Skip to main content
SpringerLink
Log in

Nebenwirkungen in der Therapie mit hochenergetischen Blitzlampen und Lasern

Side effects of therapy with flashlamps and lasers

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

Zusammenfassung

Bei der dermatologischen hochenergetischen Blitzlampen- und Lasertherapie kommt es in Abhängigkeit von eingestrahlter Wellenlänge, Energiedichte und Pulslänge zu photochemischen Prozessen, zu thermischen Effekten, zu Photoablation, photoakustischen Effekten und Photodisruption. Alle diese Effekte können bei sachgerechtem Einsatz zu dermatologisch und kosmetisch optimalen Behandlungsresultaten führen. Sie bergen jedoch bei falschem, nicht sachgerechtem Einsatz ein hohes Risiko für Nebenwirkungen und Schäden. Das Risiko, Nebenwirkungen zu erzeugen, hängt maßgeblich von der Ausbildung und Erfahrung des Behandlers ab. Wichtig ist deshalb zum einen eine gute dermatologische Ausbildung, damit Hautveränderungen in ihrer Dignität richtig beurteilt werden können, aber auch eine Schulung in laserphysikalischen Grundlagen.

Abstract

Dermatologic flashlamp and laser therapy involves photochemical, thermal, photoablative, photoacoustic and phtoodisruptive effects, depending on the wave length, energy density and pulse duration. All of these effects when properly employed can lead to optimal dermatologic and cosmetic results. They also carry a high risk for side effects and damage when not properly used. The risk of side effects depends greatly on the training and experience of the treating physician. Both a solid dermatologic training in order to correctly diagnosis skin changes and knowledge of laser principles are required.

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

Literatur

  1. Nanni C A, Alster T S (1998) Complications of cutaneous laser surgery. Dermatol Surg 24: 209–229

    Article  PubMed  CAS  Google Scholar 

  2. Strauss RM, Sheehan-Dare R (2004) Local molluscum contagiosum infection as a side-effect of pulsed-dye laser treatment. Br J Dermatol 150(5): 1047–1049

    Article  PubMed  CAS  Google Scholar 

  3. Sommer S, Sheehan-Dare RA (1999) Atrophie blanche-like scarring after pulsed dye laser treatment. J Am Acad Dermatol 41(1): 100–102

    Article  PubMed  CAS  Google Scholar 

  4. Haedersdal M (1999) Cutaneous side effects from laser treatment of the skin: skin cancer, scars, wounds, pigmentary changes, and purpura--use of pulsed dye laser, copper vapor laser, and argon laser. Acta Derm Venereol Suppl (Stockh) 207: 1–32

    Google Scholar 

  5. Mork NJ, Austad J, Helsing P, Kasbohm E (1996) Nevus flammeus in small children treated pulsed dye laser (Nevus flammeus hos sma barn behandlet med pulset fargelaser). Tidsskr Nor Laegeforen 116(29): 3474–3475

    PubMed  CAS  Google Scholar 

  6. Lanigan SW, Taibjee SM (2004) Recent advances in laser treatment of port-wine stains. Br J Dermatol 151(3): 527–533

    Article  PubMed  CAS  Google Scholar 

  7. Hammes S, Raulin C (2005) Evaluation of different temperatures in cold air cooling with pulsed-dye laser treatment of facial teleangiectasia. Lasers Surg Med 36(2): 136–140

    Article  PubMed  Google Scholar 

  8. Garrett AB, Shieh S (2000) Treatment of vascular lesions in pigmented skin with the pulsed dye laser. J Cutan Med Surg 4(1): 36–39

    PubMed  CAS  Google Scholar 

  9. Haedersdal M, Gniadecka M, Efsen J et al. (1998) Side effects from the pulsed dye laser: the importance of skin pigmentation and skin redness. Acta Derm Venereol 78(6): 445–450

    Article  PubMed  CAS  Google Scholar 

  10. Eremia S, Li C, Umar SH (2002) A side-by-side comparative study of 1064 nm Nd:YAG, 810 nm diode and 755 nm alexandrite lasers for treatment of 0.3–3 mm leg veins. Dermatol Surg 28(3): 224–230

    Article  PubMed  Google Scholar 

  11. Fodor L, Ramon Y, Fodor A et al. (2006) A side-by-side prospective study of intense pulsed light and Nd:YAG laser treatment for vascular lesions. Ann Plast Surg 56(2): 164–170

    Article  PubMed  CAS  Google Scholar 

  12. Lorenz S, Scherer K, Wimmershoff MB et al. (2003) Variable pulse frequency-doubled Nd:YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port wine stains. Acta Derm Venereol 83(3): 210–213

    Article  PubMed  CAS  Google Scholar 

  13. Raulin C, Greve B (2001) Retrospective clinical comparison of hemangioma treatment by flashlamp-pumped (585 nm) and frequency-doubled Nd:YAG (532 nm) lasers. Lasers Surg Med 28(1): 40–43

    Article  PubMed  CAS  Google Scholar 

  14. Major A, Brazzini B, Campolmi P et al. (2001) Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias. J Eur Acad Dermatol Venereol 15(6): 559–565

    Article  PubMed  CAS  Google Scholar 

  15. Bevin AA, Parlette EC, Domankevitz Y, Ross EV (2006) Variable-pulse Nd:YAG laser in the treatment of facial teleangiectasias. Dermatol Surg 32(1): 7–12

    Article  PubMed  CAS  Google Scholar 

  16. Gambichler T, Avermaete A, Wilmert M et al. (2001) Generalized essential telangiectasia successfully treated with high-energy, long-pulse, frequency-doubled Nd:YAG laser. Dermatol Surg 27(4): 355–357

    Article  PubMed  CAS  Google Scholar 

  17. Apfelberg DB, Bailin P, Rosenberg H (1986) Preliminary investigation of KTP/532 laser light in the treatment of hemangiomas and tattos. Lasers Surg Med 6: 38–42

    Article  PubMed  CAS  Google Scholar 

  18. Silver BE, Livshots YL (1996) Preliminary experiences with the KTP/532 nm laser in the treatment of facial teleangiektasia. Cosmet Dermtol 9: 61–64

    Google Scholar 

  19. Leal-Khouri S, Hruza GJ (1995) Aesthetic laser surgery. J Geriatr Dermatol 3: 249–264

    Google Scholar 

  20. Brauner G, Schliftman A, Cosman B (1991) Evaluation of argon laser surgery in children under 13 years of age. Plast Reconstr Surg 87: 37–43

    Article  PubMed  CAS  Google Scholar 

  21. Apfelberg DB, Maser MR, Lash H (1978) Argon laser treatment of cutaneous vascular abnormalities. Ann Plast Surg 1: 14–18

    Article  PubMed  CAS  Google Scholar 

  22. Dixon J, Huether S, Rotering RH (1984) Hypertrophic scarring in argon laser treatment of portwine stains. Plast Reconstr Surg 73: 771–780

    PubMed  CAS  Google Scholar 

  23. Cosman B (1980) Experience in the argon laser therapy of port-wine stains. Plast Reconstr Surg 65: 119–129

    PubMed  CAS  Google Scholar 

  24. Noe JM, Barsky SH, Geer DE et al. (1980) Port wine stains and the response to argon laser therapy: successful treatment and the predictive role of colour, age, and biopsy. Plast Reconstr Surg 65: 130–136

    Article  PubMed  CAS  Google Scholar 

  25. Wolf JT, Weinberg JM, Elenitsas R et al. (1997) Cutaneous lupus erythematosus following laser induced thermal injury (Vignette). Arch Dermatol 133: 392–393

    Article  Google Scholar 

  26. Goldman L, Hornby P, Meyer R (1965) Radiation from a Q-switched ruby laser. J Invest Dermatol 44: 69–71

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  28. Lowe N, Luftman D, Sawcer D (1994) Q-switched ruby laser: further observations on treatment of professional tattoos. J Dermatol Surg Oncol 20: 307–311

    PubMed  CAS  Google Scholar 

  29. Taylor CR, Anderson R (1990) Ineffective treatment of refractory melasma and poytinflammatory hyperpigmentation by Q-switched ruby laser. J Dermatol Surg Oncol 16: 1092–1096

    Google Scholar 

  30. Achauer B, Nelson J, Vander Kam V et al. (1994) Treatment of traumatic tatoos by Q-switched ruby laser. Plat Reconstr Surg 93: 318

    Article  CAS  Google Scholar 

  31. Anderson RR, Geronemus R, Kilmer SL, et al. (1993) Cosmetic tatoo ink darkening: a complication of Q-switched and pulsed-laser treatment. Arch Dermatol 129: 1010–1014

    Article  PubMed  CAS  Google Scholar 

  32. Ashinoff R, Levine VJ, Soter NA (1995) Allergic reactions to tattoo pigment after laser treatment. Dermatol Surg 21: 291–294

    Article  PubMed  CAS  Google Scholar 

  33. Greve B, Chytry R, Raulin C (2003) Contact dermatitis from red tattoo pigment (quinacridone) with secondary spread. Contact Dermatitis 49(5): 265–266

    Article  PubMed  Google Scholar 

  34. Graudenz K, Greve B, Raulin C (2003) Diffused traumatic dirt and decorative tattooing. Removal by Q-switched lasers. Hautarzt 54(8): 756–759

    Article  PubMed  CAS  Google Scholar 

  35. Kilmer S, Lee M, Grevelink J et al. (1993) The Q-switched Nd:YAG laser effectively treats tattoos. Arch Dermatol 129: 971–978

    Article  PubMed  CAS  Google Scholar 

  36. Levine VJ, Geronemus RG (1995) Tatoo removal with the Q-switched ruby laser and the Q-switched Nd:YAG laser: a comparative study. Cutis 55: 291–296

    PubMed  CAS  Google Scholar 

  37. Hruza GJ (1995) Skin resurfacing with lasers. Fitzpatrick’s J Clin Dermatol 3: 38–41

    Google Scholar 

  38. Lowe NJ, Lask G, Griffin ME (1995) Laser skin resurfacing: pre- and posttreatment guidelines. Dermatol Surg 21: 1025–1029

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  40. Goldman MP (2006) Cutaneous and cosmetic laser surgery, 1st edn. pp 175–176

  41. Bernstein LJ, Kauvar AN, Grossmann MC et al. (1997) The short- and long-term side effects of carbon dioxide laser resurfacing. Dermatol Surg 23(7): 519–525

    Article  PubMed  CAS  Google Scholar 

  42. Raulin C, Greve B, Warncke SH, Gundogan C (2004) Excimerlaser. Behandlung von iatrogenen Hypopigmentierungen nach Skin-Resurfacing. Hautarzt 55(8): 746–748

    Article  PubMed  CAS  Google Scholar 

  43. Manuskiatti W, Fitzpatrick RE, Goldman MP et al. (1999) Prophylactic antibiotics in patients undergoing laser resurfacing of the skin. J Am Acad Dermatol 40(1): 77–84

    Article  PubMed  CAS  Google Scholar 

  44. Fitzpatrick RE, Goldman MP, Satur NM et al. (1996) Pulsed carbon dioxid laser resurfacing of photo-aged facial skin. Arch Dermatol 132(4): 395–402

    Article  PubMed  CAS  Google Scholar 

  45. Raulin C, Greve B (2003) Laser und IPL-Technologie in der Dermatologie und Ästhetischen Medizin, 2. Aufl. Schattauer, Stuttgart, S 10

  46. Wimmerhoff MB, Hohenleutner U, Landthaler M. (2000) Isomorphic phenomenon: adverse effect after epilation with the long-pulsed ruby laser. Arch Dermatol 136(12): 1570–1571

    Article  Google Scholar 

  47. Lapidoth M, Shafirstein G, Ben Amitai D et al. (2004) Reticulate erythema following diode laser-assisted hair removal: a new side effect of a common procedure. J Am Acad Dermatol 51(5): 774–777

    Article  PubMed  Google Scholar 

  48. Moreno-Arias GA, Tiffon T, Marti T, Camps-Fresned A (2000) Urticaria vasculitis induced by diode laser photo-epilation. Dermatol Surg 26(11): 1082–1083

    Article  PubMed  CAS  Google Scholar 

  49. Moreno-Arias GA, Castelo-Branco C, Ferrando J (2002) Side-effects after IPL photodepilation. Dermatol Surg 28(12): 1131–1134

    Article  PubMed  Google Scholar 

  50. Toosi P, Sadiggha A, Sharifian A, Razavi GM (2006) A comparison study of the efficacy and side effects of different light sources in hair removal. Lasers Med Sci 21(1): 1–4

    Article  PubMed  Google Scholar 

  51. Marayiannis KB, Vlachos SP, Savva MP, Kontoes PP (2003) Efficacy of long- and short pulse alexandrite lasers compared with an intense pulsed light source for epilation: a study on 532 sites in 389 patients. J Cosmet Laser Thera 5(3–4): 140–145

    Google Scholar 

  52. Moreno-Arias G, Castelo-Branco C, Ferrando J (2002) Paradoxical effect after IPL photoepilation. Dermatol Surg 28(11): 1013–1016

    Article  PubMed  Google Scholar 

  53. Vlachos SP, Kontoes PP (2002) Development of terminal hair following skin lesion treatments with an intense pulsed light source. Aesthetic Plast Surg 26(4): 303–307

    Article  PubMed  Google Scholar 

  54. Radmanesh M, Mostaghimi M, Yousefi I et al. (2002) Leukotrichia developed following application of intense pulsed light for hair removal. Dermatol Surg 28(7): 572–574

    Article  PubMed  Google Scholar 

  55. El Bedewi AF (2004) Hair removal with intense pulsed light. Lasers Med Sci 19(1): 48–51

    Google Scholar 

  56. Schroeter CA, Groenewegen JS, Reineke T, Neumann HA (2003) Ninety percent permanent hair reduction in transsexual patients. Ann Plat Surg 51(3): 243–248

    Article  Google Scholar 

  57. Schroeter CA, Groenewegen JS, Reineke T, Neumann HA (2004) Hair reduction using intense pulsed light source. Dermatol Surg 30(2 Pt 1): 168–173

    Article  PubMed  Google Scholar 

  58. Fodor L, Ramon Y, Fodor A et al. (2006) A side-by-side prospective study of intense pulsed light and Nd:YAG laser treatment for vascular lesions. Ann Plast Surg 56(2): 164–170

    Article  PubMed  CAS  Google Scholar 

  59. Bäumler W, Vural E, Landthaler M et al. (2007) The effects of intense pulsed light (IPL) on blood vessels investigated by mathematical modeling. Lasers Surg Med 39(2): 132–139

    Article  PubMed  Google Scholar 

  60. Adamic M, Troilius A, Adatto M et al. (2007) Vascular lasers and IPLS: guidelines for care from the European Society for Laser Dermatology (ESLD). J Cosmet Laser Ther 9(2): 113–124

    Article  PubMed  Google Scholar 

  61. Bjerring P, Christiansen K, Troilius A (2003) Intense pulsed light source for the treatment of dye laser resistant port-wine stains. J Cosmet Laser Ther 5(1): 7–13

    Article  PubMed  CAS  Google Scholar 

  62. Ross EV, Smirnov M, Pankratov M, Altshuler G (2005) Intense pulsed light and laser treatment of facial teleangiectasias and dyspigmentation: some theoretical an practical comparison. Dermatol Surg 31(9 Pt 2): 1188–1198

    Article  PubMed  CAS  Google Scholar 

  63. Bjerring P, Christiansen K, Troilius A (2001) Intense pulsed light source for treatment of facial teleangiectasias. J Cosmet Laser Ther 3(4): 169–173

    Article  PubMed  CAS  Google Scholar 

  64. Clementoni MT, Gilardino P, Muti GF et al. (2005) Facial teleangiectasias: our experience in treatment with IPL. Lasers Surg Med 37(1): 9–13

    Article  PubMed  Google Scholar 

  65. Schroeter CA, Haaf-von Below S, Neumann HA (2005) Effective treatment of rosacea using intense pulsed light systems. Dermatol Surg 31(10): 1285–1289

    Article  PubMed  CAS  Google Scholar 

  66. Retemar RA, Chames C, Pellerano G (2004) Treatment of linear and spider teleangiectasia with an intense pulsed light source. J Cosmet Dermatol 3(4): 187–190

    Article  Google Scholar 

  67. Yamashita T, Negishi K, Hariya T et al. (2006) Intense pulsed light therapy for superficial pigmented lesions evaluated by reflectance-modeconfocal microscopy and optical coherence tomography. J Invest Dermatol 126(10): 2281–2286

    Article  PubMed  CAS  Google Scholar 

  68. Wan CC, Sue YM, Yanf CH, Chen CK (2006) A comparison of Q-swotched alexandrite laser and intense pulsed light for the treatment of freckles and lentigines in Asian persons: a randomized, physician-blinded, split-face comparative trial. J Am Acad Dermatol 54(5): 804–810

    Article  Google Scholar 

  69. Sorg O, Janer V, Antille C, Carraux P et al. (2007) Effect of intense pulsed-light source exposure on lipid peroxides and thymine dimmers in human skin in vivo. Arch Dermtol 143(3): 363–366

    Article  CAS  Google Scholar 

  70. Bjerring P, Christiansen K, Troilius A, Dierickx C (2004) Facial photo rejuvenation using two different intense pulsed light (IPL) wavelength bands. Lasers Surg Med 43(2): 120–126

    Article  Google Scholar 

  71. Prieto VG, Diwan AH, Shea CR et al. (2005) Effects on intense pulsed light and the 1,064 nm Nd:YAG laser on sun-damaged human skin: histologic and immunohistochemical analysis. Dermatol Surg 31(5): 522–525

    Article  PubMed  CAS  Google Scholar 

  72. Weiss RA, Weiss MA, Beasley KL (2002) Rejuvenation of photoaged skin: 5 years results with intense pulsed light of the face, neck and chest. Dermatol Surg 28(12): 1115–1119

    Article  PubMed  Google Scholar 

  73. Goldberg DJ, Samady JA (2001) Intense pulsed light and Nd:YAG laser non-ablative treatment of facial rhytids. Lasers Surg Med 28(2): 141–144

    Article  PubMed  CAS  Google Scholar 

  74. Hedelund L, Bjerring P, Egekvist H, Haedersdal M (2006) Ablative versus non-ablative treatment of perioral rhytides. A randomized controlled trial with long-term blinded clinical evaluations and non-invasive measurements. Lasers Surg Med 38(2): 129–136

    Article  PubMed  CAS  Google Scholar 

  75. Goldman MP, Alster TS, Weiss R (2007) A randomized trial to determine the influence of laser therapy, monopolar radiofrequency treatment, and intense pulsed light therapy administered immediately after hyaluronic acid gel implantation. Dermatol Surg 33(5): 535–542

    Article  PubMed  CAS  Google Scholar 

  76. Semchyshyn NL, Kilmer SL (2005) Does laser inactivate botulinum toxin? Dermatol Surg 31(4): 399–404

    Article  PubMed  CAS  Google Scholar 

  77. Sperber BR, Walling HW, Arpey CJ, Whitaker DC (2005) Vesiculobullous eruption from intense pulsed light treatment. Dermatol Surg 31(3): 345–348

    Article  PubMed  CAS  Google Scholar 

  78. Beyer DM, Wulf HC, Stender IM, Haedersdal M (2006) Treatment by non-physicians of skin diseases – including potentially malignant diseases with lasers and intense pulsed light. Ugeskr Laeger 168(45): 3899–3902

    PubMed  Google Scholar 

  79. Greve B, Raulin C (2002) Professional errors caused by lasers and intense pulsed light technology in dermatology an aesthetic medicine: preventive strategies and case studies. Dermatol Surg 28(2): 156–161

    Article  PubMed  Google Scholar 

  80. Myers P, Bowler P, Hills S (2005) A retrospective study of the efficacy of intense pulsed light for the treatment of dermatologic disorders presenting to a cosmetic skin clinic. J Cosmet Dermatol 4(4): 262–266

    Article  PubMed  Google Scholar 

  81. Hedelund L, Lerche C, Wulf HC, Haedersdal M (2006) Carcinogenesis related to intense pulsed light and UV exposure: an experimental animal study. Lasers Med Sci 21(4): 198–201

    Article  PubMed  CAS  Google Scholar 

  82. Town G, Ash C, Eadie E, Moseley H (2007) Measuring key parameter of intense pulsed light (IPL) devices. J Cosmet Laser Ther 9(3): 148–160

    Article  PubMed  Google Scholar 

  83. Weiss RA, Weiss MA, Munavalli G, Beasley KL (2006) Monopolar radiofrequency facial tightening: a retrospective analysis of efficacy and safety in over 600 treatments. J Drugs Dermatol 5(8): 707–712

    PubMed  Google Scholar 

  84. Alam M, Levy R, Pajvani U et al. (2006) Safety of radiofrequency treatment over human skin previously injected with medium-term injectable soft-tissue augmentation materials: a controlled pilot trial. Lasers Surg Med 38(3): 205–210

    Article  PubMed  Google Scholar 

  85. Fisher GH, Geronemus RG (2005) Short-term side effects of fractional photothermolysis. Dermatol Surg 31(9 Pt 2): 1245–1249; discussion 1249

    Article  PubMed  CAS  Google Scholar 

  86. Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 220(4596): 524–527

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Referententätigkeit für Fa. Cynosure.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    S. Stangl &  W. Kimmig

Authors
  1. S. Stangl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Kimmig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Kimmig.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stangl, S., Kimmig, W. Nebenwirkungen in der Therapie mit hochenergetischen Blitzlampen und Lasern. Hautarzt 59, 108–115 (2008). https://doi.org/10.1007/s00105-007-1459-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-007-1459-x

Schlüsselwörter

Keywords

Search

Navigation