Introduction:
Laser therapy has been beneficial in the treatment of various conditions in the medical field. In addition, its use in cosmetology is trending due to technological advancements. However, like any therapy with pros and cons, laser therapy also showcases specific effects on the body due to excessive exposure to high-energy lasers.
How Do Lasers Work?
The lasers work on the skin through a process called photothermolysis. The laser, with a particular wavelength depending on the skin color being treated, is exposed to the skin, which causes the lysis of skin cells in the area by generating heat. Various lasers are used for different skin conditions to choose the correct wavelength of the laser beam for the procedure.
What Are the Uses of Lasers in Cosmetology?
There are several types of lasers used for various applications, such as,
-
To treat fine lines and wrinkles.
-
Skin tightening.
-
To treat pigmented lesions.
-
To treat vascular lesions.
-
To treat precancerous lesions.
-
Tattoo removal.
-
To treat acne and acne scars.
How Do Lasers Damage the Skin?
The skin has a greater surface area than the eye, and the chance of laser exposure is more. This is because the most penetrating wavelength of light is 700 to 1200 nm. Therefore, during the application, a feeling of heat is experienced in the area, preventing injury. However, skin damage is not considered more significant as the effects are temporary. But it is not the same in the case of high-powered lasers.
Epidermal Effects:
-
The micro-injuries caused during laser tattoo removal and laser resurfacing should be taken proper care of, if not would lead to scarring, infection, and erythema.
-
Following laser therapy using carbon dioxide and erbium lasers for facial rejuvenation would lead to complications such as pain, infections, erythema, scarring, delayed healing, hypopigmentation, hyperpigmentation, contact dermatitis, and vascular proliferation.
-
Pulsed dye laser therapy would lead to adverse effects such as pain, crusting, purpura, dermatitis, scarring, and blisters.
Effects on Cell Function: The organelle that shows the early effects of laser radiation is the mitochondria. Changes in the mitochondria would lead to a series of events in the cells leading to the synthesis of proteins, nucleic acids, and enzyme activation. In addition, it causes increased proliferation of cells, migration of cells, and production of growth factors and inflammatory mediators. These events would eventually lead to the dysregulation of cell functions. Furthermore, it also alters cellular metabolism.
Thermal Effects:
-
A high-energy laser beam exposed for an extended time would lead to thermal burns.
-
Carbon dioxide and infrared lasers most commonly result in thermal burns as they can penetrate the skin deeper.
-
The degree of burns is of three types, the first degree shows reddening of the skin, the second degree shows blistering, and the third-degree shows charring of the skin.
-
Thermal burns are commonly encountered in photosensitive individuals or under medications that induce photosensitivity.
-
Thermal damage caused by high-powered lasers can lead to necrosis of the site by the denaturation of protein and collagen.
What Are the Effects of Exposure to High-Energy Lasers?
The complications of laser radiation can be short-term, medium-term, and long-term.
Short-Term Complications
-
Erythema: Redness at the site may appear immediately after the procedure, which resolves in an hour or a day. But in the case of non-ablative and ablative skin resurfacing, the redness may persist for a week or so. Individuals with sensitive skin are more prone to redness of the skin.
-
Edema: Similar to erythema, swelling takes a long time to resolve after a skin resurfacing procedure. Localized edema is noticed in treating areas above the eyebrow and below the eyes. The edematous area might worsen after two days of the procedure. Edema is often seen after full-face treatments with pulsed-dye lasers.
-
Infection: Skin infections after a skin laser treatment are common. So most dermatologists would recommend an oral antibiotic after the treatment. Susceptibility to infection is the main reason for avoiding laser treatment in immunosuppressed individuals. In addition, there are chances of recurrence of herpes simplex infection if the individual undergoing laser treatment has a recent history of herpes infection.
Medium-Term Complications
-
Hyperpigmentation: Postinflammatory hyperpigmentation is the most common immediate complication after laser exposure. It is more common in dark-skinned individuals. The hyperpigmented areas can be treated using bleaching creams and sunscreens. But later, the pigmented areas will recede completely or might leave a line of demarcation.
-
Hypopigmentation: The appearance of hypopigmented areas is less common after laser treatment. It can be due to severe injury to melanocytes. The standard procedures leading to hypopigmentation are carbon dioxide resurfacing, dermabrasion, and chemical peels. In some cases, it can resolve entirely, but in some, it can be permanent.
-
Burns: During an ablative laser resurfacing procedure, burns are common. The best way to treat it is the application of ice on the area, steroids, and emollient application.
Long-Term Complications
-
Indentation: Textural abnormalities after laser application can sometimes resolve but, in some cases, can form deep indentations. They most commonly occur in areas around the eyes and forehead. Sometimes, an indentation may be more profound than minimally invasive methods cannot treat.
-
Scarring: The ablation of skin during the procedure can lead to the proliferation of stem cells to compensate for the lost keratinocytes, which is the main reason for scarring. If the scars are small, you can hide them with makeup. However, if the scars are large, then a series of pulsed-dye lasers will be required to diminish the scar.
-
Ocular Damage: Laser exposure can lead to ocular injuries damaging the cornea, retina, and vitreous humor. It can be minimized by proper protection before starting the procedure.
Who Is Not Indicated for the Use of Lasers in Cosmetology?
The use of lasers for cosmetology procedures is not indicated if there are any of the following conditions.
-
Pregnancy.
-
Lactation.
-
Skin lesions.
-
Chronic renal failure.
-
Low blood clotting.
-
Mental illness.
-
Under any antibiotics.
Conclusion:
To avoid disappointment in the individual after laser therapy due to its complications, the individual should be explained the benefits, risks, and difficulties that might result from treatment. And before opting for the treatment, it is better to measure the balance between the benefits and side effects of the procedure to avoid unnecessary complications.
