Laser (Light Amplification by stimulated Emission of Radiation) is a device for producing a beam of intense light, which can be controlled and precisely focused. It works through the conversion of its light energy into heat at specific target points.
When the laser light falls on the skin, it absorbs the laser light. Different areas in the skin absorb laser light of different characteristics. After absorption the target area may be physically altered or destroyed. Therefore, laser is used to selectively destroy unwanted targets in the skin. Lasers have been widely used in dermatology. New lasers and techniques have extended and improved treatment possibilities.

1. Argon Laser
The Argon Laser is preferentially absorbed by oxyhaemoglobin and, to a lesser extent, by melanin in the skin. The light energy absorbed by erythrocytes within blood vessels is converted to heat, leading to red cell destruction and thrombosis of small vessels.

2. Tunable Dye Laser
This increases the penetration depth of the laser beam of light and is used for portwine stains.

3. Pulsed Tunable Dye Laser
By using microsecond impulses it is possible to confine thermal injury to a small area and target blood vessels.

4. Carbon dioxide laser
Carbon dioxide laser therapy removes tattoo and is also used for skin resurfacing.

5. Ruby Laser
Offers significant advantages in the treatment of tattoos and can also be used to treat green tattoos.

6. Nd: YAG lasers
This laser can be used to produce fading of red tattoo pigments.

The laser revolution in dermatology began with the development of lasers that produce short individual pulses of light. In the early 1980's laser surgery became more precise and effective. Since then there have been major advances in the treatment of a variety of skin disorders and cosmetic problems.

Before the advent of lasers, unsightly birthmarks such as port wine stains responded poorly to treatment. Available therapies often caused permanent facial scarring. Port wine stains can now be treated in newborns with the help of lasers. Lasers have also been used effectively to treat a variety of other disorders of blood vessels, pigmented lesions and tattoos. Many of these can be totally cleared often in just one almost painless treatment. The technology is continually evolving and the future of skin laser surgery is very bright.

1. Vascular lesions (caused by abnormal blood vessels): Haemangioma are benign tumours made up of growing blood vessels and often seen in infants. If treated early, they can be lightened and sometimes erased with lasers, if the tumours are not too deep.

Port wine stains - large, blotchy red or violet areas on the face or trunk - are caused by dilated blood vessels and can be disfiguring. Lasers shoot light energy into the vessels, destroying them from inside. Facial stains respond best and after three or four laser treatments, the average stain will be diminished by 70 to 80 percent or may even be eliminated.

Some people, especially those with light skin, develop thin, spidery blood vessels that become dilated and show up prominently on the nose. This usually occurs due to prolonged exposure to sunlight. They respond very well to lasers. Coarser blood vessels that sometimes show up in the groove between the side of the nose and the upper lip may require repeated treatments.


2. Pigmented lesions
Tattoos: Tattoo removal is in high demand, and success depends on how they are applied. Tattoos done by amateurs, using a needle and India ink, are the easiest to erase, and almost all will yield to the beam. Professional tattoos, especially those done in several colours of ink, don't absorb the laser light as well. It may take six or more sessions, even after which the tattoos may not clear entirely.

Leg veins: Although these annoying bluish networks of veins can be treated with lasers, injecting them with saline solution, or sclerotherapy, is still the standard treatment. But lasers are being more widely used for leg veins as results improve.


3. Skin resurfacing
In the past several years, lasers have taken their place alongside chemical peels and dermabrasion to remove layers of aged, wrinkled skin, creating a new, smoother surface. Laser resurfacing leads to faster healing and is less painful, though for large areas, it is done with sedation and local anaesthesia. Lasers may ultimately replace other resurfacing methods.

• Cosmetic results are good
  
  
• Setting up and maintaining a laser unit is expensive
  
  
• Multiple lesions can be treated
  
  
• Specialised training is required in a single sitting
  
  
• A CO2 laser produces a bloodless field and significantly reduces post-operative pain, minimises hospital stay and reduces the chances of keloid formation.
  
  
• A single laser system cannot treat all conditions and therefore more than one type is is required.

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