Skip to main content

Advertisement

SpringerLink
Log in

Lasertherapie in der ästhetischen Dermatologie

  • Leitthema
  • Published:
Der Hautarzt Aims and scope Submit manuscript

Zusammenfassung

Das Verständnis der Wechselwirkung zwischen Laser und Gewebe hat gemeinsam mit den Fortschritten in der Lasertechnologie zur Entwicklung differenzierter, sicherer und anwendungsfreundlicher Lasersysteme geführt, die eine effiziente Behandlung einer Vielzahl ästhetisch problematischer Hauterkrankungen ermöglichen. Die Einsatzgebiete von Lasern und die Nutzung ihrer gewebespezifischen Fähigkeiten zur Behandlung von Pigmentläsionen und Gefäßverletzungen wurden stark erweitert und umfassen heute Faltenbildung, lichtgealterte Haut, atrophische Narben und unerwünschten Haarwuchs. Überdies wurden Lasertechniken auch schon zur traditionellen "Verjüngung" gealterter Haut verwendet, beispielsweise für Straffungen der Gesichtshaut, Lidplastik und Haartransplantationen, wodurch die Operations- und die Rekonvaleszenzdauer verkürzt werden. Diese Fortschritte haben zu einer breiten Akzeptanz der Laserchirurgie in der Dermatologie geführt und finden in der Öffentlichkeit zunehmend ein positives Echo. In diesem Artikel werden die Anwendungen von Lasern in der ästhetischen Dermatologie besprochen und ihre Grenzen sowie mögliche Nebenwirkungen erörtert.

Abstract

The improved understanding of laser-tissue interaction along with the latest advances of laser technology have led to the development of sophisticated, safe, and user-friendly laser systems that provide effective treatment for a variety of aesthetic skin conditions. The use of lasers and their tissue-specific capabilities in the treatment of pigmented and vascular lesions has been greatly expanded to include rhytides, photoaged skin, atrophic scars, and unwanted hair. In addition, laser techniques have been employed in traditional "rejuvenating" procedures of aged skin, e.g., face-lifting, blepharoplasty, and hair transplantation, decreasing the intra-operative time and limiting the recovery period. These advances have led to a wide acceptance of cutaneous laser surgery by the dermatologic community and have created an increasing popularity among the public. The purpose of this article is to review the applications of lasers in aesthetic dermatology and discuss their limitations and potential side effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1.
Abb. 2.
Abb. 3.
Abb. 4.
Abb. 5.

Literatur

  1. Goldman L, Wilson RG, Hornby P et al.(1965) Radiation from a Q-switched ruby laser. J Invest Dermatol 44:69–71

    CAS  Google Scholar 

  2. Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 220:524–527

    CAS  PubMed  Google Scholar 

  3. Nelson JS, Milner T, Anvari B et al. (1995). Dynamic epidermal cooling during pulsed laser treatment of port wine stains. Arch Dermatol 131:695–700

    Article  CAS  PubMed  Google Scholar 

  4. Walsh JT, Flotte TJ, Anderson RR, Deutsch TF (1988) Pulsed CO2 laser tissue ablation: effect of tissue type and pulse duration on thermal damage. Lasers Surg Med 8:108–118

    PubMed  Google Scholar 

  5. Alster TS, Nanni C, Williams CM (1999) Comparison of four carbon dioxide resurfacing lasers. A clinical and histopathologic evaluation. Dermatol Surg 25:3:153–159

    Google Scholar 

  6. Miller ID (1997) The erbium laser gains a role in cosmetic surgery. Biophotonics Int :38–42

  7. Khatri KA, Ross V, Grevelink JM et al. (1999). Comparison of erbium:YAG and carbon dioxide lasers in resurfacing of facial rhytides. Arch Dermatol 135:1416–1417

    Article  Google Scholar 

  8. Ross VE, McKinlay JR, Anderson RR (1999) Why does carbon dioxide resurfacing work? Arch Dermatol 135:444–454

    Google Scholar 

  9. Adrian MA (2000) Pulsed carbon dioxide and lon pulse10ms-erbium:YAG laser resurfacing. A comparative clinical and histological study. J Cutan Laser Ther 1:197–202

    Article  Google Scholar 

  10. Waldorf HA, Kauvar AN, Geronemus RG (1995) Skin resurfacing of fine to deep rhytides using a char-free carbon dioxide laser in 47 patients. Dermatol Surg 21:940–946

    Article  CAS  PubMed  Google Scholar 

  11. Fitzpatrick RE, Goldman MP, Satur NM, Tope WD (1996) Pulsed carbon dioxide laser resurfacing of photoaged facial skin. Arch Dermatol 132:395–402

    Article  CAS  PubMed  Google Scholar 

  12. Alster TS, Garg S (1996) Treatment of facial rhytides with a high-energy pulsed carbon dioxide laser. Plast Reconstr Surg 98:791–794

    CAS  PubMed  Google Scholar 

  13. Alster TS, West TB (1996) Resurfacing of atrophic facial acne scars with a high-energy, pulsed carbon dioxide laser. Dermatol Surg 22:151–155

    Article  CAS  PubMed  Google Scholar 

  14. Apfelberg DB (1997) A critical appraisal of high-energy pulsed carbon dioxide laser facial resurfacing for acne scars. Ann Plast Surg 38:95–100

    CAS  PubMed  Google Scholar 

  15. Jacob CI, Dover JS, Kaminer MS (2001) Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 45:109–117

    Article  CAS  PubMed  Google Scholar 

  16. Olbricht CM (1993) Use of the carbon dioxide laser in dermatologic surgery: a clinically relevant update. J Dermatol Surg Oncol 19:364–369

    CAS  PubMed  Google Scholar 

  17. Rubenstein R, Roenigk HH Jr, Stegman SJ, Hanke WC (1986) Atypical keloids after dermabrasion of patients taking isotretinoin. J Am Acad Dermatol 15:280–285

    CAS  PubMed  Google Scholar 

  18. Herne KB, Zachary CB (2000) New facial rejuvenation techniques. Sem Cutan Med Surg 19:221–231

    CAS  Google Scholar 

  19. Goldberg DJ (1999) Non-ablative subsurface remodeling: clinical and histologic evaluation of a 1320 nm Nd:YAG laser. J Cutan Laser Surg 1:153–157

    Article  CAS  Google Scholar 

  20. Menaker GM, Wrone DA, Williams RM, Moy RL (1999) Treatment of facial rhytids with a non-ablative laser: a clinical and histological study. Dermatol Surg 25:440–444

    Article  CAS  PubMed  Google Scholar 

  21. Kelly KM, Nelson JS, Lask GP et al. (1999) Cryogen spray cooling with nonablative laser treatment of facial rhytides. Arch Dermatol 135:691–694

    Article  CAS  PubMed  Google Scholar 

  22. Trelles MA, Allones I, luna R (2001). Facial rejuvenation with a nonablative 1320 nm Nd:YAG laser: a preliminary clinical and histological evaluation. Dermatol Surg 27:111–116

    Article  CAS  PubMed  Google Scholar 

  23. Fournier N, Dahan S, Barneon G et al.(2001) Nonablative remodeling: clinical, histologic, ultrasound imaging, and profilometric evaluation of a 1540 nm Er:YAG laser. Dermatol Surg 27:799–806

    Article  CAS  PubMed  Google Scholar 

  24. Zelickson BD, Kilmer SL, Bernstein E et al. (1999) Pulsed dye therapy for sundamaged skin. Lasers Surg Med 25:229–236

    Article  CAS  PubMed  Google Scholar 

  25. Bjerring P, Clement M, Heickendorff et al. (2000) Selective non-ablative wrinkle reduction by laser. J Cutan Laser Ther 2:9–15

    Article  CAS  PubMed  Google Scholar 

  26. Rostan E, Bowes LE, Iyer S, Fitzpatrick RE (2001) A double-blind, side-by-side comparison of low fluence long pulse dye laser to coolant treatment for wrinkling of the cheeks. J Cosmet Laser Ther 3:129–136

    Article  CAS  PubMed  Google Scholar 

  27. Bitter P, Campbell CA, Goldman M (2000) Nonablative skin rejuvenation using intense pulsed light. Lasers Surg Med 12:16

    Google Scholar 

  28. Zelickson BD, Kist D (2000) Effect of pulsed dye laser and intense pulsed light on the dermal extracellular matrix remodeling. Lasers Surg Med 12:17

    Google Scholar 

  29. Negishi K, Tezuka Y, Kushikata N, Wakamatsu S (2001) Photorejuvenation for Asian skin by intense pulsed light. Dermatol Surg 27:627–631

    Article  CAS  PubMed  Google Scholar 

  30. Goldberg DJ, Cutler KB (2000) Nonablative treatment of rhytids with intense pulsed light. Lasers Surg Med 26:196–200

    Article  CAS  PubMed  Google Scholar 

  31. Leffell DJ (2002) Clinical efficacy of devices for nonablative photorejuvenation (2002). Arch Dermatol 138:1503–1508

    PubMed  Google Scholar 

  32. Noe JM, Barsky SH, Geer DE, Rosen S (1980) Port-wine stains and the response to argon laser therapy: successful treatment and the predictive role of color, age, and biopsy. Plast Reconstr Surg 65:130–139

    CAS  PubMed  Google Scholar 

  33. Raulin C, Hellwig S, Schonermark MP et al. (1997) Treatment of a non-responding port-wine stain with a new pulsed source (Photoderm VL). Lasers Surg Med 21:203–208

    Article  CAS  PubMed  Google Scholar 

  34. West TB, Alster TS (1998) Comparison of the long-pulsed dye and KTP lasers in the treatment of facial and leg teleangiectasia. Dermatol Surg 24:221–226

    Article  CAS  PubMed  Google Scholar 

  35. Ruiz-Esparza J, Goldman MP, Fitzpatrick RE et al. (1993) Flashlamp-pumped dye laser treatment of teleangiectasia. J Dermatol Surg Oncol 19:1000–1003

    CAS  PubMed  Google Scholar 

  36. West TB, Alster TS (1998) Comparison of the long-pulsed dye and KTP lasers in the treatment of facial and leg teleangiectasia. Dermatol Surg 24:221–226

    Article  CAS  PubMed  Google Scholar 

  37. Schroeter CA, Neumann HAM (1998) An intense light source. The photoderm VL-flashlamp as a new treatment possibility for vascular lesions. Dermatol Surg 24:743–748

    Article  CAS  PubMed  Google Scholar 

  38. Goldman MP, Fitzpatrick RE (1990) Pulsed-dye laser laser treatment of teleangiectasia: with and without simultaneous sclerotherapy. J Dermatol Surg Oncol 16:338–344

    CAS  PubMed  Google Scholar 

  39. Polla LL, Tan OT, Garden JM, Parrish JA (1987) Tunable pulsed dye laser for the treatment of benign vascular ectasia. Dermatologica 174:11–17

    CAS  PubMed  Google Scholar 

  40. Kauvar ANB, Grossman MC, Bernstein LJ, Geronemus RG (1996) Treatment of superficial leg veins with a long pulse tunable dye laser [abstract]. Dermatol Surg 2:404

    Article  Google Scholar 

  41. Kauvar ANB, Lou WW, Quintana AT (1999) Effect of cryogen spray cooling on treatment of leg teleangiectasia with 595 nm, 1.5 msec and 755 nm, 3 msec lasers. Lasers Surg Med 22:19

    Google Scholar 

  42. Goldman MP, Eckhouse S (1996) Photothermal sclerosis of leg veins. Dermatol Surg 22:323–330

    Article  CAS  PubMed  Google Scholar 

  43. Kauvar ANB (2000) The role of lasers in the treatment of leg veins. Semin Cutan Med Surg 19:245–252

    CAS  PubMed  Google Scholar 

  44. Kauvar ANB, Lou WW (2000) Pulsed alexandrite laser for the treatment of leg teleangiectasia. Arch Dermatol 136:1371–1375

    CAS  PubMed  Google Scholar 

  45. Dierickx CC, Duque V, Anderson RR (1998) Treatment of leg teleangiectasia. Lasers Surg Med 21[Suppl]:40

  46. Omura NE, Dover JS, Arndt KA, Kauvar ANB (2003) Treatment of reticular leg veins with a 1064 nm lon-pulsed Nd:YAG laser. J Am Acad Dermatol 48:76–81

    Article  PubMed  Google Scholar 

  47. Geronemus RG (1990) Poikiloderma of Civatte. Arch Dermatol 126:547–548

    Article  CAS  Google Scholar 

  48. Polla LL, Margolis RJ, Dover JS et al. (1987) Melanosomes are a primary target of Q-switched ruby laser irradiation in guinea pig skin. J Invest Dermatol 89:281–286

    CAS  PubMed  Google Scholar 

  49. Dover JS, Margolis RJ, Polla LL (1989) Pigmented guinea pig skin irradiated with Q-switched ruby lasers. Arch Dermatol 125:43–49

    Article  CAS  PubMed  Google Scholar 

  50. Stratigos AJ, Dover JS, Arndt KA (2000) Laser treatment of pigmented lesions-2000. Arch Dermatol 136:915–921

    CAS  PubMed  Google Scholar 

  51. Kilmer SL, Wheeland RG, Goldberg DJ, Anderson RR (1994) Treatment of epidermal pigmented lesions with the frequency doubled Q-switched Nd:YAG laser. A controlled, single impact, dose-response, multicenter trial. Arch Dermatol 130:1515–1519

    Article  CAS  PubMed  Google Scholar 

  52. Grevelink JM, Casparian JM, Gonzalez E et al.(1993) Undesirable side effects associated with treatment of tattoos and pigmented lesions with Q-switched lasers at 1064 nm and 694 nm- the MGH experience. Lasers Surg Med 131[Suppl 5]:53

  53. Grossman MC, Anderson RR, Farinelli W et al. (1995) Treatment of café-au-lait macules with lasers. A clinicopathological correlation. Arch Dermatol 131:1416–1420

    Article  CAS  PubMed  Google Scholar 

  54. Taylor CR, Anderson RR (1994) Ineffective treatment of refractory melasma and post-inflammatory hyperpigmentation by Q-switched laser. J Dermatol Surg Oncol 20:592–597

    CAS  PubMed  Google Scholar 

  55. Manaloto RM, Alster T (1999) Erbium:YAG laser resurfacing for refractory melasma. Dermatol Surg 25:121–123

    Article  CAS  PubMed  Google Scholar 

  56. Nouri K, Bowes L, Chartier T et al. (1999) Combination treatment of melasma with pulsed CO2 laser followed by Q-switched alexandrite laser: a pilot study. Dermatol Surg 25:494–497

    Article  CAS  PubMed  Google Scholar 

  57. Taylor CR, Gange W, Dover JS et al. (1990) Treatment of tattoos by the Q-switched ruby laser: a dose-response study. Arch Dermatol 126:893–897

    Article  CAS  PubMed  Google Scholar 

  58. Kilmer SL, Anderson RR (1993) Clinical use of the Q-switched ruby and the Q-switched Nd:YAG (1064 and 532 nm) lasers for the treatment of tattoos. J Dermatol Surg Oncol 19:330–338

    CAS  PubMed  Google Scholar 

  59. Taylor CR, Gange W, Dover JS et al.(1990) Treatment of tattoos by the Q-switched ruby laser: a dose-response study. Arch Dermatol 126:893–897

    Article  CAS  PubMed  Google Scholar 

  60. Fitzpatrick R Goldman M (1993) Alexandrite laser removal of tattoos: a clinical and histological study. Lasers Surg Med 13 [Suppl 5]:54

  61. Kilmer S, Lee M, Farinelli W et al. (1992) Q-switched Nd:YAG laser (1064 nm) effectively treats Q-switched ruby laser resistant tattoos. Lasers Surg Med [Suppl] 4:72

    Google Scholar 

  62. Grekin RC Shelton RM, Geisse JK, Frieden I (1993) 510-nm pigmented lesion dye laser: its characteristics and clinical uses. J Dermatol Surg Oncol 19:380–387

    CAS  PubMed  Google Scholar 

  63. Taylor CR, Anderson RR, Gange W et al. (1991) Light and electron microscopic analysis tattoos treated with the Q-switched ruby laser. J Invest Dermatol 97:131–136

    CAS  PubMed  Google Scholar 

  64. Goldberg DJ, Littler CT, Wheerland RG (1997) Topical suspension-assisted Q-switched Nd:YAG laser hair removal. Dermatol Surg 23:741–745

    Article  CAS  PubMed  Google Scholar 

  65. Nanni CT, Alster TS (1997) Laser-assisted hair removal: optimizing treatment parameters for hair removal using a topical carbon-based solution and 1064 nm Q-switched neodymium:YAG laser energy. Arch Dermatol 133:1546–1549

    Article  CAS  PubMed  Google Scholar 

  66. Grossman MC, Dierickx C, Farinelli W et al. (1996) Damage to hair follicles by normal-mode ruby laser pulses. J Am Acad Dermatol 35:889–894

    CAS  PubMed  Google Scholar 

  67. Cotsarelis G, Sun TT, Lavker RM (1990) Label-retaining cells reside in the bulge area of the pilosebaceous unit: implications for follicular stem cells, hair cycle and skin carcinogenesis. Cell 29:1329–1337

    Google Scholar 

  68. Alora MB, Anderson RR (2000) Recent developments in cutaneous laser surgery. Lasers Surg Med 26:108–118

    Article  CAS  PubMed  Google Scholar 

  69. Zensie HH, Altshuler GB, Smirnov MZ, Anderson RR (2000) Evaluation of cooling methods for laser Dermatology. Lasers Surg Med 26:130–144

    Article  PubMed  Google Scholar 

  70. Finkel B, Eliezri YD, Waldman A et al. (1997) Pulsed alexandrite laser technology fon non-invasive hair removal. J Clin Laser Med Surg 15:225–229

    CAS  PubMed  Google Scholar 

  71. Grossman MC, Dierickx CC, Quintana A et al.(1998) Removal of excess body hair with a 800 nm pulsed diode laser. Lasers Surg Med S10:201

    Google Scholar 

  72. Goldberg D (1999) Laser hair removal with a millisecond Q-switched Nd:YAG laser. Lasers Surg Med 11[Suppl]:88

  73. Weiss RA, Weiss MA, Marwaha S et al. (1998) Hair removal with a non-coherent filtered flashlamp pulsed light source. Lasers Surg Med 10:190

    Google Scholar 

  74. Dierickx CC, Grossman MC, Farinelli WA et al.(1998) Permanent hair removal by normal-mode ruby laser. Arch Dermatol 134:837–844

    Article  CAS  PubMed  Google Scholar 

  75. Grossman MC, Lou WW, Geronemus RG et al. (2000) Long term comparison of different lasers and light sources for hair removal. Lasers Surg Med 12 [Suppl]:89

  76. Lin DT, Dierickx CC, Campos VB et al. (1999) Reduction of regrowing hair shaft size and pigmentation after ruby and diode laser treatments. Lasers Surg Med 11[Suppl]:86

  77. Dierickx CC, Grossman MC, Farinelli WA et al. (1998) Permanent hair removal by normal-mode ruby laser. Arch Dermatol 134:837–844

    Article  CAS  PubMed  Google Scholar 

  78. Dierickx CC, Grossman MC, Farinelli WA et al. (1998) Comparison between a long pulsed ruby laser and a pulsed infrared laser system for hair removal. Lasers Surg Med 10 [Suppl]:201

  79. Kauvar ANB (2000) Treatment of pseudofolliculitis barbae with a pulsed infrared laser. Arch Dermatol 136:1343–1346

    CAS  PubMed  Google Scholar 

  80. Ross EV, Cooke LM, Timko AL et al. (2002) Treatment of pseudofolliculitis barbae in skin types IV, V, VI with a long-pulsed neodymium:yttrium aluminum garnet laser. J Am Acad Dermatol 47:263–270

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung für kutane Laser-Chirurgie, Fachbereich Dermatologie, Medizinische Fakultät an der Universität Athen, Krankenhaus für Haut- und Geschlechtskrankheiten "Andreas Sygros", (Griechenland)

    A. J. Stratigos

  2. SkinCare Physicians of Chestnut Hill, Fachbereich Dermatologie, Medizinische Fakultät an der Universität Yale, Medizinische Fakultät Dartmouth, (USA)

    J. S. Dover

  3. SkinCare Physicians of Chestnut Hill, Fachbereich Dermatologie, Medizinische Fakultät an der Universität Yale, Medizinische Fakultät Dartmouth, Fachbereich Dermatologie, Medizinische Fakultät Harvard, (USA)

    K. A. Arndt

  4. SkinCare Physicians of Chestnut Hill, Fachbereich Dermatologie, Medizinische Fakultät an der Universität Yale, Medizinische Fakultät Dartmouth, Fachbereich Dermatologie, Medizinische Fakultät Harvard, 1244 Boylston Street, Chesnut Hill, MA 02467, USA

    K. A. Arndt

Authors
  1. A. J. Stratigos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. S. Dover
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. A. Arndt
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stratigos, A.J., Dover, J.S. & Arndt, K.A. Lasertherapie in der ästhetischen Dermatologie. Hautarzt 54, 603–613 (2003). https://doi.org/10.1007/s00105-003-0549-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-003-0549-7

Schlüsselwörter

Keywords

Search

Navigation