Laser therapies

Laser therapy deals only with superficial scars. Different lasers are reported in the literature to be effective (diode, Nd YAG, pulsed Dye) even if they could have adverse effects such as hypo/hyperpigmentations. 

McBurney El (2002) Side effects and complications of laser therapy. Dermatol Clin 20(1) 165-176... 

Provide patient education with regard to disease state, drug therapy, and surgical or laser therapy ... 

It is known that peroxynitrite is able to induce DNA strand breakage, which activates nuclear enzyme poly(ADP ribose) synthase (PARS). Szabo et al. [257] showed that the inhibition of PARS by oral treatment with lipophilic inhibitor 5-iodo-6-amino-l,2-benzopyr-one delayed the onset of arthritis in rats. It is possible that infrared pulse laser therapy can be useful for the treatment of RA patients [258]. 

Musabayev A, Spicina A, Ibadova G, Ibadov R (1996) Clinical pathogenic substantiation of intravascular laser therapy in complex management of patients with acute and chronic hepatitis. Int Islamic Med J Baku Azerbaijan 2 33-36... 

Oxidant and Antioxidant Status of Patients with Chronic Leg Ulcer Before and After Low Intensity Laser Therapy... 

The technology of Low Level Laser Therapy (LLLT) was introduced into clinical medicine more than three decades ago. This form of treatment has great appeal due to its novelty, ease in use, relatively cost-efficient and low morbidity profile [5], LLLT has been shown to improve remarkably the process of wound healing in humans [5-8] and animal models [9-11], In vitro studies demonstrated that LLLT has a stimulating effect on cell mitosis [12] and proliferation and migration of fibroblasts [13], keratinocytes [14, 15] and endothelial cells [16], LLLT enhances NO secretion [17] and cytokine production [18, 19] and may lead to increased dermal angiogenesis [20],... 

Before commencing the sessions the patients were assessed by physical examination and full medical history including age, sex, occupation, residence, special habits of medical importance with particular emphasis on the history of the underlying disease including duration of ulcer, mode of onset, ulcer pain, history of deep vein thrombosis or varicose veins, trauma, lump, varicosities, contact dermatitis and symptoms suggestive of ischaemia. Photographic reference of ulcer and ulcer area measurements were carried out at the commencement of treatment and during the follow up laser therapy, which continued for 6 months. 

After laser therapy there was a significant decrease in the mean size of ulcer (Figs. 27.1-27.3) compared to its level before laser therapy (14.40 1.98 vs 17.34 2.28, p<0.01). The total number of ulcers which showed complete healing was 23 (34%). An incomplete healing was found in 42 cases (63%) and two ulcers deteriorated (3%). 

Fig. 27.1 Chronic leg ulcers of a 60 years old male patient before and after laser therapy, three sessions per week at energy fluence of 0.5 J cm , He-Ne laser. Duration of ulcer was 16 months...

Fig. 27.2 Chronic leg ulcers on the lateral lower half of the leg of a 45 years old male patient before (a) and after laser therapy (b). Duration of ulcer was 2 years and the ulcer size before treatment was 5 cm. This patient received three sessions per week of 0.5 Jcm He-Ne laser LETT and complete healing was achieved in the 12th session...

Before Laser Therapy After Laser Therapy... 

Fig. 27.3 Decrease in mean size of ulcer after laser therapy...

The increase in levels of tissue CAT is compatible with previous results which showed that LLLT induced an increase in CAT activity of irradiated isolated cardio-myocytes compared to controls. It was suggested that laser therapy efficacy in chronic wounds and ulcers can be attributed to the activation of CAT in tissue fluids [62]. He-Ne laser has been shown to cause photoactivation and structural modifications of catalase enzymes that positively correlated with its functional properties in cell free system [63]. 

Sugrue M, Carolan J, keen E, Feeley T, Moore D, Shanik G (1990) The use of infrared laser therapy in the treatment of venous ulceration. Ann Vase Surg 4(2) 179-181... 

Yasukawa A, Hrai H, Koyama Y, Nagai M, Takakuda K (2007) The effect of low reactive-level laser therapy (LLLT) with helium-neon laser on operative wound heahng in a rat model. J Vet Med Sci 69(8) 799-806... 

Colin W, Steiniechner B, Dyson M (1993) The effect of low level laser therapy on the proliferation of keratinocytes. Laser Therapy 5 65-73... 

Schindl A, Schindl M, Schindl L, Jurecka W, Honigsmann H, Breier F (1999) Increased dermal angiogenesis after low intensity laser therapy for a chronic radiation ulcer determined by a video measuring system. J Am Acad Dermatol 40 481 84... 

---