Radiation in Cosmetic Lasers Vs Cancer Treatments?

Question

My doctor is suggesting Fraxel Repair for hyperpigmentation after Fraxel Restore, and I'm a bit concerned about the possible long-term side effects of these treatments. What is the difference between the radiation used in Fraxel and other lasers, and the radiation used for cancer treatments? Have the long-term side effects of facial treatments with these type of lasers been studied?

Michael A. Persky, MD · Answer

Hi awalk,
Very good question, as well as a concern that I had 20 years ago when I first began using lasers on patients.  I did not want to find out like Madam Curie did with X-ray radiation that the lasers caused cancer years later.
With respect to "laser damage" versus "solar damage" radiation, the effects of UV radiation on skin are well established.  The UV wavelengths in the electromagnetic spectrum are 100-400 nanometers (nm).  While there are beneficial effects of UV such as activation of Vitamin D, the harmful effects include direct absorption into DNA causing pyrimidine dimer formation, free radical formation, direct damage to collagen, destruction of Vitamin A, etc. X-rays used in cancer treatment are at an even smaller wavelength than UV.
 In contrast, the laser wavelengths of say Fraxel are 1550, 1440, and 10,600nm, all of these are well outside of the damaging UV range.  The effects on tissue include coagulation or ablation surrounded by a zone of coagulation.  The biological effects actually induce neocollagenesis or new collagen formation.  There is no evidence that these three wavelengths cause DNA damage or increase the risk of skin cancer.  In fact, these lasers have been shown to treat precancerous lesions and reduce the incidence of non-melanoma skin cancers.
The long term side effects of lasers at the Fraxel wavelengths have been thoroughly studied and are quite safe.
Be well, and wear your sun block (against those "bad UV rays")
Dr. P

Ron Shelton, MD · Answer

The difference between cancer radiation and cosmetic lasers is significant.
Cosmetic lasers are in the visible or infrared spectrum, not the X-ray wavelengths which is what cancer radiation uses. There have been no clinical reports of cosmetic lasers inducing skin cancer.

Radiation in Cosmetic Lasers Vs Cancer Treatments?

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Radiation in Cosmetic Lasers Vs Cancer Treatments?

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