Lasers in dermatology: a selective historical review

Lasers have been used in dermatology for over 20 years. Multiple lesions including port wine stains, decorative tattoos, malignant tumors, and keloids have been treated with various lasers. Initial therapy exploited the laser property of spatial confinement of an extremely high energy density to create a localized thermal effect. With increased understanding of laser technology, skin optics, and laser-tissue interactions, other laser properties such as monochromaticity and pulsewidth variability have been exploited to even further confine damage to pathologic tissue while maximally sparing surrounding normal tissue. This increased knowledge has led to a vast improvement in the results of dermatologic laser therapy. Despite this, laser therapy still remains a surgical art, with wound healing playing a large part in the final outcome.