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    Fractional lasers point to future with smart technology

    Denver — Smart fractional technology represents an exciting development for medical treatments with fractional lasers, says an expert who spoke at the 72nd Annual Meeting of the American Academy of Dermatology.

    Current devices do the equivalent of carpet-bombing their targets, making patterns of injury to the desired depth, according to R. Rox Anderson, M.D., Harvard Medical School, director of the Wellman Center for Photomedicine and adjunct professor of health sciences and technology at Massachusetts Institute of Technology (MIT), Boston.

    "But we're not really shooting at anything. I look forward to the day when we have some image guidance behind those microbeams, which are clearly well tolerated by the skin."

    Such technology, perhaps using optical frequency domain imaging (a project of his Wellman colleague Ben Vakoc, Ph.D.), could one day target sebaceous gland specifically, for example, or remodel the surface of scars, Dr. Anderson says.

    "If you look at our colleagues in ophthalmology, LASIK is a very well-developed procedure that basically changes the shape of tissue with a laser microbeam. We never do that in dermatology, but I believe it would be easy. Industry is missing this boat," he says.

    While laser-assisted drug delivery uses the microscopic channels created by fractional beams to transport medications through the skin, Dr. Anderson says he is perhaps more intrigued by the possibility of using these channels to remove unwanted elements such as tattoo pigment.

    "Tattoos consist of nanoparticles that are embedded in cells within the dermis. We use Q-switched lasers to rupture the ink and kill the cells, but then the ink particles don't really exit the skin. I believe it's possible to combine Q-switched and fractional laser" to make these channels perform that function, Dr. Anderson says.

    John Jesitus
    John Jesitus is a medical writer based in Westminster, CO.

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