Basic foods:
- The risk of non-melanoma skin cancers among patients undergoing annual laser treatments was reduced by 48% compared to controls.
- The procedure requires only 1 week of downtime.
Non-ablative fractional laser resurfacing can offer cosmetic benefits to patients and may also prevent non-melanoma skin cancer, according to an expert.
Non-ablative fractional lasers are FDA-approved for the treatment of actinic damage and have previously demonstrated the ability to treat precancerous actinic keratoses (AKs), while ablative fractional lasers have shown efficacy in the prevention of non-melanoma skin cancer.
In 2023, a group of researchers published a study in Dermatological Surgery which showed that non-ablative fractional lasers also reduce the risk for subsequent facial skin cancer lesions and may offer a preventive benefit similar to that of ablative fractional lasers.
Healio spoke to me Swati Kannan, MD, a dermatologist, Mohs surgeon and associate professor of dermatology at the UC San Diego School of Medicine, about these results and how they apply to the latest non-ablative fractional laser practices for the prevention of non-melanoma skin cancer.
Healio: How does annual non subtractive Resurfacing with fractional laser reduces the risk for development of non-melanoma skin cancer and why it may be preferred over ablative lasers?
Kanan: In 2023, a team at Harvard looked at patients who had a history of skin cancer. One group underwent annual nonablative fractional laser resurfacing (n = 43) and the other group was controlled (n = 52). Among patients who received annual laser treatment, the risk of non-melanoma skin cancers was reduced by 48% compared to controls. If they did develop a new skin cancer, there was a significant delay in when they developed the next skin cancer when they received the annual laser resurfacing.
The reason we think this is because the laser gets rid of sun damage as well as precancerous cells called AKs. Healthier, younger skin is much less likely to develop skin cancer. However, damage from sun exposure affects the cells’ DNA, which cannot be cured. Therefore, patients must continue with annual resurfacing laser treatments versus just one and they’re done.
Non-ablative laser resurfacing means that these tiny columns are created in the skin by the laser without removing the epidermis. This allows for much less downtime and better recovery.
Healio: Who should seek this treatment and when should it start?
Kanan:The ideal patient is someone with a history of sun damage who has multiple AKs, or any patient with light skin who has a high lifetime cumulative UV dose. It is also great for patients who want cosmetic benefits because they are going to have improved skin texture, better skin tone and fewer wrinkles. It’s a win-win when it comes to these antiaging treatments.
In terms of frequency, I usually recommend about once a year. I live in California where we don’t have seasons. So I recommend that patients take it whenever they can plan for about 1 week of downtime. In other parts of the country where they have real fall and real winter, it’s ideal to do it when the sun exposure is much lower.
Healio: What are the best techniques when performing this procedure?
Kanan: This particular article focused on non-ablative fractional laser resurfacing, but we know that we can also use ablative fractional laser resurfacing, as both can reduce the risk of skin cancers. However, there is less downtime with non-subtractive resurfacing.
The wavelength of choice for most non-ablative fractional lasers is the 1927 nm wavelength, which is best for surface pigment and clearance of AKs. In my office, patients come in an hour before their appointment and we apply a local anesthetic for about 60 minutes. The numbness is then removed. We put on eye shields and then do the laser treatment with the 1927 nm, where we do about eight passes over the whole face or any treatment area, whether it’s the neck or the chest.
Typically for light skinned patients, I will use a higher flow and slightly higher density. For patients with darker skin or patients who are actively tanned, I will lower my flow and use a lower density, which can cause patients to feel sunburned for about 1 hour after the procedure. The next day they can start wearing make-up, sunscreen and go about their daily activities, avoiding the sun at its peak.
Healio: How important is it for people to seek preventive skin cancer procedures like this?
Kanan: Younger generations still experience sun damage and many don’t wear sunscreen, so it’s important to practice preventative care. Especially where I live in California, the burden of skin cancer is very high. I see skin cancers at a much younger age than when I lived in the Midwest.
Annual resurfacing treatments and annual topical treatments can help reduce the burden of skin cancer and skin cancer surgeries, which can cause disfigurement. Admittedly, we have no proof whether these lasers can reduce the risk of melanoma, which is the deadliest skin cancer. We know that they reduce the risk for basal cell and squamous cell carcinoma, and that’s a really great area to focus on for our patients.
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For more information:
Swati Kannan, MD, you can contact dermatology@healio.com.
