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-CyASIA-Energy-based Devices in Aesthetic Dermatology

My Choice of Lasers and Light Devices in Dermatology Over the Past Decades

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Chee-Leok Goh
Senior Consultant
Dermatologist at the National Skin Centre
Clinical Professor
Faculty of Medicine of the National University of Singapore
Singapore
drgohcl@gmail.com
Saturday, April 16
CyASIA-Energy-based Devices in Aesthetic Dermatology
Venue:Room B,2F
13:20-13:50
Educational Background
University of Singapore
Work Experience
Dermatologist since 1985
He is currently a Senior Consultant Dermatologist at the National Skin Centre and
Clinical Professor of the YLL School of Medicine, Faculty of Medicine of the National
University of Singapore and Adj Professor, LKC School of Medicine, Nanyang
Technology University.
He was the Medical Director of the National Skin Centre, Singapore between 1990 and
2004. His special interests are in Aesthetic and Cutaneous Lasers procedures, Acne
related disorders, and Contact and Occupational Dermatitis,
He is a member of the International Contact Dermatitis Research Group. He was past
president of the Society of Laser Medicine and Surgery of Singapore and also past
president of the Environmental and Occupational Dermatology Society of Singapore. He
was a member of the Global Alliance to Improve Outcomes in Acne, member of the
Asian Acne Board.
He is a past member of editorial board of the Contact Dermatitis (Munksgaard
Publication) and past international editorial board member of the Archives of
Dermatology and Journal of the American Academy of Dermatology. He has published
more than 300 scientific papers in peer review journals and chapter contributor to
numerous dermatology reference books and co-editor of several reference
dermatology books and several educational books for the lay public.

Topic: My Choice of Lasers and Light Devices in Dermatology Over the Past Decades
Abstract:
Since the introduction of the theory of selective photothermolysis by Anderson and Parrish in 1980s,
many lasers and light devices has been put into clinical use. These devices have helped clinicians
improve treatment outcome of many skin disorders. Unfortunately, the functions of lasers are limited by
their wavelengths, pulse duration and fluence. Hence, laser operators must have a good understanding
of laser physics and should be experienced in their use. Lasers are also very expensive. Here I share my
experience with my choice of lasers and light devices over the past 4 decades in my clinical practice in an
institution.
I will divide the use of dermatological lasers according to various clinical applications as follow:
1. Pigment lasers (including various QS lasers and picosecond lasers, IPL, Pulsed dye laser
2. Vascular lasers (including pulsed dye lasers, IPL, Long pulsed Nd: YAG and Alexandrite lasers).
3. Skin resurfacing lasers (including ablative lasers, fractional lasers (ablative and non-ablative)
4. Hair removal devices (including long pulsed Nd: YAG, alexandrite, lasers and IPL devices
4. Skin tightening devices (including RF, ultrasound devices).
The commonest use devices are the “pigment lasers” . With the introduction of the picosecond laser
recently we have a more effective way to treat dermal pigmentary lesions and tattoos compared to the
nanosecond lasers. But for superficial lesions, the conventional QS laser is just as effective. Hence I still
consider the nanosecond lasers as a backup pigment lasers.
The second most commonly used lasers are the hair removal devices. I prefer to use the LP Nd: YAG
lasers over the other devices as most Asians who seek hair removal treatment are has darker skin type.
Similarly IPL cannot be used on darker skin types for hair removal as the risk of skin burn in darker skin
type is high.
For vascular lesions, PDL remains the most versatile vascular laser. I often use the LP ND: YAG laser to
complement the PDL in the treatment of vascular lesions eg large telangiectasis on the nose in rosacea.
Skin resurfacing is usually done with the fractional ablative lasers. In my practice most resurfacing is
done for atrophied acne scars. Hence I prefer ablative fractional lasers over non-ablative lasers. The
treatment of atrophied scars is seldom a monotherapy. I often need adjunctive treatment e.g. subscision.
One can add on the picosecond fractional laser treatment to supplement the rejuvenation effects of
fractional lasers. But it is an expensive inclusion.
Skin tightening treatment outcome is often unpredictable and an expensive.

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