“The number one reason people come in for laser and light treatments is for sun damage, sun freckles and/or treating fine lines and wrinkles that appear as a result of sun exposure,” said Patricia Richey, MD, FAAD. , director of Mohs surgery at Boston Medical Center in Massachusetts during a recent interview with Dermatology Times. “There are 2 different wavelengths in particular that we’ve looked at for preventing skin cancers.”
Richey shared insights from her clinical experience and research into the use of laser treatments to prevent skin cancer.
The prevalence of skin cancer and preventive measures
“First of all, we know that skin cancer is the most common cancer in the US,” Richey said, emphasizing the broad nature of this health issue.1 Despite the high prevalence, he noted that significant strides have been made in both prevention and treatment. “We have amazing ways to treat skin cancer, but we know that while there are certain genetic risks that can put you at risk for skin cancer, there are certain treatments, both topical and laser, that can help prevent them. , UV exposure, so sun exposure is still, by far, our biggest contributor.”
Richey emphasized the importance of reminding patients to take precautions against UV exposure, suggesting SPF 50 or higher with zinc oxide in it and wearing some protective clothing.
Advances in laser treatments
Richey believes that laser treatments are becoming an increasingly important tool in skin cancer prevention. Historically, most laser research has focused on ablative lasers, which remove part of the skin. Although effective, Richey noted the downsides, saying, “It’s a painful procedure. You need more time off work, and because you’re removing pieces of skin, it can lead to some kind of pigmentation and you can have some scarring.”
Exploring non-ablative fractional lasers
According to Richey, a major advance in this area is the shift to non-ablative fractional lasers. She explained, “More recently, I would say, in the last year and a half, there have been a lot of different ways that you can treat precutaneous cancers, actinic keratosis, and or treat the underlying skin to prevent skin cancers.” These newer treatments offer reduced downtime and fewer side effects, making them more patient-friendly.
The 2 main wavelengths used in these lasers are the 1927 nanometer and the 1550 nanometer fractional non-ablative lasers. Richey elaborated, “The fractional, non-ablative 1927 nanometer laser is the laser that comes back to the surface. So it treats the lens and brown spots. Then a slightly deeper version of the fractional laser, the 1550 nanometer laser, primarily heats the your dermis to produce this wound healing response.” Both lasers have shown effectiveness in preventing skin cancers while improving the overall appearance and health of the skin.2-3
Benefits for skin health and different skin types
Richey emphasized the potential of these treatments to enhance skin health and possibly reduce post-surgical scarring. He noted, “When we do these fractional lasers, they increase something called insulin-like growth factor [IGF] on your skin. IGF is anti-carcinogenic, so we believe that maybe this is one of the mechanisms by which the laser prevents skin cancers, but also helps your overall skin health. So, combined with that warming of your skin creating a wound healing response may mean your skin is better at healing, but we can’t say for sure right now.”
The effectiveness of non-ablative fractional lasers on various skin types is another critical advantage. Richey pointed out, “If you have someone who knows what they’re doing with their settings, 1550 nanometers in particular can be used safely on all skin types.” This content is crucial because skin cancer can affect people of all skin tones, and historically, treatments have not always been suitable for darker skin, especially since delayed diagnosis is common with darker skin.4
Long-Term Prevention and Future Prospects
Discussing the future of laser treatments in dermatology, Richey expressed optimism about their role in skin cancer prevention. “In the most recent studies, and this came primarily from Matt Abram and Brian Hibler at Mass Gen, they found that people who received even 1 of these non-ablative, fractional laser treatments were half as likely as their counterparts to have another skin cancer in 6 years,” she shared.5
Current limitations and ongoing research
While non-ablative fractional lasers show promise in prevention, Richey is cautious about their use in treating existing skin cancers. “I wouldn’t necessarily use lasers at this point to treat what we know is skin cancer on someone’s face, but I think that day is coming,” he said. For now, traditional methods such as Mohs surgery remain the gold standard for higher-risk tumors and those located in critical areas such as the face or hands.” [non-ablative fractional lasers] as it plays an amazing role in preventing skin cancer. Again, without treating skin cancers, you’re actually doing an excision or Mohs surgery on a known basal cell or a squamous cell,” he concluded.
References
- US Department of Health and Human Services. The Surgeon General’s call to action to prevent skin cancer. Washington (DC): Office of the Surgeon General (US). 2014. Skin cancer as a major public health problem. Available from: https://www.ncbi.nlm.nih.gov/books/NBK247164/
- Brauer JA, McDaniel DH, Bloom BS, Reddy KK, Bernstein LJ, Geronemus RG. Nonablative fractional resurfacing 1927 nm for the treatment of facial photopigmentation. J Drugs Dermatol. 2014? 13(11):1317-1322.
- Friedman P, Chapas A, Kilmer S, et al. Optimizing results with the 1550/1927 nm dual-wavelength non-ablative fractional laser: Recommendations from experienced users. J Drugs Dermatol. 2021? 20 (11): 1150-1157. doi:10.36849/jdd.6181
- Gupta AK, Bharadwaj M, Mehrotra R. Concerns about skin cancer in people of color: Risk factors and prevention. Asian Pac J Cancer Prev. 2016? 17(12):5257-5264. Published December 1, 2016. doi:10.22034/APJCP.2016.17.12.5257
- Simple laser treatments may help prevent non-melanoma skin cancer. Press release. Massachusetts General Hospital. 18 January 2023. Accessed 17 June 2024.
