The growing diversification of the patient population coupled with the increasing demand for cosmetic
laser rejuvenation has highlighted the need to develop cutaneous
laser systems and establish treatment protocols for patients with a wide range of skin conditions and phototypes. Recent technologic advancements have provided viable treatment options to achieve clinical outcomes that were previously only attainable in patients with lighter skin tones. This review provides an updated discussion of the range of
laser treatments available for pigmented skin and sets the stage for further advancements. Pigment-specific
laser technology with green, red, or near-infrared light targets a variety of pigmented lesions such as
lentigines, ephelides, café-au-lait macules, and
melanocytic nevi as well as
tattoos and unwanted hair. Short-pulsed
alexandrite, ruby, and
neodymium:
yttrium-aluminum-garnet (
Nd:YAG) lasers are used for pigmented lesions and
tattoos, whereas their longer pulse-width
laser counterparts are used for
laser-assisted
hair removal. Vascular lesions and
hypertrophic scars can be treated with a variety of vascular-specific
lasers, but it is the
pulsed dye laser (PDL) that has long been the gold standard treatment for these lesions due to its high specificity for
hemoglobin and its ability to improve skin surface texture in children and adults.
Laser skin resurfacing techniques for photodamaged skin and atrophic
scars have been optimized with fractional technology to produce excellent clinical outcomes and minimal complication risks. Radiofrequency and nonablative
lasers are also used to provide skin tightening and
collagen remodeling with virtually no postoperative recovery.