Laser Surgery for Lesions and Skin Conditions

There are many different types of lesions and skin conditions that can be treated with laser surgery. These include birthmarks, which are skin abnormalities present at birth. Your healthcare provider will decide if you are a candidate for the particular surgery. Here is a look at some of the skin conditions that can be treated with laser surgery.

Port-wine stains

A port-wine stain is a birthmark caused by swollen blood vessels. It creates a pink, red, or purple discoloration of the skin. As the child grows, the mark may become darker. Port-wine stains can appear on any part of the body and can vary in size. They can be linked to a neurological disorder. 
Pulsed dye laser is the laser of choice for port-wine stains. This is a type of laser that has a high electric lamp that creates a short, high-energy flash of light. The light is colored when it passes through a dye. The color of the dye can be changed, depending on the type of colored (pigmented) skin spots that are being treated. Adults may have this procedure done with only local anesthesia on an outpatient basis. This means they can go home the same day. Children or people with large port-wine stains may be treated under general anesthesia. Multiple treatments may be needed.

Hemangiomas

Hemangiomas are a common type of birthmark. They are caused by an abnormal buildup of blood vessels. Hemangiomas may vary in appearance. They may range from red raised patches to deeper purple areas. Hemangiomas usually appear within the first month of a child’s life and grow quickly for the first year. They may start to go away by the time the child is 5 years old. About 50% of hemangiomas become smaller on their own by age 5. Hemangiomas may be in the top skin layers. Or they may be deeper in the skin.

Surgery, injections into the hemangioma, or an oral medicine called propranolol may be used for large or growing hemangiomas. These treatments may also be used for hemangiomas that are causing problems because of their location. Multiple treatments with a laser may be needed.

Café au lait spots

These are tan-colored lesions that may appear anywhere on the body. The size of the lesions varies. Some can be very large, and cosmetic removal may be desired. It’s common for these spots to come back.

Telangiectasias

These are small blood vessels under the surface of the skin. They may be red, purple, or blue. They are often seen on the face, upper chest, and neck. Related vessels called spider veins can be found in the legs. Removal is usually done for cosmetic reasons.

There are many causes of telangiectasias. These include heredity, sun damage, hot and spicy foods, emotions, hormones, some medicines, and rosacea. Treatment of these lesions may include lasers or sclerotherapy. Sclerotherapy is a procedure that uses a small needle to inject medicine into the vessels. This makes them shrink. New vessels may continue to develop throughout the person's life. It depends on what caused the lesion to form. KTP lasers and pulsed dye lasers are commonly used on the face. 

Wrinkles

Laser treatment to help remove wrinkles is called a laser peel. This is one of the great advances in cosmetic plastic surgery. When done by an experienced surgeon, this type of wrinkle removal process is safer than other methods of wrinkle removal. There is less chance of scarring, swelling, and crusting with a laser peel. Newer lasers have fewer side effects and a shorter recovery time. Before the surgery, your healthcare provider may prescribe facial medicines for you to use to help prepare your skin. These medicines may be used for 4 to 6 weeks before the laser peel. After the laser peel, your provider will explain proper skin care to prevent crust formation and infection. Sunscreen is an important part of your after-treatment skin care routine. Many different types of lasers may be used for laser peels.

Warts

Warts are growths of skin or membrane. They are benign. This means they are not cancer. Warts are caused by the human papilloma virus (HPV) and are often hard to get rid of. Many different types of treatments have been used for wart removal. These include surgical removal, putting medicines on the wart, or freezing the wart. But these treatments all have side effects. So laser removal has become a good option. Several laser treatments may be needed until the wart is gone. Pulsed dye lasers, carbon dioxide lasers, and Q-switched lasers have all been shown to work well for certain warts.

Scars

Scars may occur for many different reasons. These include infections, surgery, injuries, or inflammation of tissue. A scar is the body's natural way of healing and replacing lost or damaged skin. Scars may appear anywhere on the body. The makeup of a scar may vary. The scar may be flat, lumpy, sunken, colored, painful, or itchy. Scars may be treated with a variety of different lasers. This depends on the underlying cause of the scar. Lasers may be used to smooth a scar, remove the abnormal color of a scar, or flatten a scar. Most laser therapy for scars is done along with other treatments such as steroid injections, special dressings, and bandages. Multiple treatments may be needed.

Tattoo removal

There are several types of tattoos. These include:

  • Decorative tattoos. These are designs placed on the body for decorative purposes.

  • Cosmetic tattoos. These are also called permanent cosmetics. They include permanent eyeliner or lipstick.

  • Traumatic tattoos. These occur when an injury forces a foreign substance, like dirt, into the skin.

  • Medical tattoos. These are placed by a healthcare provider as landmarks for radiation therapy.

  • Amateur tattoos. These are homemade tattoos that people have done on themselves. Or tattoos that were done by nonprofessionals. 

Many things help determine if laser surgery will be successful at removing a tattoo. These include:

  • The person’s age and skin type

  • The type of tattoo

  • The tattoo’s age, color, size, and depth

  • Whether or not the tattoo was done by a professional

Some ink colors may be completely resistant to laser treatment. Laser removal of tattoos breaks up the color without damaging normal skin. The body then absorbs the pieces of pigment without leaving a scar, unlike previous tattoo removal methods. Multiple treatments may be needed.

Online Medical Reviewer: Berman, Kevin, MD, PhD
Online Medical Reviewer: Sather, Rita, RN
Last Review Date: 3/1/2017
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