Erasing skin marks with lasers - includes related article on medical use of lasers - Cover Story

FDA Consumer, March, 1992 by Ricki Lewis

So far, only blacks have been reported to be affected, and their skin responses range from redness and mild pigmentation, to dark coloration, to the appearance of nodules. Although the CO, laser is now the only one used on these blemishes, Smith suggests that a ruby laser may work even better, considering the recently reported success of this type of laser in removing tattoos.

Tattoos Skidoo

Since 6000 B.C., people have had their skin tattooed--and then later regretted it. Unfortunately, treatments to remove the marks often marred the skin further. Ronald Wheeland and co-workers of the University of California at Davis reported in the December 1990 Journal of Dermatological and Surgical Oncology that a preliminary study indicated treatment with a ruby laser to remove tattoos is "vastly superior" to standard methods, such as dermabrasion and surgical removal.

The ruby laser works much the way the pigmented lesion laser does, and also feels like a rubber band snap. The laser light is absorbed by melanin and the carbon-based pigments used in tattoos. The skin initially turns white for 10 to 20 minutes, then swells and turns red, feeling like a sunburn. Although the skin stays red for one to three weeks, healing takes 10 to 14 days, and fading continues for months. There are no open wounds. The researchers treated 163 tattoos on 80 patients and found that black and blue tattoos more than 10 years old responded best to the treatment.

The success of laser surgery in treating benign skin lesions has encouraged many people to seek help who would otherwise have relied on disguising or hiding their blemishes. Lasers have also helped thousands of others who were unhappy with the results of more traditional treatments. In the future, this kind of laser surgery may become more common for an increasing number of people with problems that are more than skin deep.

Ricki Lewis, a writer in Scotia, N. Y., teaches biology at the State University of New York at Albany.

Laser Basics

Since the mid-1960s, lasers have proven to be powerful surgical tools. The word "laser" is actually an acronym for "light amplification by stimulated emission of radiation," which means that the intense and narrow beam of light is of one wavelength. Ordinary "white" sunlight, in contrast, is a continuum of light of many wavelengths, corresponding to the colors of the spectrum plus the infrared (heat) and ultraviolet wavelengths that sandwich them.

A medical laser device includes a source of electricity, mirrors to direct the beam, a crystal or gas that is stimulated to emit the light, and tubing to deliver the energy. Design of the instrument is tailored to specific uses.

"The diameter of the light beam is picked to match the diameter of the area to be treated," says Joel M. Noe, M.D., assistant professor of plastic and reconstructive surgery at Harvard Medical School. "For example," he explains, "to treat a blood vessel 1 millimeter in diameter, you would use a 1-millimeter handpiece. If the target is a group of vessels, you would use a larger diameter handpiece."