All lasers are not the same. They are tools or instruments that come in a variety of different forms and are designed to perform different tasks. Some lasers vaporize the outer layers of sun-damaged or aging skin. Some can also pass through the outer layers of the skin and destroy deeper birthmarks (port-wine stains) or tiny blood vessels (spider veins.)

As is the case with most technology the use of lasers is an art form that improves with training and experience. Lasers, like any technology must be used for the right reasons. The right reason is that, in the facial surgeon’s opinion, it is superior to other forms of treatment, in terms of safety and outcomes. For some conditions, lasers exceed other forms of treatment. For others, I have found laser therapies to be inferior. So, if training in dermabrasion and chemical peeling was not offered during residency or fellowship, it is recommended that the surgeon arrange to spend enough time with a colleague who performs these procedures to feel comfortable offering and performing them.

Information about skin resurfacing technology is best received from experienced surgical colleagues, not from the sales representatives of the companies who manufacture and sell the equipment. And keep in mind that some colleagues are compensated spokespersons for technology companies. When reading written materials or attending lectures on skin resurfacing, pay attention to disclosures each speaker is required to state at the beginning of the presentation.

■ Laser Hair Removal

Unwanted hair on various parts of the body haunts men and women. Fortunately, there are lasers that can address the problem, when the hair is dark. Fine, lightly colored hair is more difficult to eradicate. Laser therapy will remove existing hairs. Those that have not yet come through the skin may require some future treatment.

In reality “laser hair removal” should be considered “hair reduction” because a small percentage of hair grows back, no matter what form of laser hair removal is used. And patients should be thusly informed prior to treatment. Patients who experience regrowth of hair, however, will usually have a finer, less dense population of hair in that anatomical area. Electrolysis and other spa treatments may achieve additional improvement.

Laser-assisted hair removal is less painful and provides longer-lasting results than the traditional methods of hair removal (electrolysis). In experienced hands, scarring is much less apt to occur with laser hair removal than with electrolysis.

Laser hair removal has several advantages. In experienced hands, it is a safe and cost-effective method with few side effects. This method takes a matter of minutes and is virtually pain free. It is also the most effective method of permanent hair reduction approved by the U.S. Food and Drug Administration (FDA).

■ Dilated Blood Vessels, Rosacea, and Pigmented Spots

After years of unprotected sun exposure, the skin will lose its smooth, uniform, youthful appearance. Certain chronic skin conditions (like rosacea) can also cause damage to the collagen and elastic fibers of the dermal layers. Maintenance and rejuvenation of collagen and elastic fibers help maintain a youthful appearance to the skin. Some types of skin conditions improved by laser therapy are benign vascular lesions (telangiectasias, rosacea, flushing, hemangiomas), sunspots, photoaging, different colorations in the skin, fine wrinkles, large pores, and loss of tone and elasticity.

■ Leg Veins