Light 'Em Up

Your Guide to Aesthetic Light-Based Treatments April 2006 Kevin Tan talks to Malaysian dermatologist Dr. Ko Chung Beng and U.S. cosmetic dermatologist Dr. William F. Groff to get enlightened about aesthetic light based treatments. Since their discovery in the late 1950s, cosmetic lasers or aesthetic lasers have become an indispensable tool in the cosmetic surgery industry. Used by both plastic surgeons and dermatologists worldwide, aesthetic lasers are able to quickly, efficiently and safely treat a vast range of common skin problems like birthmarks, spider veins, acne and more.

In lieu of going under the knife, treatment with aesthetic lasers are also an antiaging option as they are capable of rejuvenating aging skin and remove age spots and wrinkles.

Because of its minimally invasive nature, many aesthetic laser procedures can be performed in the space of the average lunch hour. Most skin conditions such as warts or liver spots can be resolved and treated in a single session. Other procedures like skin resurfacing, hair removal or treating acne, require several visits.

For those averse to pain, aesthetic lasers are a godsend. Many procedures only require topical anaesthesia instead of general or local anaesthesia - omitting the need for injections along with the inherent risks associated with stronger forms of anaesthesia, and also allowing the patient to be up and about after the procedure.

A variety of aesthetic lasers exist on the market. Available under a variety of different brand names, aesthetic lasers are primarily differentiated from one another based on what skin conditions each can effectively treat. Cosmetic dermatologist Dr. William F. Groff from the La Jolla Cosmetic Surgery Centre in San Diego, California explains, "Aesthetic lasers use specific wavelengths of light to heat up different targets in the skin. These targets absorb the laser's energy, which causes a controlled injury to improve the skin's appearance or to improve specific imperfections." Because of this, aesthetic lasers are designed to treat specific skin conditions by being calibrated to fire specific wavelengths of light. For example, a pulsed dye laser is great at getting rid of red coloured birthmarks and fine red facial veins as its wavelength of light is well absorbed by red blood vessels, while a diode laser is excellent at treating acne because it can specifically target and shrink the oil glands in the skin. While effective, aesthetic lasers also have their limitations, particularly when treating darker skin types. When used on dark skin, some aesthetic lasers may cause burns, scarring or create hypopigmentation (where the skin permanently loses its colour) or hyperpigmentation (where the skin turns even darker).

In this regard, darker skinned patients have to be careful and aware that certain aesthetic lasers may not be suitable for their skin tone. However, newer generations of aesthetic lasers entering the market like the Fraxel 2 or the Portrait PSR are able to safely treat darker skin with significantly less risk of injury.

Other than aesthetic lasers, a range of other treatments exist that use other forms of energy such as radio frequency, plasma or infrared energy as alternatives to improve skin texture and treat cellulite. Together, they fall under a catchall term known as aesthetic light-based treatments or cosmetic laser surgery. In short, aesthetic light-based treatments represent a solution for patients that are seeking minimally invasive procedures that offer results with minimal downtime.

WHAT IS RIGHT FOR ME?

Individuals seeking treatment for skin conditions are often surrounded by marketing hype and complicated terminology spilling from brochures and newspaper advertisements that confuse as much as they promise miracles. Due in part to the massive boom in the aesthetic dermatology market, a plethora of beauty salons have sprouted like mushrooms, each promising cures that no legitimate doctor would promise and using aesthetic lasers that may be watered down versions of actual lasers or worse, the real-deal but held in the hands of someone without the training to use it.

So, how do you tell if you're getting the real deal and not some quack? Dr. Groff advises, "The most important thing for patients to consider when undergoing treatment is to seek a properly certified dermatologist that is registered with the country's medical board. A dermatologist is the best specialist to go to for skin-related treatments because it is our specialty, and we deal with skin exclusively."

An accredited dermatologist can show you his certification, which can be further verified with the local medical board. In Malaysia, a practicing dermatologist is registered with the Malaysian Dermatology Association.

To validate your choice for a dermatologist, ask to see before and after photos. "You should always ask to see the dermatologist's before and after photos and ask which of the patients he or she actually treated. These should be actual case photos, not the photos that a manufacturer of a laser gives to a physician. What you want to see is his or her handiwork," says Dr. Groff.

Even though these may all check out, another widespread problem remains - physicians will often have other staff members, such as nurses and technicians, conducting the procedures. In this regard, a patient may not be getting the right, or even safe treatment.

Dr. Groff advises, "Always choose a facility where the dermatologist does all the consultations and treatments on patients. I wouldn't go to a facility where the treatment is delegated to medical staff who are not physicians and have no formal dermatology or laser training - consequences of this can be serious. I see complications from facilities like these on a daily basis."

According to Dr. Groff, patients who receive treatment from unqualified individuals could end up with burns, blistering, permanent scars, hypo- or hyperpigmentation and possibly, even craters and lumps in the skin.

"A large part of the patient and doctor experience is through a level of trust, rapport and understanding," says Dr. Ko. He adds that choosing a doctor is a highly personal choice and that one should choose a doctor they trust and feel comfortable with as well as being able to address their concerns.

Dr. Groff adds, "Nothing is stronger than a referral from a relative or a friend. If a friend or family member has had a positive experience with their dermatologist, this is a good indication that you will too. It's a combination of all these things that ensures a successful treatment with your cosmetic dermatologist." With that comes another quandary. With the proliferation of new and improved technologies, logic will have it that you'd go for the physician with the most up to date equipment. Unfortunately, in some instances, while a physician may have cutting edge technology at his practice, he may not necessarily have the experience to handle it.

So which comes first? Dr. Ko believes that, "Both the experience of the physician and the need to get the latest technologies are equally important. With experience but without the latest tools, a doctor can't offer you the best treatment possible. With the best tools but without experience, the same applies and additionally, may possibly harm you or cause unintended side effects." He emphasizes both skill and technology are needed. But most important of all is patient education, awareness and their rapport with the doctor.

Excerpted from Cosmetic Surgery & Beauty Magazine article by Kevin Tan

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