Zusammenfassung
In dieser Arbeit soll ohne Anspruch auf Vollständigkeit auf einige relevante Innovationen in der dermatologischen Lasertherapie eingegangen werden. Eine der wichtigsten stellt die fraktionale Lasertherapie dar. Insbesondere für die Behandlung der Altershaut und der Aknenarben hat sich diese neue Behandlungsoption bewährt. Bei Melasma und anderen Hyperpigmentierungen ist das Verfahren zumindest bei manchen Patienten wirksam, und auch für andere, seltenere Indikationen gibt es Erfolg versprechende Berichte. Ein zweites Verfahren, das zunehmend Verbreitung findet, ist die Laserlipolyse, sei es zur Unterstützung der Liposuktion oder als alleinige Therapieoption. Mittels subkutan eingeführter Fasern bzw. Handstücke wird das Fettgewebe durch Laserlicht lysiert und wohl auch dermales Bindegewebe erhitzt. Im Vergleich zur alleinigen Liposuktion sollen die Nebenwirkungen geringer sein, und zusätzlich soll eine Gewebestraffung induziert werden. Unklarheit besteht noch darüber, welche Wellenlängen(kombinationen) und Parameter hier als optimal einzustufen sind und ob das Verfahren klassischen Liposuktionstechniken überlegen ist. Darüber hinaus wird noch auf einige Verbesserungen in der Therapie von vaskulären Veränderungen, insbesondere durch den Einsatz längerer Wellenlängen, und einige unkonventionelle, experimentelle Therapieansätze bei nicht klassischerweise durch Laser behandelbaren Erkrankungen eingegangen.
Abstract
Dermatologic laser therapy is a rapidly-changing field with many new innovations. One of the most important is the introduction of fractional photothermolysis. This method is established for skin rejuvenation and acne scars; both the original non-ablative devices and newer ablative ones are available. While its side effects and the patient’s downtime are considerably less than with ablative skin resurfacing, its efficacy is much better than non-ablative laser skin rejuvenation. This approach is also effective for melasma and other forms of hyperpigmentation in some patients. Successful reports exist also for treating other, more infrequent dermatoses. Another new procedure is laser lipolysis. It can be used as an adjunct to classical liposuction or as laser lipolysis alone. Fat lysis is achieved by laser energy via fibers that are inserted in the subcutaneous fat, and the additional heating of dermal tissue may lead to the reduction of side effects such as bleeding and to reduction of skin laxity. Nevertheless, the superiority of laser lipolysis to classical liposuction techniques is not yet established, and the ideal wavelengths and treatment parameters are not yet fully clear. There have been improvements in the therapy of vascular lesions, especially the use of longer, infrared wavelengths. In addition, there is early information on experimental therapeutic approaches for diseases normally not amenable to laser therapy such as onychomycosis, hemorrhoids and allergic rhinitis.
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Hohenleutner, U. Innovationen in der dermatologischen Lasertherapie. Hautarzt 61, 410–415 (2010). https://doi.org/10.1007/s00105-009-1881-3
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DOI: https://doi.org/10.1007/s00105-009-1881-3