Lasers in dermatology

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					All the attention garnered by medical lasers' aesthetic indications has
overshadowed the fact that lasers' utility for treating medical
conditions continues to grow, an expert says.      Among U.S. medical
applications, photodynamic therapy (PDT) ranks as probably the most
important underused laser technology, says Jill Waibel, M.D., a
dermatologist in private practice at Palm Beach Esthetic Dermatology &
Laser Center, West Palm Beach, Fla., and a volunteer faculty member with
the University of Miami Department of Dermatology.

  "In Europe, physicians are starting to use PDT not only for skin
cancer, but also for ovarian cancer and other cancers. We know that PDT
prevents skin cancer and treats pre-cancers of the skin," yet the U.S.
healthcare system spends billions of dollars annually to freeze actinic
keratoses (AKs) or to excise skin cancers only after they've developed,
Dr. Waibel says.       Also in the area of skin cancer, she says her
colleagues are doing preliminary research with laser-assisted imaging
systems that would allow a dermatologist to view skin cancer down to the
microscopic level while it's still on the body.       Additional
applications for PDT include treating actinic chelitis, basal cell
carcinoma nevus syndrome and disseminated porokeratosis, she says. Dr.
Waibel says she's also achieved very good results with PDT in treating
acne keloidalis nuchae, pseudofolliculitis barbae and hidradenitis
suppurativa.       Furthermore, she says European researchers have begun
exploring the possibility of spraying on the photosensitizing agent
aminolevulinic acid (ALA).       New photosensitizers being studied for
treating acne vulgaris include indole-3-acetic acid and methyl
aminolevulinate, she says.       Additionally, Dr. Waibel says that work
is being done to decrease pain while using the 1,450 nanometer diode
laser for acne.       Another promising possibility that she says could
yield fruit in the future is nano suturing -” utilizing light generated
by medical lasers in conjunction with light-activated dyes such as Rose
Bengal to close surgical wounds without stitches.       In this area, Dr.
Waibel says researchers at Massachusetts General Hospital's Wellman
Center for Photomedicine are leading the way.       For burn patients
experiencing functional and cosmetic problems due to scarring, Dr. Waibel
says she recently completed a study using the Fraxel (Solta) device.
In the study, she says, "Patients experienced great results on all
counts, including functionality, cosmetic concerns and self-esteem
issues."      Perhaps within the next five years, she adds, this laser
device may be used in the medical arena as a drug delivery system.
Regarding the treatment of port wine stains with vascular lasers, she
says recent research reinforces that patients fare best if physicians
begin treating these problems early (Chapas AM, Eckhorst K, Geronemus
RG.Lasers Surg Med. 2007 Aug;39(7):563-568).       "One can treat an
infant with port wine stain as early as 2 weeks of age and every two
weeks thereafter," Dr. Waibel says. For port wine stains that had failed
treatment with the PDL, a study has shown the alexandrite can produce
excellent results.       Dragonlasers - No 1 online store for green laser
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