When California physicist Theodore Maiman created the first laser in 1960, skeptics described the technology as "a solution looking for a problem. "Scientists and engineers simply couldn't envision a practical use for it. 

Today, lasers are all around us. They have revolutionized construction, communications, medicine and even supermarket checkout lines. And in the last few years, they have transformed aesthetic medicine. Aesthetic lasers, in fact, have expanded into a half-billion dollar industry.* 

In particular, fractional ablative lasers are catching physicians' attention as the latest tool against aging. These devices resurface and tighten the skin without producing the harmful effects of their fully ablative predecessors. They do so with less downtime and fewer complications so people can get back to their busy lifestyles within one week of treatment. For many patients and physicians, this represents a significant improvement over past technologies. 

Early Lasers 

The traditional CO2 lasers have long been the gold standard in skin resurfacing. These devices effectively sandblasted the top layers of skin, producing smooth, supple results with about three weeks' downtime. But the procedure wasn't without risk. Adverse reactions, such as scarring, infection and abnormal pigmentation, occurred at alarming rates. 

In one study, 36 percent of patients experienced hyperpigmentation after conventional CO2 laser treatments. Physicians also worried about creating unsightly demarcation lines between treated and untreated areas. 

Given these problems, the industry responded with its next generation of lasers, which promised quick, safe results. These nonablative lasers (Nd:YAG 1064 nm, 1320 nm) stimulated collagen and elastin formation by heating, but not ablating or coagulating, the skin. 

Interest in these lasers surged, but the results disappointed. The procedure typically produced a 10 percent to 20 percent improvement in skin tightening and acne reduction, says Jeffrey Epstein, MD, medical director of Cherry Hill Laser and Skin Care Center in New Jersey. "If patients are coming in and paying $3,000, a 10 percent to 20 percent improvement is just not good enough," he says. 

The third generation, fractional ablative lasers, merges the strengths of their predecessors. These lasers break infrared light into thousands of microbeams that bore holes up to 1.5 mm into the epidermis, leaving skin noticeably tighter and more rejuvenated with less downtime and adverse reactions. 

"Fractional ablative lasers are revolutionary because they can erase years from the face with only one week of recovery and minimal risk," says Elizabeth L. Tanzi, MD, co-director of the Washington Institute of Dermatologic Laser Surgery in Washington, DC. 

Ideal candidates are those with deep wrinkles, acne scarring or dyspigmentation. Other indications include surgical and traumatic scars, melasma and stretch marks. 

*Millennium Research Group, US Markets for Aesthetic Lasers and Energy Devices 2007.

Millennium Research Group data quoted in ADVANCE for Healthy Aging magazine and on the Web site. www.advanceweb.com. ADVANCE for Healthy Aging is published by Merion Publications, Inc. Merion Publications' magazines and web sites reach more than 1.8 million doctors, nurses and healthcare professionals in the United States. Click here to view the entire article.

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