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Laser & Light Source Treatments for the Skin
Mathew M Avram, Paul M Friedman, Marc R Avram
CHAPTER 1:
Introduction to Lasers: Light—Tissue Interaction and Laser Safety
INTRODUCTION TO LASERS
Light—Tissue Interaction
Laser Safety
CHAPTER 2:
Laser and Light Treatment for Cutaneous Vascular Lesions
INTRODUCTION
PORT-WINE STAINS
Parameters
INFANTILE HEMANGIOMA
TELANGIECTASIAS
CHERRY ANGIOMAS
Parameters that may be Appropriate
SPIDER ANGIOMAS
Parameters that may be Appropriate
VENOUS LAKES
VENOUS MALFORMATIONS
SPIDER VEINS
ANGIOKERATOMAS
CONCLUSION
CHAPTER 3:
Pigmented Lesions: General Considerations and Epidermal Lesions
PIGMENTED LESIONS: GENERAL CONSIDERATIONS
Discrete Pigmented Lesions
New on the Horizon: Picosecond Laser
Diffuse Pigmentation
Nonablative Fractional Resurfacing
Intense Pulsed Light
CONCLUSION
CHAPTER 4:
Tattoos, Melasma and Dermal Pigment
INTRODUCTION
TATTOO REMOVAL
Laser Principles
Wavelength Selection
Pulse Duration Selection
Alternative Treatments
Clinical Principles/Consultation
Tattoo Types
Tattoo Color
Contraindications
Treatment Details
Anesthesia
Endpoint
Post-treatment Care
Number of Treatments Needed
Treatment Complications
Future Directions in Tattoo Removal
DERMAL PIGMENT
Melasma
Treatment Principles
Fractional Lasers
QS Laser
Intense Pulsed Light
NEVUS OF OTA AND OTHER DERMAL MELANOCYTOSES
Treatment Principles
CHAPTER 5:
Laser Hair Removal
INTRODUCTION
THE HAIR FOLLICLE
Hair Anatomy
Hair Growth
Hair Types
Hair Color
Classification of Excess Hair
MECHANISM OF LASER HAIR REMOVAL
KEY FACTORS IN OPTIMIZING TREATMENT
Patient Selection
Informed Consent
Preoperative Preparation and Laser Safety
Device Variables
Wavelength
Fluence
Pulse Duration
Spot Size
Skin Cooling
Postprocedure Care
Long-term Efficacy
Complications
CONCLUSION
Future Directions
Advances in Pain Control
Home Use Laser and Light Source Devices for Hair Removal
Alternative Technologies for Hair Removal
Acknowledgments
CHAPTER 6:
Laser and Light Therapy for Acne Vulgaris
INTRODUCTION
LASERS
Vascular Selective Lasers
Mid-infrared Lasers
NONCOHERENT LIGHT SOURCES
Narrow-Band Light Sources
Intense Pulsed Light Sources
Photodynamic Therapy
LIPID SELECTIVE LIGHT: TOWARDS A TRUE SEBACEOUS GLAND SELECTIVE LASER
CONCLUSIONS
CHAPTER 7:
Introduction to Laser Skin Resurfacing
INTRODUCTION TO LASER RESURFACING
RESURFACING LASERS: EVOLUTION AND MECHANISM OF ACTION
Ablative Resurfacing
Nonablative Resurfacing
Fractionated Resurfacing
CLINICAL INDICATIONS
Facial Aging
Atrophic Scars
Epidermal and Dermal Lesions
PATIENT SELECTION AND PREPARATION
LASER SAFETY AND OPERATIVE TECHNIQUE
Safety
Technique
POSTOPERATIVE MANAGEMENT
COMPLICATIONS
CONCLUSION
CHAPTER 8:
Nonablative Fractional Resurfacing
INTRODUCTION
PATIENT SELECTION AND PREPROCEDURE INSTRUCTIONS
CLINICAL INDICATIONS AND OUTCOMES
RHYTIDES
PHOTOAGING: DYSCHROMIA, LENTIGINES, SKIN TEXTURE RESURFACING AND TIGHTENING
MELASMA
OTHER PIGMENTARY AND VASCULAR DISORDERS
Poikiloderma of Civatte, Nevus of Ota/Ito, Minocycline-Induced, Postinflammatory Erythema and Hyperpigmentation
SCARS: ACNE SCARRING, HYPOPIGMENTED, HYPERTROPHIC, BURN, SURGICAL
STRIAE DISTENSAE/RUBRA/ALBA
BENIGN SKIN NEOPLASMS AND DEPOSITION DISORDERS
Syringomas, Dermatosis Papulosa Nigra, Xanthelasma, Colloid Milium
PRECANCEROUS LESIONS
Actinic Cheilitis, Actinic Keratoses, Disseminated Superficial Actinic Porokeratoses
GRANULOMA ANNULARE
RESIDUAL HEMANGIOMAS
POSTPROCEDURE CARE AND COMPLICATIONS
WHAT LIES AHEAD: THE FUTURE OF FRACTIONAL PHOTOTHERMOLYSIS
CHAPTER 9:
Ablative Fractional Resurfacing
INTRODUCTION TO ABLATIVE LASER RESURFACING
INTRODUCTION TO FRACTIONAL LASER RESURFACING
INTRODUCTION TO ABLATIVE FRACTIONAL LASER RESURFACING
RHYTIDES
PHOTOREJUVENATION
Pigmentation Changes (Lentigines, Dyschromia, Skin-tone Irregularities) and Epidermal Dyspigmentation
Textural Changes (Skin Laxity, Pore-size and Solar Elastosis-related Textural Changes)
SCARS
KERATOSES AND OTHER EPIDERMAL LESIONS
OTHER INDICATIONS
CONTRAINDICATIONS
NOVEL APPLICATIONS AND POSSIBILITIES
CONCLUSION
SUMMARY
Indications
Advantages
Disadvantages
CHAPTER 10:
Photodynamic Therapy
INTRODUCTION
HISTORY
MECHANISM OF PHOTODYNAMIC THERAPY
Photodynamic Therapy Mechanism of Action
Topical Photosensitizers: Aminolevulinic Acid and Methyl Aminolevulinate
Light Irradiation
Light Sources
CLINICAL APPLICATIONS IN GENERAL DERMATOLOGY
Actinic Keratoses
Background
Treatment Options for Actinic Keratoses
Advantages/Disadvantages of Aminolevulinic Acid-Photodynamic Therapy for Actinic Keratoses
Treatment Results of Aminolevulinic Acid- Photodynamic Therapy for Actinic Keratoses
Blue Light
Green Light
Yellow-Orange Light: Pulsed-Dye Laser
Red Light Sources
Intense Pulsed Light
Treatment Results of Methyl Aminolevulinate-Photodynamic Therapy for Actinic Keratoses
Combination Therapy for Actinic Keratosis Treatment
Treatment Protocol
Skin Preparation
Incubation Time
Light Sources
Patient Comfort and Photoprotection and Follow-Up
Clinical Technique
Aminolevulinic Acid-Photodynamic Therapy for Actinic Keratoses
Nonmelanoma Skin Cancer
Bowen's Disease/Squamous Cell Carcinoma
Superficial Basal Cell Carcinoma
Nodular Basal Cell Carcinoma
Unique Patient Populations
Aminolevulinic Acid-Photodynamic Therapy for Squamous Cell Carcinoma in Situ and Superficial Basal Cell Carcinomas
Acne Vulgaris
Photodynamic Therapy with Blue Light
Photodynamic Therapy with Intense Pulsed Light
Photodynamic Therapy with Pulsed-Dye Laser
Photodynamic Therapy with Red Light Sources
Adverse Reactions and Summary of Findings for 5-Aminolevulinic Acid and Methyl Aminolevulinate-Photodynamic Therapy for Acne Vulgaris
Aminolevulinic Acid-Photodynamic Therapy for Acne
CLINICAL APPLICATIONS IN COSMETIC DERMATOLOGY
Photorejuvenation
Definition of Photoaging
Light Sources in Aminolevulinic Acid- Photodynamic Therapy Photorejuvenation
Treatment Results of Aminolevulinic Acid-Photodynamic Therapy and Methyl Aminolevulinate-Photodynamic Therapy in Photorejuvenation
Photodynamic Therapy with Blue Light
Photodynamic Therapy with Red Light
Photodynamic Therapy with Intense Pulsed Light
Photodynamic Therapy with Pulsed-Dye Laser
Combination Therapy for Photorejuvenation
Summary of Findings for ALA-PDT in Actinic Keratoses Treatment and Photorejuvenation
Aminolevulinic Acid-Photodynamic Therapy for Photorejuvenation
PRACTICAL CONSIDERATIONS IN PHOTODYNAMIC THERAPY
Patient Selection for Aminolevulinic Acid-Photodynamic Therapy
Exclusion Criteria
Safety, Adverse Effects and Complications of Photodynamic Therapy
CONCLUSION
CHAPTER 11:
Intense Pulsed Light
INTRODUCTION
VARIOUS DEVICE MODELS AND DEVICE MODIFICATIONS
PIGMENTED LESIONS
VASCULAR LESIONS
PHOTOREJUVENATION
HAIR REMOVAL
PHOTODYNAMIC THERAPY
ACNE
OTHER
COMPLICATIONS
WHAT'S NEW?
CONCLUSION
CHAPTER 12:
Noninvasive Skin Tightening and Body Contouring
INTRODUCTION
DETERMINING YOUR PATIENT'S CURRENT STATUS AND TREATMENT GOALS
PHYSICAL TREATMENT OF FAT AND CELLULITE
Noninvasive Devices
Radiofrequency Devices
Ultrasound Devices
Lasers and Light Sources
Cryolipolysis
CONCLUSIONS
SUMMARY
CHAPTER 13:
Laser Treatment in Asians
INTRODUCTION
LASER FOR THE TREATMENT OF CONGENITAL PIGMENTARY CONDITIONS
Café au lait Patch (Figs 13.1A and B)
Becker's Nevus (Figs 13.2A and B)
Melanocytic Nevi (Figs 13.3A and B)
Nevus of Ota (Figs 13.4A and B)
LASER AND LIGHT SOURCES FOR THE TREATMENT OF ACQUIRED PIGMENTARY CONDITIONS
LASER AND INTENSE PULSED LIGHT TREATMENT FOR FRECKLES AND LENTIGO (FIGS 13.5 AND 13.6)
MELASMA (FIGS 13.7 AND 13.8)
ACQUIRED BILATERAL NEVUS OF OTA-LIKE MACULES (ABNOM OR HORI'S MACULES)
LASER TREATMENT OF VASCULAR LESIONS IN ASIANS (FIGS 13.10A TO D)
ABLATIVE, NONABLATIVE AND FRACTIONAL SKIN RESURFACING (FIGS 13.11 AND 13.12)
CONCLUSION
CHAPTER 14:
Lasers and Energy-Based Devices for the Consumer: The Future of Esthetic Energy-Based Devices
INTRODUCTION
OVERVIEW OF OFFICE-BASED ESTHETIC LASERS AND ENERGY-BASED DEVICES
DEVICES DEVELOPED FOR HOME USE
Hair Removal
Tria
Home Skinovations
Remington/Shaser
Syneron/Candela (Irvine, CA)
Other Notable Hair Removal Devices
Acne Treatment
Individual Lesion Devices
Zeno
Therma Clear
No!No! Skin (PhotoMedex, Radnor, PA)
Claro
Large-Area Devices
Clear-U
Tanda Clear
Tria
Other Panel-Based Devices
Skin Rejuvenation
Fractionated Lasers
PaloVia
Other Notable Fractionated Lasers
Nonfractionated Lasers
OTHER APPLICATIONS (Fig. 14.5)
THE FUTURE
INDEX
TOC
Index
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