Introduction

The 2008 Annual Meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS) was held on December 4-7, 2008, at Wynn Hotel in Las Vegas. The meeting included exceptional presentations by nationally known experts on a wide range of topics in cosmetic dermatology. This summary highlights a few of the excellent presentations.

Best Practice- Best Light Sources for Common Indication

E. Victor Ross MD, Scripps Clinic, San Diego, California, discussed various lasers for treatment of common dermatological conditions. For vascular lesions, he prefers Potassium-Titanyl-Phosphate (KTP) 532nm and Pulse Dye Lasers (PDL; especially for port wine stain), although Intense Pulse Light (IPL) and Alexandrite lasers can also be used. Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser is best for deeper vascular lesions or those in dark skin patients. Tattoos are difficult to treat; various Q- switched lasers including 532nm, Ruby, Alexandrite and Nd:YAG as well as fractional lasers have been used with variable results. For epidermal pigmented lesions, Q- switched 532nm laser is the gold standard; Ruby, Alexandrite, and long pulse KTP 532nm lasers also provide excellent results, however they are associated with hyperpigmentation. IPL can be used but it does not work for light lentigines. For dermal pigmentation (Nevus of Ota), Q-switched lasers such as Alexandrite, Ruby and Nd:YAG work best. Laser treatment of melasma has been disappointing; sun protection and bleaching cream remains mainstay of treatment. Q-switched Nd:YAG can provide good result but it is associated with recurrence. For laser hair reduction, Dr. Ross likes Alexandrite laser followed by the Diode laser; he uses Nd:YAG lasers for darker skin. Leg veins are best treated by sclerotherapy however if one desires laser treatment, long pulsed Nd:YAG laser is preferred. Early pink striae best respond to PDL however treatment of older non-pink striae is difficult. Sebaceous hyperplasia is best treated with hyfrecator, however Erbium, YAG, CO2, long pulsed KTP, or PDL lasers can also be used. In summary, Dr. Ross uses his KTP laser the most since many of his patient’s desire removal of brown spots. He also uses Q-switched alexandrite, long pulsed alexandrite for hair reduction, non-ablative fractional laser for rejuvenation, and PDL for vascular lesions, striae and scars.