The Future of Fractional Lasers

Recent insights to the potential of fractional skin treatments have established standard laser procedures to treat aged, sun-damaged skin and scars. On top of this, the concept has been extended to fibrosing conditions, to remove foreign bodies and to treat inflammatory skin diseases. The biggest potential, however, is foreseen with the option of a contact-free temporary opening of the epidermal barrier (TOR, German: gate) to promote new and intensified treatment regimen. To date these concepts are predominantly experimental, although first clinical studies already show a better response rate if actinic keratoses are treated by fractional laser-intensified photodynamic therapy (PDT) in comparison to the conventional PDT. Possible risks may arise due to the fact that fractional laser home devices are at hand. Used in conjunction with topicals of all origins, toxic and allergic reactions may occur. Principles of current fractional laser interventions are presented as facts while visions are given as future indications.