Laser technologies in the treatment of pigment and vascular pathologies

A laser (from the English LASER - Light Amplification by Stimulated of Radiation - light amplification by stimulated radiation) is a device that allows you to create a flow of radiation that has unique properties for use in medicine. A laser beam is a stream of monochromatic light with a small cross-sectional area. Light is an electromagnetic wave that propagates through space at a tremendous speed.

The following are the main chromophores for laser exposure in cosmetology and aesthetic medicine:

1. Water. Transparent in and around the visible wavelength range (200-900 nm), but absorbs light with wavelengths less than 150 nm and greater than 1300 nm well.
2. Hemoglobin. The absorption maximum of oxy- and deoxyhemoglobin is in the range of 600-750 nm.
3. Melanin. The range of 630-1100 nm is considered relatively selective for the effect on melanin. The intensity of absorption of light energy by melanin decreases with an increase in the wavelength of radiation. Short waves can damage pigment cells, having a relatively low energy.
4. Carbon. Pure carbon enters healthy tissue only from the outside and is known as a tattoo pigment. Due to the very strong absorption in a wide range of waves, carbon does not transmit light to the inside of the skin, which leads to high surface heating.

The effect of different types of lasers on pigment defects should be considered. The determining factor in the choice of laser will first of all be the depth of the pigment. In the event of a false diagnosis, accordingly, the laser therapy and parameters may be incorrectly selected.

1. Superficial epidermal lesions – laser radiation, which has a high melanin absorption coefficient, can be used for their removal. These can be both long-pulse and short-pulse lasers, and IPL systems.
2. Superficial epidermal damage with keratosis requires the destruction of not only the pigment, but also the tissue, so the main method of their removal will be ablative photothermolysis - a solid or fractional beam of UV: Yag and CO2 lasers.
3. Dermal pigment defects require high-energy short-pulse exposure to Q-switched nanosecond and picosecond lasers with wavelengths of 755 and 1064 nm. In case of dermal defects, grinding is contraindicated.

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