Laser and light technologies are rapidly evolving

0304-LasersIf you were up to date with the latest laser devices last year, you are out of date now.

“There has been a significant increase in movement in the laser and light arena in the last year or two,” said Jill S. Waibel, MD, founder and medical director of Miami Dermatology and Laser Institute, chief of dermatology at Baptist Hospital, and clinical assistant professor of dermatology at the University of Miami Miller School of Medicine. “There are new devices, new wavelengths, new uses and new accessories for laser applications.”

Dr. Waibel will direct a special session, “Advances in Lasers and Light Sources: What’s the Truth?” (F022) from 1 to 3 p.m. Friday in Room 207B.

The session includes expert input from academic, community practice and military dermatology, Dr. Waibel said. One of the hot topics is a look at the potential for microneedling to replace lasers for some applications. Microneedles are promising, but the FDA has not looked kindly on all of the microneedle devices that have moved toward marketing.

Dr. Waibel will explore some of the newest laser devices to enter dermatology in the last year. One of the most exciting is the Halo, the first combination fractional laser device approved by the FDA. Halo delivers 2,940 nm plus 1,470 nm from the same applicators.

“The 1,470 penetrates 200 to 700 microns and targets pigment,” she said. “It is great for things like melasma, post-inflammatory hyperpigmentation, brown spots, and sun damage. The 2,940, which is traditional for resurfacing, only penetrates 100 microns. You can do a fairly aggressive treatment for wrinkles, texture, pores, and brown spots on Friday, and the patient can be back at work on Monday. We’ve never had a device where you can get truly great results with so little downtime.”

There also is a class of devices Dr. Waibel calls laser accessories. Interventions such as CoolSculpting and Kybella are not light-based, but they have opened the way to treat submental fat. Complete treatment typically includes lasers along the jowls or for texture. Optical coherence tomography (OCT) is another new laser accessory.

“OCT is coming to dermatology,” Dr. Waibel added. “It gives dermatologists live information in areas like oncology, blood vessels, hemangiomas, and port-wine stains. Better information will help us to better determine our laser parameters.”

Dermatologists also can expect new wavelengths and new applications. Researchers at Harvard are working on 1,726 nm for acne, and Dr. Waibel participated in a phase III study for laser-activated gold nanoparticle treatment.

Another new development is laser treatment for burn scarring as early as three months after injury. Lasers also are being developed to boost transdermal drug delivery. And look for femtosecond lasers, commonly used in ophthalmology, to move into dermatology with 1012th pulse duration.

European researchers have made dramatic strides using indocyanine green, a water-soluble tricarbocyanine dye. ICG is a familiar contrast agent that may also be used to augment the therapeutic effect of diode lasers for port-wine stains, photodynamic therapy for actinic keratosis, and other light-based applications.

“The truth about lasers is that development was pretty quiet during the recession,” Dr. Waibel said. “Research and development are booming, and it is becoming difficult to keep up with new devices and the clinical trials that promise to deliver still more devices and applications in the near future.”

Dr. Waibel is a speaker for Zeltig Aesthetics, which makes CoolSculpting, and a principle investigator for Sciton Inc., which makes Halo.

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