Advancements in Laser Technology

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In this interview, Dr Jessica Labadie discusses cutting-edge advances in laser technology used in dermatology, providing an in-depth look at these devices. She notes safe practices, patient-centric care, continuous learning, and the transformation of the medical field with the advent of this technology, creating a significant impact on the lives of patients.

The Dermatologist: Can you provide an overview of the new developments in laser technology within the eld of dermatology and how these advancements have improved patient care and outcomes?
Dr Labadie: There are recent developments that enhance the dermatologist’s toolbox, offering noninvasive treatments for photo rejuvenation, skin discoloration, acne, scarring, wrinkles, and sunspots. Noteworthy lasers in the market include the 1726-nano-meter lasers targeting sebum to treat acne, such as AviClear and Accure, US Food and Drug Administration (FDA) approved for severe acne vulgaris. Additionally, there is a new energy-based device called Ellacor, a micro-coring device promoting scarless healing, collagen production, and tightening. Another significant addition is the 2910-nanometer Acclaro laser, UltraClear, which specializes in resurfacing treatments.

Regarding how these advancements have improved patient care, the field of lasers and energy-based devices is dynamic and evolving for the better. These technologies are becoming more advanced, safer, and efficient, resulting in enhanced treatments with a potential reduction in required sessions. Importantly, these innovations expand the patient population that we can effectively treat. All these devices are approved for diverse skin types and various conditions.

The Dermatologist: Can you discuss the range of skin conditions or concerns that lasers can effectively treat?
Dr Labadie: When we refer to lasers, we encompass both lasers and energy-based devices. These technologies, including microneedling and radiofrequency, address FDA-approved on-label indications like brown spots, scarring, acne scarring, photo rejuvenation, tightening, redness, port wine stains, hemangioma, and laser hair removal. Off-label uses include laser-assisted drug delivery, treating wrinkles differently, delivering topical anesthesia, and unique approaches to skin cancer prevention. The field is expansive and evolving rapidly.

The Dermatologist: Are there any conditions that have seen particularly remarkable results with the use of lasers?
Dr Labadie: Absolutely. Laser treatments can be life-changing when used correctly. Notable examples include treating port wine stains and hemangiomas with pulsed dye lasers, even on infants. Laser treatments for acne scarring can significantly improve the appearance and function of the skin over time. Addressing brown spots with nonablative fractional devices can not only enhance cosmetic appearance but also prevent and treat pre-skin cancer.

The Dermatologist: How do you determine which type of laser treatment is most suitable for a specifc patient or condition? Can you explain the thought process and considerations involved in selecting the appropriate treatment approach?
Dr Labadie: Selecting the right laser involves considering the patient’s characteristics, the targeted condition, skin type, potential risks, and the patient’s medical history. A comprehensive consultation with a board-certified dermatologist, preferably one with a fellowship in cosmetic surgery and lasers, is crucial. Assessing what lasers are available in the office, understanding the patient’s previous treatment history, and ensuring proper training and safety measures are in place all contribute to the decision-making process.

The Dermatologist: Patient safety is crucial when using lasers in dermatology. Can you explain the safety precautions and measures you take to minimize potential risks or adverse effects associated with laser treatments?
Dr Labadie: Patient safety is a priority, and comprehensive safety protocols are essential. I have conducted numerous publications regarding this, and we are currently in the process of developing patient safety protocols through the American Society for Laser Medicine and Surgery (ASLMS). 

It is important to consider both patient safety and operator safety when using lasers, as lasers can also present occupational hazards. I aim to assist others in implementing robust laser safety protocols in their practices. This involves developing a comprehensive safety checklist to be considered before operating a laser, including basic requirements like ensuring everyone using the laser is properly trained and the correct use of safety placards and appropriate treatment rooms. For example, mirrors must be covered, smoke evacuators should be at hand if necessary, and cooling devices should be checked for functionality. Regular safety inspections must be carried out by a certified laser safety officer.

When it comes to patient treatment, it is critical to use the correct laser for the appropriate disease and patient. The laser should be in optimal working conditions, and the correct eye protection must be worn as lasers can potentially damage the eye if not used correctly. Make sure everyone in the room is wearing laser-appropriate safety goggles and safety wear. It is important to ensure that the correct settings are used with the lasers to prevent inadvertently scarring or burning the patient, and understanding what visual cues you are looking for and which to avoid is crucial. If a lot of fumes are being generated, a smoke evacuator should be used, or at least wear protective masks, either regular surgical masks or N95-grade masks. Patients must also be provided with post care instructions to ensure proper wound care post treatment.

In my practice, we use a laser safety protocol. The easiest way to ensure this is by having these protocols attached directly to the laser or making sure you are well-versed in the procedures. It is also beneficial to have a laser safety officer or the person providing treatment present in the room at all times, vigilant for any signs of potential complications.

The Dermatologist: As a dermatology practitioner, how do you stay updated with the latest research and developments in lasers?
Dr Labadie: Staying current in my field is a continuous effort. I attend annual meetings like the Mount Sinai Symposium and the ASLMS Annual Conference, where new products and safety discussions take place. I engage with colleagues, discuss challenging cases, and participate in conferences such as Controversies and Conversations and the American Society for Dermatologic Surgery meeting. This ongoing involvement keeps me informed about the latest research and advancements in laser technology.