University of Iowa Health Science Relations and
Christopher Arpey, MD
Associate Director of Dermatologic Surgery
First Published: November 2000
Peer Review Status: Internally Peer Reviewed

Do you have a birthmark such as a port wine stain? A tattoo that is no longer the great idea you thought it would be? Liver or age spots? Facial hair that is not one of your finer features?

Laser surgery may be the answer for you.

Christopher Arpey, MD, associate director of dermatologic surgery at the University of Iowa, said the key to success with lasers is using the right laser for the job. He compared using the right laser to using the right tool or kitchen appliance.

"You wouldn't use your coffee maker to make toast. The same is true for lasers. Each type of laser was developed to meet a specific need, and you need to know what each laser can and cannot do."

Laser surgery uses a narrow band of light aimed at a specific area. The light is absorbed by specific parts of the body and is ignored by the rest of the body.

"For example," Arpey said, "some lasers are developed to work on blood vessels but ignore pigmentation while some focus on pigmentation and ignore blood vessels." In laser surgery, the light is absorbed, for example, by red blood cells in visible veins or by melanin pigment found in an age spot or freckle. The light then helps to seal the nearby blood vessels, remove unwanted cells or help break up the pigment and help it fade."

Arpey said laser surgery is not the answer for everything.

"Laser surgery is the way to go to treat a port wine stain." In fact, he said, most practitioners agree that is the most effective means to successfully fade them. However, laser surgery is not as reliable as injection method to treat leg veins. Laser surgery is improving in that field, but it is not quite as good as the traditional method in most instances.

There are four main areas where laser dermatologic surgery is used:

• Vascular - Treat red birthmarks, broken facial veins, and small varicose and spider veins.
• Pigmented lesions - Remove or lighten liver or age spots, tattoos and some birthmarks.
• Hair removal - Remove unwanted facial or body hair.
• Resurfacing - Smoothing wrinkles and superficial scars.

The cost for laser surgery varies with each treatment and the number of times treatment is needed.