As of March 20, 2020 we are no longer seeing patients in our office due to COVID-19. We are happy to continue caring for you during these uncertain times. We are now offering remote appointments for new and established patients although we will no longer be able to see you in person. For some patients, an in person visit is best, but if you feel that your concern could be addressed online, this may be a convenient option for you.
There are many lasers available for physicians to treat different skin concerns. Lasers can be used for: wrinkles, brown spots, broken blood vessels, red marks, tattoos, hair removal, rosacea, acne, acne scars, skin tightening and fat reduction.
Not every laser is the same. For some skin conditions multiple laser treatments may be needed. Depending on the type of laser used, the recovery time can vary greatly. Some lasers will leave you just slightly pink for less than an hour while other lasers make you very red for over a week. Be sure to ask your dermatologist about the number of treatments needed, the recovery time and what type of results to expect.
Additionally, if you are prone to getting cold sores, you should let your provider know so that they can prescribe medication to prevent these from coming out after a treatment is done close to the lips and mouth. Some lasers feel like a snap against the skin whereas others feel like a warm pinch. During laser treatments you will be given protective glasses to wear to protect your eyes from the laser beam.
There are many brands of fractionated non-ablative lasers available to dermatologists. Common brands you may have heard of are Fraxel and the 1540nm XD Optic Icon Laser.
These lasers work best to treat textural problems such as acne scars, fine lines and wrinkles. They also work well for brown discoloration and can treat symptoms associated with melasma. Additionally, fractionated non-ablative lasers can work to reduce the appearance of stretch marks. Any part of the body can be treated with this laser, but it is most commonly used on the face.
With this laser, 4-6 treatments are usually required to achieve the results desired. The actual treatment only takes a few minutes in office, though most patients will arrive to the office early to use a numbing cream for approximately 1 hour prior to treatment to make the procedure more comfortable.
Patients usually experience redness on average for 2-3 days after treatment, however there is no peeling or bleeding of the skin. Immediately after treatment, the skin may feel as though it is sunburned, but this sensation usually subsides within 1 hour. Some patients will experience a temporary flare of acne after treatment, but this only occurs in 5% of patients and quickly resolves.
The pulse dye laser (PDL) has been around for many years and and is the gold standard of lasers to help “get the red out”. PDL can be used for the treatment of many skin conditions that are red in color on any part of the body. Treatment of flushing, small broken blood vessels (telangiectasias), angiomas, and port wine stains is very common and successful. PDL can also be used to treat the redness associated with rosacea.
While pills and creams can help with the pimples of rosacea, PDL can drastically improve the appearance of the associated redness and flushing. Additionally, PDL can be used to effectively treat a type of acne scarring called post-inflammatory erythema, a type of scarring that occurs after acne has healed and small red marks are left behind. Treatment in office is quick and hardly painful. Often, no numbing cream is used prior to treatment.
Patients describe the feeling of the laser on the skin as being snapped with a small rubber band. Patients will wear protective goggles during treatment, however they still may be able to detect a bright flash of light. Depending on what is being treated, more than one session may be required to achieve desired results, usually spaced out monthly. For a few days to one week after treatment, the treated area will look red. In some cases, patients will experience purplish bruising, and in the face, there can be swelling. Like any bruise, this will resolve in 1-2 weeks. Ice packs help drastically reduce the amount of swelling and soothe the skin.
There is no pain associated with treatment after leaving the office, just a slight sensation of stinging in some patients for a short time afterward which also quickly resolves.
There are many types of Q-Switched lasers available to physicians today. They are all intended for the purpose of minimizing the appearance of pigmented lesions in the skin. This includes freckles, sun spots, age spots, brown spots, melasma, and some birthmarks. It can also effectively be used for tattoo removal as well.
The laser works by breaking up the pigment into smaller fragments which are then able to be naturally cleared away from the body. The Q-Switched lasers are a safe and more gentle alternative to some of the more invasive skin resurfacing procedures. The laser energy will feel like tiny warm snaps on your skin, but is tolerable and though mostly unnecessary, numbing creams can be used to minimize discomfort if desired.
Numbing medicine is always used for those undergoing tattoo removal. A mild to moderate irritation of the overlying skin is to be expected for a few days to a week, depending on the depth and amount of pigment to be removed. Usually only one to two treatments are needed to improve pigmented lesions. Tattoo removal requires many more sessions and varies greatly from patient to patient but an average of 6-10 treatments may be needed.
Intense pulsed light is grouped here under lasers, but although many refer to it as such, it is technically a light device and not a laser. The specific device we have in our office is the Icon MaxG. IPL is used to improve sun damage (photo damage), brown spots, and red spots. Any part of the body can be treated, but we most commonly see success with treating the face, chest, and backs of hands.
The best time to treat these areas is when the patient does not have an ongoing sun tan, as doing IPL on top of a sun tan can result in complications. During treatment, the patient’s eye are protected using metal goggles. Because the light is so bright, patients will still describe detecting the flash of light. A cold, clear gel is applied to the skin prior to treatment to make the procedure more safe and comfortable. On the chest, the pain associated with treatment is minimal. On more sensitive areas of the face and body, a topical numbing cream can be applied to minimize discomfort.
It takes about 10 minutes to treat a full face, and about the same for the chest. After treatment, the area may appear pink which can last anywhere from 1 day to several days depending on how sensitive your skin is. Some patients will experience swelling on the face, so ice packs can be used immediately after treatment to reduce this. When brown spots are treated, they will look darker for 1-2 weeks before fading. With IPL, more than one treatment is almost always needed.
Our goal here at The Dermatology of Institute of Boston is protect the health of our patients and staff. To continue caring for our patients during these uncertain times, while strictly adhering to the guidelines set by the CDC, we will be only offering virtual consultations. For some patients, an in person visit is best, but if you feel that your concern could be addressed online, this may be a convenient option for you.