Laser treatment methods

Hello! My name is Vladimir Khomchenko. I am the director and one of the founders of the LINLINE Medical Systems. I have been doing research on the interaction between laser radiation and biological tissues since 1994. The results of this research are the methods of laser treatment implemented in our company’s production and protected by national and international patents.

I bring to your attention a series of articles dedicated to the methods of laser treatment in surgery, dermatology, and cosmetology. The articles are based on materials from my presentations at international congresses and conferences on laser medicine, and discuss the main issues which have emerged in the process of physician training.

The following material is meant primarily for physicians working with high-energy lasers. The present status of training physicians to use laser technology is simply disastrous. Judge for yourselves: the path to becoming a physician may take anywhere from 4 to 19 years (college, medical school, residence, specialisations, Ph.D.), but it takes only 1 week to 1 month of training in order for a physician to become a specialist in the field of laser medicine. What is the result? In the majority of cases, laser treatment nowadays is represented by therapeutic procedures while the global history of laser surgery is over 40 years old. Physicians often say, “I’ve worked with lasers, I consider the treatment of (of condition) ineffective.” To the question what laser they worked with and with what light parameters, at best, they will name only the light wave; at worst – the laser device’s trade name. I believe that only high quality physician training will put laser medicine in its rightful place in medical practice.

I believe my articles may also be of interest to patients who are planning treatment with laser methods. I will try to answer all of your questions.

The multiple types of laser treatment used in medicine can be divided into two classes – selective and non-selective.

Selective methods of laser treatment

The point of selective laser treatment is that only a specifically selected target is destroyed. The remaining biological tissues within the range of treatment do not get destroyed. If other biological tissue gets destroyed along with the selected target, the treatment is non-selective.

At present, the majority of “selective” laser treatments do not meet this criterion and cause unnecessary trauma during procedures: during laser removal, micro- or macroscarring of the skin may occur; during coagulation of enlarged blood vessels – burns and scars; during treatment for hyperpigmentation – hypo- or hyper-depigmentation, and often, scarring as well; the destruction of tattoo pigments is also accompanied by scarring. The list can go on and on.

How can we distinguish between the selective treatment and the pseudo-selective treatment directly during the time of the procedure and not by the treatment results? The main criterion is pain. If the procedure cannot be performed without an anesthetic, if the pain in the area with the destroyed “targets” and outside of it is relatively similar, then the method is not selective enough. What is pain, anyway? Pain is the natural signaling system of the body in cases of excessive trauma. If only local bio-entities are being destroyed, the feelings of pain will form based on the signals coming from the nerve endings located directly inside or near the entity which is being destroyed. If there is no “target” in the laser radiation field, there should not be any pain because there is no radiation absorption and, consequently, no trauma.

Therefore, the main task in the development of selective methods for laser treatment is to increase the treatment’s “degree of selectivity” so that the risk of undesirable side effects is minimised as much as possible and the treatment process becomes predictable.


Non-selective methods of laser treatment

With non-selective methods, all the biological tissues in the laser radiation range experience approximately the same effect – coagulation, vaporisation or ablation (depending on the laser radiation parameters). The non-selective methods can be used effectively in those cases when the tissues subjected to the treatment are on the surface and are not covered by healthy tissues whose destruction is undesirable.

In aesthetic medicine, the non-selective methods are used for the removal of various formations, wrinkles, scars, the treatment of acne and psoriasis, and many other procedures.

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