Ablative and Non-ablative Laser

Erbium and CO2 such as Ablative lasers are more invasive, but these produce the best clinical results. In this procedure the outer layer of the skin is vaporized. Their results usually last for 1-5 years. Ablative lasers are considering being the best lasers so far especially in reducing the signs of aging. They are also used for the treatment of pigmentation irregularities, acne scarring and unwanted lesions. On the other hand Non ablative lasers are less invasive. They don’t destroy the targeted tissue instead heat it up. This process helps in the stimulation of the body’s collagen production to fill unwanted skin imperfections like wrinkles or fine lines.

In this review we will be examining the advantages and disadvantages of ablative and non-ablative lasers focusing on acne scaring.

According to (Bergsute & Fork, 2010)     recent modification in laser technology called ablative fractional laser treatment has made this technology even more exciting. These lasers works by removing the microscopic tubules of skin, while the surrounding areas are left untreated, in that way it allows the skin to heal more quickly. Beside its noticeable results it also requires a downtime, of one to two weeks in this regard laser resurfacing peels are more effective as they required a downtime of only 2-4 days before makeup can be applied.

(Anil, 214) Found that among the most common adverse affects of  ablative laser treatment includes prolonged postoperative erethema, acne, edema and milia formation, hypertropic scar formation, pigmentary alteration and delayed wound healing time. For that reason there have been many researches for the introduction and use of alternative modes of facial rejuvenating treatments. And it is found that several different non ablative lasers are more effective in an effort to ameliorate scars without epithelial disruption, thus most of the risks associated with ablative lasers are eliminated.

(Gregor, Zenzie, Anderson, Burke, & Manstein, 2014) conducted non-ablative laser study on a sample of 20 females, with a mean age of 47.7. The result was evaluated by comparing pre-treatment and post treatment after 12 weeks by giving six sessions. It was observed that sixty five percent achieve seventy five percent positive results, five percent experienced more wrinkled skin while twenty percent did not achieve any remarkable results.

Non ablative lasers treatments do not produce the equal degree of enhancement as ablative resurfacing techniques, but these laser treatments are an excellent alternative for those who want aesthetic improvement with slight recovery, (Janson & Williams, 2002)     discussed in his paper.  So far no non ablative treatment has emerged as the most superior system. The decision to prefer one treatment over the other depends on the particular concerns of the patient.

The introduction of ablative and non-ablative laser has revolutionized the approach to acne scaring, but it still has to go a long way in order to get more observable and satisfying results in short time. The results archived by these laser treatments are still disappointing for those patients who are longing for dramatic improvement in short time. Although there are very less side effects associated with both ablative and non-ablative lasers yet they are not devoid of risks. The ultimate goal of having either of the treatment is not total perfection rather it is making scars less visible (Andrei & Alster, 2010).

A study conducted by (Peter & Egevist, 2008)    to evaluate the efficacy and safety of ablative laser treatment. He took a sample of 20 with post acne scarring, on the completion of study; only sixteen patients were available for evaluation. All of them had healing in their scaring but with varying results. Two of the patients were seen with almost clear skin, while large number of patients showed moderate to mild improvement of acne scars. The side effects included burning or mild pain during the treatment, scaling and transient pigmentation and post treatment crusting. After this study he concluded that ablative laser maybe a useful tool in the treatment of atrophic acne scarring.

   (Christina & Ross, 2002)    Is of the view that ablative laser provides an effective and safe treatment for moderate to severe facial acne scarring, but additional studies are required to help define the optimal treatment parameters and some other potential indications for the use of this device. During his research he experienced some major drawbacks such as the need for effective anesthesia, the risk of scarring and hyperpigmentation, the downtime associated with this treatment, the need for intensive postoperative care, the need to avoid exposure to sun for extended periods and the long lasting erythema, other than these cost and pain are also consider as barriers.

According to (Hans & Tannous, 2006)        beside the effects of non-ablative laser on acne scars these lasers can also treat loss of skin tone and helps in the improvement of complexion if one is having a sun damaged skin. Non ablative laser means that skin surface is not injured or removed and the energy is delivered into dermis, non-ablative are generally done as a series of treatments with usually little or no downtime.

 

Conclusion

According to the above literature on ablative and non ablative laser treatments it is concluded that these laser treatments (where they treat just the fraction of the skin) are very effective and extremely successful at minimizing scars, improving skin texture and reducing stubborn pigmentations (Andrei & Alster, 2010).

Acne scars have been a challenge for patients and clinicians alike. Although the use of fractional laser treatments have produced some visible results yet these treatments are not good enough for those patients who needs some instant dramatic results (Bergsute & Fork, 2010). According to the literature discussed above it is seen that the dermal pathology associated with atrophic acne scars has made it convenient for the clinician to select a modality that can effectively reach the depth of both superficial and deep scars. In most studies the use of ablative or non ablative laser treatment has given very positive results yet these treatments been not were not able to heal 100 percent. For that reason it is expected and needed that there should be more research and advancement in this field of skin surgery.

Beside its drawbacks if this technology is used correctly with cautious can produce excellent results. Selection of appropriate technique requires patient factors as well as the benefits and risks of the procedure by weighed.

 

Bibliography

Andrei, M., & Alster, T. (2010). Fractional laser skin resurfacing tretment complication. Dermatoligical surgery, 36(3), 299-306.

Anil, G. (214). Laser in skin color. Recent Advances in Dermatology, 3(279).

Bergsute, G., & Fork, R. (2010). Beamed energy for ablative laser.

Christina, H., & Ross, V. (2002). Nonablative ;aser skin modelling. Dermatoligical clinic, 97-111.

Gregor, A., Zenzie, H., Anderson, R., Burke, J., & Manstein, D. (2014). Methods and appratus for photothermal treatment of tissue at depth .

Hans, L., & Tannous, Z. (2006). Skin responses to fractional photothermolysis. lasers in surgery and medicine, 142-149.

Janson, L., & Williams, C. (2002). Nonablative laser skin resurfacing using 1540 nm erbium glass laser. a clinical and histologic analysis. Dermatologic surgery.

Peter, B., & Egevist, H. (2008). Selective non -ablative wrinkle reduction by laser. Journal of cosmetic and laser surgery, 9-15.