds heal to form a scab over a period of 1-2 weeks depending on the location and size changes.
Laser removal of viral warts
Most viral warts will resolve spontaneously. CO2 laser ablation has been used to delete individual, problem (such as warts podpaznokciowe) and refractory to medical treatment changes (plantar warts, common warts of hands, flat warts).
Laser removal of actinic keratosis lesions
Ablative laser treatment of actinic keratosis lesions allows the exfoliation of the epidermis and superficial dermis in a controlled manner, while obtaining most of the clinical and histological improvement after a single treatment. The use of laser ablation is a procedure most patients who present with numerous outbreaks of keratosis. The procedure is performed under local anesthesia. The healing period is usually 1-3 weeks.
Laser removal of some forms of basal cell carcinoma
The lesions are relatively superficial nature can be treated with ablative laser therapy. In the case of patients with basal tumors ratings apply adjunctive therapy with photodynamic therapy, used in cases of superficial as well as laser ablation, in cases challenging the surgical procedure. Surgical removal is the treatment of choice when a change is large, behaves aggressively, is located in a cosmetically or functionally important areas, there is a high risk of complications.
For the treatment of superficial and micronodular form of basal cell carcinoma in difficult anatomical conditions for the operation can be applied superpulsacyjny CO2 laser. Laser treatment is performed under local anesthesia. Healing time is between 1-4 weeks depending on the location of the lesion.
Laser removal of genital warts
Therapies used to treat genital warts can be divided into invasive and noninvasive. Due to the frequent occurrence of multiple lesions and the location of the external genitalia should numb the area subjected to treatment with 1% solution of lidocaine. Exophytic changes should be evaporated completely with a 5 mm edge of the skin intact skin. In case of recurrence, further treatment should be repeated once weekly for 3 weeks.
In some cases, genital warts around the genital mucosa apply topical treatment 5% imiquimod for three weeks, 2-3 days a week. Then, after six weeks of treatment topical, it is recommended that ablative laser therapy to evaporate the remaining tissue and coagulation of the bottom changes. It is strongly recommended topical treatment 5% imiquimod for six weeks after the last laser ablation, in order to avoid recurrence.
Laser removal of rhinophyma in the course of rosacea (acne rosacea)
Tuberosities formed over many years in patients with rosacea require ablation or removal by surgical methods. The advantage of the CO2 laser is to reduce the risk of intraoperative bleeding from numerous and dilated blood vessels. The recommended technique for the treatment of rhinophyma is called. decortication, involving the evaporation of successive layers of overgrown tissue, which protects against damage to the cartilage located beneath them.
For anesthesia, the surgical field is used by infiltration of 1% lidocaine solution with 0.1% solution of adrenalin. Laser ablation laser treatment superpulsacyjnym progresses in two phases. Initially evaporated hypertrophic nodules then modeled the shape and size of the nose using a laser beam of appropriate parameters. The procedure is recommended postoperative sterile dressings with mupirocin for 7 days. Complete wound healing after 4 weeks
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