Focus on non-ablative cutaneous laser treatment

Mitchel P. Goldman, M.D., referenced numerous studies in his seminar, "Advances in Non-Ablative Cutaneous Surgery," which he presented at the Fall Clinical Dermatology Conference, held here.

Dr. Goldman, associate clinical professor of dermatology at the University of California, San Diego and Medical Director of La Jolla Spa MD, began by noting various laser technologies and their characteristics:

"This technology has the ability to control pulse shape and deliver 'squared off,' homogeneous pulses with the Universal IPL head and is unique to the Lumenis One (Lumenis) device," he tells Dermatology Times. "This enables the use of lower fluences to attain effective treatment results. The bottom line with this device is maximum optimal energy and maximum safety with the least pain."

Dr. Goldman cites the results of various published studies involving non-ablative cutaneous laser surgery.

"In a study on gross and microscopic findings in patients treated with non-ablative full-face resurfacing using IPL, the authors found there to be better cellular polarity, a decrease in horny plugs, new rete ridges, decreased elastosis and a presence of dermal neo-collagen," Dr. Goldman says.

"In a split-face study comparison pilot study of IPL and 10 mm Spot
532 nm KTP for photo-rejuvenation, 16 patients with diffuse redness and
pigmentation were observed," Dr. Goldman says. "With the KTP side there was 64 percent overall improvement, 50 percent with the IPL side. Fourteen of the 16 patients said they preferred KTP for future treatments."

In another study, this one on non-thermal LED array for reversal of photoaging, 90 patients were treated eight times over four weeks with a 590 nm LED device set at 0.1 J/cm2. Exposure was over 35 seconds with 200 m-per-second to 250 m-per-second pulses.

"Eighty-five percent of the patients showed 25 percent global improvement," Dr. Goldman says, "with a 10 percent improvement in topography."

According to Dr. Goldman, the biggest advance in non-ablative therapy has been the introduction of photodynamic therapy utilizing the IPL. He says he's found that one treatment with Levulan (DUSA) ALA and IPL with the Lumenis One in treating telangiectasia and pigmentation is equivalent to three to five IPL treatments without Levulan.

"Dr. Jeff Dover recently published a similar study confirming my results," Dr. Goldman says, "and adding that there was no additional adverse effects with the addition of Levulan except for 24 hours of photosensitivity."

In summary, Dr. Goldman says the studies reflect not only a widening variety of uses for laser devices, but a continuing trend in combination therapies.