Color Eradicates Skin Lesions

Posted Tuesday, September 11, 2007 to PROCEDURES > Skin

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Clinical Associate Professor, Department of Dermatology Cornell University Medical College, Neil Sadick, explained to Jodi Thiessen how the Pro-Yellow treats both red blood vessels and brown spots.

Light energy can selectively damage certain components of the skin. This is the fundamental process behind which lasers have been utilized in modern medicine to eradicate vascular lesions, pigmented lesions, tattoos, wrinkles and even hair.

The power, exposure duration and wavelength of the laser all create a different biological response. The power or energy must be sufficient to cause heating above 70 degrees Celsius but below 100 degrees Celsius. The exposure duration or pulse light must approximate the thermal relaxation time of the targeted skin structure and the wavelength must correspond to the absorption peak of what is being treated for maximum results. What this means is different components of body tissue absorb light at different wavelengths.

Hemoglobin found in red blood vessels has maximum absorption with yellow light (578nm) while melanin that causes pigmented lesions has maximum absorption with green light (511nm). Asclepion's Pro-Yellow laser has the ability to treat both these problems by having both of these wavelengths. Dr Neil Sadick explained:"We can treat both red blood vessels as well as pigmented lesions because the Pro-Yellow has both yellow and green wavelengths."

There are other lasers that do have variable wavelengths and can be used to treat various vessels but the Pro-Yellow is much less expensive with very good results.

Vascular Lesions

The target in vascular lesions is hemoglobin (the pigment inside the blood cells that gives blood its red color). Vascular lesions may be spider veins, rosacea and port wine stains.

The yellow wavelength of light is used to help eradicate all of these problems. "The Pro-Yellow can be used for port wine stains but its main use is for treating spider veins on the face, rosacea blood vessels and lower extremity red telangiectasia. It's also very good for leg veins that are less than one millimeter.

The difference between using green and yellow light sources is how the light reacts with the epidermis while passing through the dermis to target the blood vessels. There is melanin in the epidermis which gives skin its color. Yellow light (578nm) is specifically absorbed in blood and only minimal absorption occurs in melanin. This means, while using yellow light, less of its energy is taken up by the epidermis, allowing more to pass through to the blood vessels and also causing less damage to the skin.

The Pro-Yellow also has a longer pulse duration which creates a different reaction within the blood vessel. "You don't get purpura with this laser because of the pulse duration," explained Dr Sadick. "It allows more gentle heating. A shorter wavelength produces rapid heating so blood vessels get "blown up" and that's how you get blood cells outside the vessels."

Dr Sadick has performed many studies on various lasers. He has found the blood vessel undergoes a fibrosis (develops fibrous tissue), closing it down. "The vessel has been shown in our studies to undergo an actual fibrosis, a heat shock protein and beta fibroblastic growth factor are expressed and the vessel undergoes subsequent fibrosis and wound healing without a scar."

Swelling for 3-5 days may follow treatment. Blistering and crusting while possible are very rare. Patients with spider veins on the cheeks, nose or forehead can expect a 75-90% reduction of the size and number of visible vessels within 6-8 weeks of treatment.

Exciting work currently being done with vascular lasers is with stretch marks. "If stretch marks are red the yellow wavelength will be effective in improving it," said Dr Sadick. "Theoretically it should also build up collagen and elastin tissue as well as diminish the redness. 585-600nm wavelength lasers do stimulate new collagen synthesis and this wavelength is very close."

Pigmented Lesions

The Pro-Yellow laser is non-selective in treating pigmented lesions. The green light is absorbed by the melanin causing the lesion, so the process is only selective in as much as these wavelengths are more strongly absorbed by pigmented tissue rather than normal or lightly pigmented skin. The destruction of the lesion is done through thermal necrosis and the degree and depth is controlled by the duration, repetition and total number of treatments. "The melanin is heated and it causes destruction. The lesion peels off," explained Dr Sadick.

Treatment can be mostly done without anesthetic, however, if there are many pigmented lesions, a topical cream may be used. A light scab follows treatment and heals in 5-7 days. Slight redness may last for a couple of weeks.

Regardless of the lesion being treated, the procedure is the same. "The Pro-Yellow laser has a cooling window that cools the skin and protects the epidermis and targets the wavelength against the chromophore (which is hemoglobin or melanin)," said Dr Sadick. "The cooling window means the patient has very little discomfort. The procedure takes 10-20 minutes, is relatively painless and there is no post-operative care."

The Pro-Yellow is one laser able to treat both red blood vessels and brown spots economically, effectively and relatively painlessly.

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