Alster Tina S, Khoury Randa R
Washington Institute of Dermatologic Laser Surgery, 1430 K Street, NW, Suite 200, Washington, DC 20005, USA.
Facial Plast Surg. 2009 Dec;25(5):316-23. doi: 10.1055/s-0029-1243080. Epub 2009 Dec 18.
Modern lasers and light-based sources that were developed based on the theory of selective photothermolysis are capable of destroying specific tissue targets while minimizing the risk of scarring and pigmentary changes. This is accomplished through the use of a wavelength and pulse duration that is best absorbed by a specific chromophore such as melanin or hemoglobin. However, not all lasers and light sources adhere to this principle. Continuous wave (CW) lasers are least selective and may produce unwanted tissue damage and scarring through heat conduction to normal skin. Quasi-CW lasers limit excessive thermal destruction by delivery of a series of brief laser pulses but still pose a higher risk of nonspecific tissue damage and thermal injury. The pulsed and Q-switched (QS) systems adhere most closely to the principles of selective photothermolysis and result in the highest degree of selective destruction with the lowest risk of scarring from excessive thermal diffusion. Certainly, any laser system potentially can result in scarring and tissue damage when used incorrectly; therefore, adequate operator education and skill are essential. Side effects and complications that occur as a consequence of laser treatment can be significantly reduced if diagnosed and treated in an expeditious manner.
基于选择性光热解理论开发的现代激光和光基光源能够破坏特定的组织靶点,同时将瘢痕形成和色素沉着变化的风险降至最低。这是通过使用特定发色团(如黑色素或血红蛋白)最易吸收的波长和脉冲持续时间来实现的。然而,并非所有激光和光源都遵循这一原理。连续波(CW)激光选择性最低,可能通过热传导至正常皮肤而产生不必要的组织损伤和瘢痕形成。准连续波激光通过发射一系列短暂的激光脉冲来限制过度的热破坏,但仍存在较高的非特异性组织损伤和热损伤风险。脉冲和调Q(QS)系统最严格地遵循选择性光热解原理,导致最高程度的选择性破坏,同时因过度热扩散而形成瘢痕的风险最低。当然,如果使用不当,任何激光系统都可能导致瘢痕形成和组织损伤;因此,操作人员接受充分的培训并具备相应技能至关重要。如果能迅速诊断并治疗,激光治疗引起的副作用和并发症可显著减少。