Innovations in dermatologic laser therapy

Dermatologic laser therapy is a rapidly-changing field with many new innovations. One of the most important is the introduction of fractional photothermolysis. This method is established for skin rejuvenation and acne scars; both the original non-ablative devices and newer ablative ones are available. While its side effects and the patient's downtime are considerably less than with ablative skin resurfacing, its efficacy is much better than non-ablative laser skin rejuvenation. This approach is also effective for melasma and other forms of hyperpigmentation in some patients. Successful reports exist also for treating other, more infrequent dermatoses. Another new procedure is laser lipolysis. It can be used as an adjunct to classical liposuction or as laser lipolysis alone. Fat lysis is achieved by laser energy via fibers that are inserted in the subcutaneous fat, and the additional heating of dermal tissue may lead to the reduction of side effects such as bleeding and to reduction of skin laxity. Nevertheless, the superiority of laser lipolysis to classical liposuction techniques is not yet established, and the ideal wavelengths and treatment parameters are not yet fully clear. There have been improvements in the therapy of vascular lesions, especially the use of longer, infrared wavelengths. In addition, there is early information on experimental therapeutic approaches for diseases normally not amenable to laser therapy such as onychomycosis, hemorrhoids and allergic rhinitis.