Diseases and Conditions

Laser Surgery for Lesions and Skin Conditions

There are many different types of lesions and skin conditions that can be treated with laser surgery. Your doctor will decide if you are a candidate for the particular surgery. The following is a brief overview of some of the skin conditions that can be treated with laser surgery:

  • Port-wine stains. Port-wine stains are congenital (present at birth) capillary malformations. The color of this birthmark is usually pink, red, or purple. About 0.3% of children are born with port-wine stains. As the child grows, the mark may become darker. Port-wine stains can appear on any part of the body and can vary in size.

    A pulsed dye laser is a type of laser that has a high electric lamp that produces a short, high-energy flash of light. The light is colored when it passes through a dye. The color of the dye can be changed, depending on the type of pigmented skin spots that are being treated. Pulse dye laser is the laser of choice for port wine stains. Adults may have this procedure performed on an outpatient basis with only local anesthesia. Children or people with large port-wine stains, may be treated under general anesthesia. Multiple treatments may be necessary.

  • Hemangiomas. Hemangiomas are a common type of vascular birthmark. About 10% of whites have hemangiomas. Hemangiomas may vary in appearance, from red, raised patches to deeper, purple areas. Hemangiomas usually appear within the first month of life, grow rapidly for the first year, and may start to go away by the time the child is 5 years old. In fact, 50% of hemangiomas become smaller naturally by age 5. Hemangiomas are either superficial or deep. Surgery, injections into the hemangioma, or an oral medicine called propranolol may be used for large or growing hemangiomas, or hemangiomas that are causing problems because of their location. Multiple treatments may be necessary.

  • CafĂ© au lait macules. These are tan-colored lesions that may appear anywhere on the body. The size of the lesions varies. Some of the lesions can be very large, and cosmetic removal may be desired. Recurrence is common.

  • Telangiectasias. Telangiectasias are small blood vessels that are located under the surface of the skin. The vessels may appear red, purple, or blue. The most common places these are seen include the face, upper chest, and neck. Related vessels can be found in the legs, called spider veins. Removal is usually for cosmetic reasons.

    There are many causes of telangiectasia. These include heredity, sun damage, hot and spicy foods, emotions, hormones, some medicines, and rosacea. Treatment of these lesions may include lasers or sclerotherapy. Sclerotherapy is a procedure in which a small needle is used to inject medicine into the vessels. This causes them to shrink. New vessels may continue to develop throughout the person's life. It depends on what caused the lesion to form. KTP and pulse dye lasers are commonly used on the face. 

  • Wrinkles. The use of lasers to help remove wrinkles is one of the great advances in cosmetic plastic surgery. The term used to describe this procedure is a laser peel. This type of wrinkle removal process is safer than other methods of wrinkle removal when performed by an experienced surgeon. There is less of a chance of scarring, swelling, and crusting with the laser peel. Newer lasers have fewer side effects and a shorter recovery period. Prior to the actual surgery, your health care provider may prescribe facial medicines for you to use to help prepare your skin. These medicines may be used for 4 to 6 weeks before the laser peel. After the laser peel, your health care provider will explain proper skin care to prevent crust formation and infection. Many different types of lasers may be used for laser peels.

  • Warts. Warts are growths of skin or membrane that are not malignant (cancerous). Warts are caused by the human papilloma virus and are often hard to destroy. Many different types of treatments have been used for wart removal. These include surgical removal, application of medicines to the wart, or freezing the wart. As a result of the side effects of these treatments, use of the laser has become acceptable. Multiple treatments may be necessary until the wart is gone. Pulsed dye lasers, carbon dioxide lasers, and Q-switched lasers have been shown to be effective for certain warts.

  • Scars. Scars may be formed for many different reason. These include infections, surgery, injuries, or inflammation of tissue. A scar is the body's natural way of healing and replacing lost or damaged skin. Scars may appear anywhere on the body. The makeup of a scar may vary. The scar may be flat, lumpy, sunken, colored, painful, and/or itchy. Scars may be treated with a variety of different lasers. This depends on the underlying cause of the scar. Lasers may be used to smooth a scar, remove the abnormal color of a scar, or flatten a scar. Most laser therapy for scars is performed in conjunction with other treatments, like injections of steroids, use of special dressings, and the use of bandages. Multiple treatments may be necessary.

  • Tattoo removal. There are several types of tattoos: decorative tattoos, which are placed for decorative purposes; cosmetic tattoos, which are known as permanent cosmetics, like permanent eyeliner or lipstick; traumatic tattoos, which are a result of a trauma that embeds a foreign substance, like dirt, in the skin; medical tattoos, like those placed by a health care provider as landmarks for radiation therapy; and amateur tattoos, done by individuals on themselves or by nonprofessionals. There are many factors that determine the outcome of laser surgery on removing tattoos. These include the patient's age, skin type, type of tattoo, age of the tattoo, color of the tattoo, and size and depth of the tattoo. Also whether the tattoo was performed by a professional or an amateur. Some ink colors may be completely resistant to laser treatment. Laser removal of tattoos breaks up the color without damaging normal skin. The body then absorbs the pieces of pigment without leaving a scar unlike previous tattoo removal methods. Multiple treatments may be necessary.

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