The PDL laser, or dye laser, acts on the haemoglobin in the blood vessels, allowing it to fade the redness of the skin and achieve a gradual disappearance of the capillaries. The PDL laser treats vascular lesions on the skin, acne, scars, benign pigment spots, psoriasis on certain parts of the body and many other dermatological indications. It also gives very good results as a method of non-invasive skin rejuvenation.

What is a PDL laser?

The Pulsed Dye Laser (PDL) belongs to the group of vascular lasers. The light source of a PDL laser is an organic dye mixed in a solution. A high-energy light source (another laser or an intense pulsed flash) in the device stimulates the dye molecules to a higher energy level, where they start emitting light of a specific wavelength. The PDL laser emits light at a wavelength of 595 nm with a pulse duration of 0.45-40 ms.

How does the dye laser (PDL laser) work? 

The PDL laser works on the principle of selective photothermolysis. The laser light is selectively absorbed in the target structure without damaging the surrounding tissue. The target structure in vascular lasers is the haemoglobin in the blood vessels, overheating of which causes damage to the capillary wall. In the wall of red capillaries, the heat effect causes proteins to coagulate, and these are gradually broken down and removed by the body’s own mechanisms. The absorbed energy of the laser light produces a clinical effect, which is ultimately visible as a fading of the redness and a gradual disappearance of the capillaries.

Which lesions are treated with the PDL laser?

Vascular changes on the skin

• fire marks (lat. Nevus flammeus),
• superficial haemangiomas,
• tiny red telangiectasias on the face, nose, legs and elsewhere,
• angiomas and spider angiomas,
• Rosacea,
• skin redness in Keratosis pilaris,
• Poikiloderma Civatte on the neck and chest,
• reticular capillaries formed after sclerosation of smaller veins,
• bruising after aesthetic or surgical procedures.

 

The PDL laser’s light energy acts primarily on haemoglobin in the blood vessels, where the light is targeted and converted into heat, which damages the blood vessel wall. These are subsequently gradually broken down. The settings of the device vary depending on the location of the lesions on the skin, their appearance and the skin type of the patient. The width of the light beam and the use of higher energies allow the laser light to penetrate deeper and target larger blood vessels. Lower energies of light are used in areas at increased risk of scarring, such as the chest, neck and eye area. In most cases, the fading of the scars is 80-95% after 8-10 repetitions of the treatment. Fire marks on the face and neck fade faster than those on the legs.

Other dermatological indications 

• viral warts on the hands and feet,
• pyogenic granuloma and angiofibroma,
• inflamed acne,
• red scars and stretch marks.

On average, three repetitions should be done at 4-6 week intervals, more often for acne.

Benign pigment spots  

• lentigo simplex
• lentigo solaris

Burn scars and hypertrophic scars

The PDL laser has proven to be an effective alternative to surgical excision in patients with hypertrophic scars and burn scars. Several clinical studies have demonstrated the efficacy of the PDL laser in reducing redness and thickness of scars, as well as its effect on reducing itching and improving the aesthetic appearance of the scar.

Nail psoriasis / plaque psoriasis

Several studies have shown the effectiveness of PDL laser in plaque psoriasis. A few studies have also shown efficacy for nail psoriasis.

Non-invasive skin rejuvenation

The laser light also has a skin rejuvenating effect. After the procedure, collagen is re-formed in the skin, which has been proven in clinical studies. The skin becomes smoother, more radiant and has fewer wrinkles. The advantage of this form of skin rejuvenation over other forms of skin rejuvenation is the absence of a recovery period and the almost completely painless procedure. PDL laser skin rejuvenation is suitable for the initial form of photoaging of the skin and for the prevention of ageing. It can be combined with other procedures.

Preparing for the PDL laser procedure

PDL laser treatment is preceded by a visit to a specialist doctor, which includes an examination of the skin lesions to be removed, a discussion of associated diseases and medications, and a discussion of dietary substitutes. Most important is the diagnosis of the lesion to be removed. This is particularly important in the case of pigmented skin lesions, as laser treatment of skin cancer should be avoided.

You will discuss the risks and benefits, possible side effects and expected results of PDL laser therapy. Individual patient characteristics such as phototype and other skin characteristics, gender, age and medication intake will also influence the final effect. The effect of the procedure may vary between individuals and also between individual therapies, which should be carefully reviewed and assessed before repeating the procedure.

The PDL laser procedure can only be performed on skin that is not tanned by the sun.

PDL laser procedure

Before the PDL laser procedure, the skin is cleaned of creams and fine dust particles, and the patient’s eyes are protected with goggles.

• The laser tip is placed on the surface of the skin, then the device is activated.
• In diagnoses where it is necessary to induce bruising, increasing energy flux intensity is applied until bruising occurs.
• Many patients feel every pulse of the laser like a rubber band.
• The laser has built-in cooling with a cooling gas that protects the epidermis and pigment cells of the skin from excessive overheating. Before and after the pulse of laser light, the skin surface is cooled by the cooling gas, which reduces the sensation of pain. Some indications require the laser to be operated without gas cooling.
• Immediately after the procedure, the skin can be further cooled with a cooling gel.

Skin care after the procedure

• Avoid scratching, rubbing the skin and using cleansing gels with granules for the first few days after the procedure.
• Syndet (a liquid wash with a pH of 5) is recommended for washing the skin.
• We recommend using SPF 50+ creams on exposed areas and moisturisers (with Dexpanthenol, aloe vera, hyaluronic acid, etc.) on covered areas of the body.
• Bruising or redness from the procedure can be covered with a coloured concealer on visible parts of the body (face, neck, backs of hands).
• Avoid sun exposure before and during the procedure to avoid tanning of the skin. This reduces the chance of brown spots – the so-called ‘over-pigmentation’ of the skin after inflammation.

What are the side effects and expected occurrences after using the PDL laser?

The expected effects after PDL laser are usually mild, of which:

• Pain during the procedure is relieved by a cooling gas sprayed on the skin a few milliseconds before and after the pulse of the laser beam.
• Redness, itching and mild swelling of the skin, mild burning pain after the procedure, a tightening sensation that occurs immediately after the procedure and may last for a few days.
• The appearance of bruising after the procedure depends on the settings of the PDL laser pulse duration. Extremely short pulses of light cause the capillary wall to break down, resulting in a post-procedure bruise. The bruise disappears in about a week. For some diagnoses (Nevus flammeus, scars after surgery or burns, hypertrophic scars, psoriasis, Keratosis pilaris and viral warts) we advise this setting to increase the efficacy and reduce the number of repeat procedures.

Unexpected side effects include:

• Reactivation of Herpes simplex (usually in procedures around the mouth).
• Very rarely, the skin pigment can absorb too much of the laser beam’s energy, causing blistering and scabbing. This condition disappears without consequences. Treatment with an antiseptic cream helps to prevent the appearance of skin bacterial infections.
• Change in skin pigmentation. It is rare for damage to the pigment cells of the skin to occur, resulting in the appearance of dark or light patches. In general, with all types of lasers, this is more likely to happen with darker skin phototypes, so it is safer to use lasers on lighter skin phototypes.
• Scar formation (appearing in extremely rare cases, it can be removed with ablative 
• fractional laser).

Who should not have PDL laser treatment?

The procedure is not recommended for people with the following characteristics/in the following cases:

• less than 6 months after taking Roaccutane,
• tattoo therapy
• pregnancy,
• photosensitive epilepsy,
• taking medications: anticoagulants, photosensitising drugs, iron substitutes or taking certain food supplements (discuss these with your doctor before the procedure),
• application of medicinal and cosmetic creams (to be discontinued 3 days before the procedure),
• infection with herpes viruses – as laser therapy is not possible during reactivation/active inflammation,
• active infection of the skin with fungi or bacteria,
• sensitivity to cold (Reynaud’s phenomenon, urticaria to cold, etc.),
• built-in medical devices (pacemakers and other devices); in which case consultation with a doctor is required,
• sun-tanned skin – as blistering or hyper-/hypopigmentation of the skin may occur.

Galerija

Appointments and further information

To book an appointment, contact us Monday to Friday from 8:00 to 16:00 on the following telephone number: 064 12 80 15 or send an e-mail: info@derma-rogaska.si