Under The Skin: How Lasers Really Work

One of the most important medical advances in the last (just over half) century is lasers. As noted by the National Institutes of Health, “While the history of laser begins in 1951, the first medical application is reported by Goldman in 1962. In cardiovascular surgery McGuff first used a Ruby-Laser in 1963 for the experimental ablation of atherosclerotic plaques. After a long time of investigations and new developments in laser technology first clinical applications were performed by Choy and Ginsburg in 1983.” Those early applications, geared toward cardiovascular health, soon led to more and more surgical and non-surgical laser-assisted, or laser-focused techniques. As rapidly as creativity and science could keep up with each other, the field grew. Today there are more uses for lasers, including those that TSLMS members frequently use, than most anyone can count. 

So what exactly are lasers and how do they work? 

 

What Are Lasers

Universal Laser Systems is a company that designs and manufactures lasers. This is how they describe the technology:

A laser is a device that emits a beam of coherent light through an optical amplification process. There are many types of lasers including gas lasers, fiber lasers, solid state lasers, dye lasers, diode lasers and excimer lasers. All of these laser types share a basic set of components… Gain medium capable of sustaining stimulated emission; Energy source to pump the gain medium; Total reflector to reflect energy; Partial reflector; Laser beam output. The gain medium and resonator determine the wavelength of the laser beam and the power of the laser.

The US Food and Drug Administration (USDA), defines medical lasers as: “Medical lasers are medical devices that use precisely focused light sources to treat or remove tissues. The term “laser” stands for light amplification by stimulated emission of radiation. Ordinary light, such as that from a light bulb, has many wavelengths and spreads in all directions. Laser light, on the other hand, has a specific wavelength. It is focused in a narrow beam and creates a very high-intensity light. Because lasers can focus very accurately on tiny areas, they can be used for very precise surgical work or for cutting through tissue (in place of a scalpel).”  In the case of the dermatologist, “lasers have become a critical part of the dermatologist’s armamentarium for modulating cutaneous biology, both in treating skin disorders and providing tangible cosmetic alterations to the skin. Although modern lasers are relatively straightforward to use, they are powerful tools that are capable of considerable damage when used incorrectly. Developing an understanding of how these lasers function is essential to their safe and responsible use.” (Source).  And, for even those among the TSLMS constituency who are not doctors, these devices have become one of the most prolific and helpful tools out there. 

 

The Regulation of Lasers

Lasers are used in many types of surgical procedures. The FDA has defined the following as approved uses of laser procedures on people: 

• Cosmetic surgery (to remove tattoos, scars, stretch marks, sunspots, wrinkles, birthmarks, spider veins or hair).

• Refractive eye surgery (to reshape the cornea in order to correct or improve vision as in LASIK or PRK).

• Dental procedures (such as endodontic/periodontic procedures, tooth whitening, and oral surgery).

• General surgery (such as tumor removal, cataract removal, breast surgery, plastic surgery and most other surgical procedures).

This list is dramatically expanded when procedures that are common, but are not necessarily condoned by the FDA, are considered. The FDA regulates lasers and there are regulations in place to protect against the potential harm of medical grade lasers:

The FDA recognizes four major hazard classes (I to IV) of lasers, including three subclasses (IIa, IIIa, and IIIb). The higher the class, the more powerful the laser is and the greater the potential to pose serious injury if used improperly. The labeling for Classes II–IV must include a warning symbol that states the class and the output power of the product. Roughly equivalent IEC classes are included for products labeled under the classification system of the International Electrotechnical Commission. 

Class III and Class IV encompass most of the medical devices that TSLMS members are familiar with. These include industrial, research, and medical device lasers. “There are laws, regulations, and standards that require engineering controls and risk communication to aid in the management of the biological hazards associated with each laser class. However, no controls are completely effective if lasers are improperly used.”

 

Top Laser Uses for Beauty

In spite of the heavy regulation of lasers, the market is booming and the creativity flowing. There is a laser-based treatment for almost anything any of us can consider treating, as a matter of face. At this point lasers are being used to regrow lost hair, as well as to keep unwanted hair in check. They are used to reduce wrinkles and to instigate skin rejuvenation. They help to remove unwanted tattoos, moles, freckles and skin tags. These same devices, set on different frequencies, are used in the most intricate and delicate surgeries to repair facial features damaged by trauma and to repair damage to the eye due to age and environmental exposure. There is very little that lasers are not used for. 

If you are new to this field and just beginning to explore how to use lasers please follow our blog and plan to attend SCALE Music City in July 2020.