Ablative Laser

Laser systems of various wavelengths are used in dermatology. In order to achieve selective photothermolysis of the target structure without causing thermal damage to the surrounding tissue, the wavelength, energy and pulse duration of the laser radiation must be specifically selected. Ablative lasers ablate parts of the epidermis and the upper dermal areas - creating a wound surface. The guideline for laser therapy of the skin lists CO2 lasers and erbium:YAG(erbium:yttrium-aluminum-garnet) lasers as ablative laser systems.

Important areas of application for ablative lasers include the treatment of actinic keratoses and scar therapy.

Actinic keratoses: Laser-assisted PDT: Ablative fractionated lasers can also support photodynamic therapy (PDT) for actinic keratoses with field carcinogenization: the use of lasers significantly improves the uptake of 5-methyl-aminolevulinic acid - a metabolic precursor of the photosensitizer protoporphyrin IX (laser-assisted drug delivery [LADD]).

After ablative laser therapy, the guideline provides for adequate follow-up care. The focus here is on protecting against infections and free radicals, modulating inflammation, supporting cell proliferation and accelerating migration as well as promoting remodeling. One option mentioned in the guideline is the use of topical products containing dexpanthenol, such as ^Bepanthen® wound and healing ointment.

1. S2k guideline on laser therapy of the skin, AWMF register number 013-095, 2022; available at: https://www.awmf.org/uploads/tx_szleitlinien/013-095l_S2k_Lasertherapie-der-Haut_2022-03.pdf; accessed: o7.1.2023