What are the risks of laser treatments?

Risks of laser treatments will depend on which laser is used and the purpose.

• Skin burns

Lasers work by imparting energy. Certain lasers, such as the CO2 or erbium laser, are designed to completely remove the outer layer of skin to varying depths. When used by trained physicians, these lasers can be very effective at reducing wrinkles and improving skin pigment. They can be equally effective, when used inappropriately, at permanently scarring the skin.

Other lasers are designed to target certain colors of cell, such as pigment or blood. If the energy in the laser is high enough, they too can produce burns and permanent scarring.

It is very important when undergoing laser treatments that appropriate safeguards are in place to protect the patient. People with darker skin, such as African Americans, are particulary susceptible to burning from certain types of lasers. These patients should be extra cautious about any laser treatments as they can cause permanent scarring.

• Skin color changes

Some laser treatments can produce a permanent lightening or even darkening of the skin. Darkening of the skin can often be helped with other treatments while lightening of the skin can be a permanent and often untreatable condition.

• Eye damage

When undergoing facial laser treatments, be sure to wear goggles and close the eyes. Lasers do have the potential to cause blindness.

• Pain

Again, depending on the type of laser used, pain can be anything from feeling like a rubber band popping, to burning that is best controlled with either local or general anesthesia.

Newer lasers in use today are very safe and often have built in safeguards to protect patients. It must be remembered that these are destructive devices that, when used incorrectly, can cause permanent scarring. When used correctly, they can produce excellent results, often with minimal side effects and down time.

As always when undergoing a cosmetic surgery procedure, be sure it is done by or under the direct supervision of an experienced and trained physician.

The main concerns with laser energy and safety are burns and eye injury. Lasers aren’t dangerous in and of themselves. Just as much as a knife in and of itself is not dangerous, unless it is in the wrong hands. If it’s used properly, if safety measures are taken, risks can certainly be avoided.

Eye injury and eye safety are of the utmost concern. The most dangerous, in that particular realm, is the Yag laser. That is the 1064 nanometer laser. That’s because it goes very, very deep. If the eye was not adequately protected, it could cause blindness. This is extremely rare because most practitioners would never treat anyone without proper eye protection. If you are treating on the face there should be goggles that are completely occlusive. Meaning that they are small, right over the eye, completely covering the eye and that the laser is never used within the bony rim around the eye and never pointed directly towards the eyeball. As long as this is followed you’re completely safe. However, you can still see some bright lights and flashing because the light flashes through the sinuses. This is not directly pointed at the eyeball or the retina, so it’s not dangerous to cause blindness of any sort. But it can be very surprising.

The other wavelengths of energy - for instance, the pulsed dye laser, the IPL, the Alexandrite and the other lasers we use here and many other types of lasers that are used elsewhere - some can cause a flash-related injury and others can cause a corneal burn but not blindness as they do not reach the retina. Still, eye protection is essential.

Heat injuries of course are dangerous in that you never want to burn the skin. Proper use of the laser and proper cooling of the skin is important - never overheating the skin, never using energies that are too high for the skin, never using lasers that are improper for the color of the skin. Tan skin, and skin of color you cannot use a short wavelength laser or you risk burning the skin.

Heating the skin too much could lead to a blister or burn. A superficial burn, if properly cared for, can heal without a scar. It is very important to properly care for any skin with an excessive reaction to it immediately whether it be a bruise or a blister or a crust.

The biggest concern for protecting the skin is cooling. Many of the lasers, particularly the ones that I use, either have contact cooling like a sapphire lens that goes against the skin that protects the outermost layer or a cryogen spray that sprays against the skin, right on the outermost surface at the exact same time that the laser goes against the skin. And that protects the skin. It’s the outermost layer that you want to protect so that it is completely protected from the heat that bounces back up.