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 percent 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 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. 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 percent of Caucasians 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 percent of hemangiomas become smaller naturally by age 5. Hemangiomas are either superficial or deep. Surgery or medication may be indicated for large or growing hemangiomas, or hemangiomas that are causing problems because of their location. Multiple treatments may be necessary.
- Café au lait macules. These are tan-colored lesions that may appear anywhere on the body. The size of these lesions varies. Some of these 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, including heredity, sun damage, hot and spicy foods, emotions, hormones, some medications, and adult acne. Treatment of these lesions may include lasers or sclerotherapy. Sclerotherapy is a procedure in which a small needle is used to inject medication into the vessels, causing them to shrink. New vessels may continue to develop throughout the person's life, depending on the underlying cause of the lesions.
- 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. Prior to the actual surgery, your doctor may prescribe facial medications for you to use to help prepare your skin. These medications may be used for four to six weeks prior to the laser peel. After the laser peel, your doctor 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, including surgical excision, application of medications to the wart, or freezing the wart. As a result of the side effects of these treatment modalities, use of the laser has been warranted. Multiple treatments may be necessary until the wart is gone.
- Scars. Scars may be formed for many different reasons, including 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 composition 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, depending 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 such as 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, such as permanent eyeliner or lipstick; traumatic tattoos, which are a result of a trauma that embeds a foreign substance, such as dirt, in the skin; medical tattoos, such as those placed by a doctor 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 to remove tattoos. These include the patient's age, skin type, type of tattoo, age of the tattoo, color of the tattoo, size and depth of the tattoo, and 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 as previous tattoo removal methods did. Multiple treatments may be necessary.
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