CHAPTER 38: CUTANEOUS LASER SURGERY Flashcards
emit a beam of light whose output power is constant over time, resulting in a long, continuous exposure.
Continuous-wave lasers
Shutter the continu- ous beam into short segments, producing interrupted emis- sions of constant laser emission.
Quasi–continuous-wave lasers
produce short, high-energy pulses of light.
Pulsed lasers
are able to generate extremely high-energy pulses over very short (nanoseconds or picoseconds) pulse durations and are used primarily for treating pigmented lesions.
Q-switched (quality-switched) lasers
It is The target structures that absorb laser light , with the most common in the skin being water, hemoglobin, and melanin
chromophores
is an extremely useful instrument for the treatment of vascular lesions. These lasers have traditionally been used for port wine stains, telangiectasias, erythematotelangiectatic rosacea, and hemangiomas.
pulsed dye laser (PDL)
is the treatment of choice for port wine stains.
pulsed dye laser (PDL)
are suited to treatment of individual telan- giectasias of the face, cherry angiomas, and small spider angio- mas.
potassium titanyl phosphate (KTP) laser
are best used for larger and deeper vessels, such as large-vessel venous malformations, vascular blebs in port wine stains, blue reticular veins, venous lakes, and lower extremity spider veins
Long-pulsed laser
include the alexandrite (755 nm), diode (800 nm, 940 nm), and neodymium:yttrium-aluminum-garnet (Nd:YAG; 1064 nm).
although technically not a laser, uses a flashlamp that emits a noncoherent broad spec- trum of light (400–1200 nm) at various pulse durations and intervals
used for the treatment of facial telangiectasia and rosacea.
intense pulsed light (IPL)
are used to treat epidermal pigmented lesions and tattoos.
the target chromophore is the melanosome.
Q-switched lasers
are hyperpigmented macules composed of an increased number of basal melanocytes.
Lentigines
used to treat solar lentigines and those associated with certain syndromes (e.g., Peutz-Jeghers),
Café au lait macules and Becker’s nevus,
Nevus of Ota and nevus of Ito
Q-switched lasers
tx for melasma
First-line treatment includes strict sun protection, discontinu- ing any offending systemic medication, and the use of topical agents such as **hydroquinone and retinoids. **
Laser treatment is often ineffective
laser tx for the ff tattoo:
Traumatic, Amateur black, professional black and blue tattoo:
green, red, yellow, violet, red, and flesh tattoo:
**Traumatic, Amateur black, professional black and blue tattoo: **
QS ruby;
QS alexandrite;
QS Nd:YAG (1064 nm)
green, red, yellow, violet, red, and flesh tattoo:
QS Nd:YAG (532 nm)
Hair removal lasers target the *________
, and given the size of the target chromophore, longer pulse durations are required to generate enough heat to damage the bulbar stem cells.
melanin within the follicle
emits an invisible infrared beam of 10,600 nm and can be used in continuous-wave or superpulsed mode
effective for the treatment of actinic damage and photoaging, large plantar and peri- ungual warts
for refractory keloids.
xanthelasma, rhinophyma, and syringomas.
actinic cheilitis and superficial basal and squamous cell carcinomas.
CO2 laser
emits an invisible near-infrared beam of 2940 nm, resulting in significantly more efficient absorption by water (16 times) and a more explosive ablative effect than with the CO2 laser.
The decreased thermal injury and collagen ablation is an advan- tage for treatment of scars, photodamaged skin, rhytids, and rhinophyma
Erbium:yttrium-aluminum-garnet laser
or
Er:YAG laser
an ablative laser is adminis- tered in a pixilated pattern over a grid. These lasers created small columns of thermal injury, or microthermal zones (MTZ), which are separated by areas of untreated skin.
for acne scars, residual hemangioma residuum, and pigmentary disor- ders. such as melasma
fractional photothermolysis or
Fractional resurfacing
