Skin treatments with laser

Pigment spots - especially sun and age spots as well as freckles - are common skin changes that many people find annoying.

Sun and age spots typically appear from middle age onwards on sun-exposed areas such as the face, décolleté and back of the hands. These yellowish-brown discolourations are the result of many years of UV exposure.

Freckles, on the other hand, are genetic and are merely intensified by sunlight.

Laser therapy has established itself as an effective treatment method. It enables precise removal of pigment spots with minimal impact on the surrounding tissue. After treatment, the spots initially darken, but then disappear after around 10 days due to natural skin desquamation, revealing lighter-coloured skin.

Depending on the severity and type of pigmentation, 1 to 3 treatment sessions are usually required at intervals of 4-6 weeks.

Before treatment:

• Avoid intensive sun exposure (sun and solarium) 4 weeks beforehand
• Do not use self-tanning products
• Skin area must be free of inflammation

After treatment:

• Avoid direct sunlight (UV light, solarium) for 4 weeks
• High sun protection (SPF 50+) for at least 4 weeks
• Do not scratch or rub treated areas
• Use mild, fragrance-free skin care

Melasma (also known as "chloasma" or "pregnancy mask") is a common pigmentation disorder that occurs primarily on the face and is characterised by dark, blotchy discolouration, mainly on the forehead, cheeks and upper lip.

As the cells that give the skin its colour - the melanocytes - are more active, melasma can be more noticeable in people with a darker complexion.

Although it mainly affects women, men can also develop melasma.

The development is complex and multifactorial. The following influencing factors are known:

• Hormonal changes (pregnancy, hormonal contraception)
• UV radiation
• Genetic predisposition
• Certain medications

Treatment is correspondingly complex and requires a multi-stage approach.

Basic measures:

• Strict UV protection (SPF 50+)
• Avoidance of direct sunlight
• Special bleaching creams to inhibit melanin production

Laser treatment:

According to current research results and clinical experience, the following types of laser are considered particularly effective in the treatment of melasma: Nd:YAG 1064nm laser toning, fractional non-ablative lasers. The number of laser sessions required varies depending on the individual characteristics of the melasma and the type of laser used. Depending on the severity, between 5 and 15 treatment sessions are necessary.

The combination of different therapy approaches generally leads to better results than individual treatments.

Seborrhoeic keratosis, also commonly known as senile warts, is a benign, light brown to black, wart-like skin change with a rough, fissured surface. It typically occurs between the ages of 40 and 60 and becomes more common with increasing age. Preferred anatomical localisations are the trunk, face, forearms and back of the hands.

Seborrhoeic keratoses can occur singly or in groups and occasionally cause itching.

Although they are harmless, they can sometimes be mistaken for malignant skin lesions because of their similarity to moles or skin tumours.

Their development is associated with genetic factors, UV radiation and the natural ageing process.

Laser treatment:

Seborrhoeic keratoses can be removed precisely and gently using a laser. The treatment is carried out under local anaesthetic and leaves a superficial abrasion that heals within a few weeks. The wound usually heals without scarring. Possible side effects may include redness, swelling or, in rare cases, changes in pigmentation.

The choice of the right type of laser and the treatment being carried out by a specialist with laser experience are crucial to the success of the treatment.

Teleangiectasias, also known as dilated veins, are visible dilations of small superficial blood vessels in the skin and mucous membrane. They appear as fine, usually red, sometimes bluish lines that shimmer through the surface of the skin and often occur on the face and upper body.

Laser treatment:

Telangiectasias can be treated effectively and gently with vasculature-selective lasers. The laser closes the vessels by applying targeted heat.

It should be noted that several treatment sessions may be necessary and the choice of laser depends on the extent and localisation of the telangiectasia as well as the patient's skin type.

Spider veins are small, dilated blood vessels that mainly appear on the legs and are visible as small, reddish-bluish lines. They can occur in both women and men. Medically, spider veins are classified as a form of varicose veins (varices) and are therefore also referred to as spider vein varices.

Laser treatment:

The long-pulsed Nd:YAG laser can be used to successfully treat spider veins without injections. The laser emits light pulses that are absorbed by the blood in the vessels. This leads to heating and damage to the vein walls with subsequent shrinkage of the spider veins. Depending on the extent of the spider veins, several treatments may be necessary. After the treatment, sun exposure must be avoided for 6 weeks.

Das Blutschwämmchen, auch Kirschangiom oder seniles Angiom genannt, ist eine gutartige Gefäßveränderung der Haut. Die kirschroten bis dunkelblauen, stecknadelkopfgrossen Knötchen haben einen Durchmesser von 1 bis 5 mm und entwickeln sich typischerweise ab dem 30. Lebensjahr. Sie können einzeln oder in Gruppen auftreten und sind vorwiegend am Rumpf lokalisiert. Die  Hautveränderungen können aus kosmetischen Gründen sehr schonend und effektiv mit dem Laser entfernt werden.

Laserbehandlung:

Der Laser arbeitet mit spezifischen Wellenlängen, die vom roten Blutfarbstoff selektiv absorbiert werden. Dadurch werden die erweiterten Gefässe erhitzt und verödet, woraufhin sie vom Körper auf natürliche Weise abgebaut werden. Nach der Behandlung bildet sich eine kleine Kruste, die nach etwa einer Woche abfällt. Meist reichen 1 bis 2 Sitzungen aus.

Rosacea is a chronic inflammatory skin disease that is often characterised by dilated blood vessels (couperose, copper rose) on the face.

The clinical picture is characterised by persistent redness, particularly on the cheeks, nose, chin and forehead, as well as visible veins, inflammatory nodules and pustules. Various factors such as UV radiation, temperature changes, spicy food, alcohol, stress and hormonal changes can exacerbate the symptoms.

The exact causes of rosacea have not yet been fully clarified scientifically. Current research points to several factors: genetic predisposition (familial clustering), impaired immune response of the skin, increased incidence of Demodex mites, microvascular disorders.

Laser treatment:

Early treatment is important as otherwise the disease may worsen.

Laser therapy for rosacea is aimed at treating the dilated veins (couperose). The laser penetrates the affected skin layers in a targeted manner and cauterises the visible veins through selective photothermolysis. The laser light is absorbed by the red blood pigment. The targeted heat causes lasting damage to the dilated blood vessels. They are no longer supplied with blood and are broken down naturally by the body over time.

Laser treatment for rosacea usually requires 2-4 sessions at intervals of 4-6 weeks. As rosacea takes a chronic course and new vessels can form, annual refresher treatments (1-2 sessions) are recommended.

Erythrosis interfollicularis colli manifests itself as extensive, permanent reddening of the lateral parts of the neck and in the décolleté area, often associated with telangiectasia (visible vascular dilatation) and occasionally hyperpigmentation. A typical feature is the shadowy recess of the submental region (below the chin). The redness can be intensified by heat stimuli, alcohol or stress. The condition is also known as "plucked chicken skin" as the follicles can protrude in the atrophic skin.

The main cause is long-term UV exposure, particularly through sun exposure or visits to solariums. This leads to chronic photodamage such as solar elastosis and vasodilatation. Middle-aged to older people who spend a lot of time outdoors for work or leisure are often affected.

Laser treatment:

We use various lasers and laser-like therapy methods to treat erythrosis interfollicularis colli. The choice of method depends on the individual clinical appearance.

The aim of the therapy is to reduce the redness of the area, treat the dilated vessels, improve pigmentation disorders, regenerate the skin and improve skin quality.

Different types of laser are often combined to achieve these goals.

The treatment is usually carried out in several sessions in order to achieve optimal results while minimising the risk of side effects. On average, around 3 to 6 treatments are necessary. However, the exact number of sessions required may vary depending on the severity of the condition and the response to treatment.

A port-wine stain (medical term: naevus flammeus) is a benign, congenital malformation of small blood vessels (capillaries) in the skin. Approximately 0.3 per cent of all newborns are affected. Port-wine stains appear as: light red to bluish-purple, sharply defined spots on the skin, which are irregularly shaped and vary in size. They can appear anywhere on the body, but usually only one side of the body is affected. They occur most frequently on the face and neck.

The exact cause is not yet fully understood. New research points to genetic factors (mutations in the GNAQ gene), damaged connections between nerves and blood vessels, rarely in the context of hereditary syndromes such as Sturge-Weber syndrome or Klippel-Trénaunay syndrome.

If left untreated, port-wine stains can become darker over the course of a lifetime and tend to form nodules and thicken the skin in adulthood, which can be accompanied by disturbing bleeding from the smallest injuries.

Laser treatment:

Port-wine stains are treated with vascularised laser therapy. The laser closes the small blood vessels by applying targeted heat.

It is important to note that several sessions are required to achieve a good result. Laser treatment of the naevus flammeus usually requires at least 6 sessions. Adults often require more sessions than children.

The number of sessions depends heavily on factors such as the size, location and colour of the port-wine stain.

A lip border angioma, also known as a "venous lake", is a haemangioma on the lip. A venous lake appears as a lentil to pea-sized, blue-red bulge with a smooth surface, predominantly on the lower lip.

It is a dilation of blood vessels (veinctasia) in the dermis. Lip border angiomas occur more frequently in older people, which indicates a connection with the ageing process.

Laser treatment:

In laser therapy of a lip marginal angioma, the laser beam is directed specifically at the dilated blood vessels. The blood pigment haemoglobin absorbs the laser energy, which obliterates the vessels. This causes the angioma to recede. The treatment is usually carried out with an Nd:YAG laser.

The number of treatments depends on the size and depth of the angioma. Often 1 to 2 treatments are sufficient.

Early treatment is recommended in order to achieve an optimal cosmetic result and reduce the risk of complications such as bleeding or ulceration.

Skin tags are small, soft, skin-coloured growths that often appear in skin folds such as the neck, armpits or groin. They are completely benign and usually cause no symptoms.

Possible causes for the development of skin tags are genetic predisposition, hormonal changes, metabolic factors such as obesity and mechanical friction of the skin.

Laser treatment:

The laser can be used to remove skin tags precisely and gently. The treatment is carried out under local anaesthetic and leaves a superficial abrasion that heals after 7 to 10 days.

Spider naevi (naevus araneus) are enlargements of small arterial skin vessels that often occur on the chest wall, face or neck.

They have a characteristic appearance. In the centre is a red dot the size of a pinhead, from which fine vascular branches radiate in a star shape, reminiscent of the legs of a spider.

Laser treatment:

In laser therapy for naevus araneus, the laser is targeted at the central vessel and the fine, spider leg-like vessels. The laser emits short pulses of light that heat up and thus destroy the dilated blood vessels. In most cases, 1 to 2 treatments are sufficient.

Healthy facial skin is crucial for a fresh and vital appearance.

Laser therapy supports the regeneration of the skin and repairs damage caused by sun exposure or age-related changes.

Laser treatment

During laser treatment, thermal energy is introduced into the skin, which triggers a healing process. This process leads to the elimination of old skin components, the contraction and new formation of collagen fibres and elastic fibres, which are responsible for the firmness and elasticity of the skin, as well as the increase in basic substances such as hyaluronic acid, which are important for moisturising the skin. Blood circulation is stimulated, which leads to a better supply of nutrients to the skin. Scientific studies show that significant improvements in skin texture and elasticity can be observed after just a few sessions.

Fractional laser technologies in particular have proven to be effective and low-risk, as they target microscopic heat spots that stimulate wound healing without leaving a large wound.

The result is a fresh and even complexion, an improvement in skin texture and a tightening effect as well as the reduction or disappearance of fine lines and wrinkles. The degree of effectiveness depends on the choice of protocol and the individual skin condition.

Therapy with autologous blood

Autologous blood therapy contains highly concentrated growth factors that accelerate the healing process. The combination involves taking a small amount of blood, centrifuging it and isolating the growth factors. After the laser treatment, several injections are made and the outer layer of the skin is treated, allowing it to penetrate the skin through the microchannels created by the laser. The benefits of this combination are improved skin renewal, accelerated wound healing with shorter downtime and stimulation of collagen production.

It is the same procedure as deep skin regeneration, but the laser penetrates less deeply into the skin.

This method is particularly suitable for the first signs of skin ageing (younger people aged between 25 and 45) to refine the skin texture, reduce pigmentation spots and wrinkles and prevent skin ageing.

The result is refreshed skin: a healthy glow, a more even skin surface, refined pores and increased skin elasticity.

The treatment is very gentle with minimal downtime. The method enables subtle skin rejuvenation with low risk and rapid recovery.

Therapy with autologous blood

Autologous blood therapy contains highly concentrated growth factors that accelerate the healing process. The combination involves taking a small amount of blood, centrifuging it and isolating the growth factors. After the laser treatment, several injections are made and the outer layer of the skin is treated, allowing it to penetrate the skin through the microchannels created by the laser. The benefits of this combination are improved skin renewal, accelerated wound healing with shorter downtime and stimulation of collagen production.

Light-aged skin is also characterised by pigment irregularities and dilated skin vessels.

Photorejuvenation with laser and other light wave-based techniques fades pigmentation spots and dilated veins and leads to an improvement in skin structure and elasticity.

Therapy with autologous blood

Autologous blood therapy contains highly concentrated growth factors that accelerate the healing process. In this combination, a small amount of blood is taken, centrifuged and the growth factors isolated. After the laser treatment, several injections are made and the outer layer of the skin is treated, allowing it to penetrate the skin through the microchannels created by the laser. The benefits of this combination are improved skin renewal, accelerated wound healing with shorter downtime and stimulation of collagen production.

Acne scars are permanent skin changes that can remain after severe acne inflammation.

We distinguish between three main types of acne scars: Atrophic, hypertrophic and keloid scars. Atrophic scars are depressions that occur when too little new connective tissue is formed to completely fill the tissue defect. In contrast, too much connective tissue is formed in hypertrophic scars and keloids. Hypertrophic scars form bulges over the surface of the skin that are limited to the original defect. Keloids, on the other hand, are uncontrollably proliferating scars that expand into the surrounding tissue. All three types are an expression of impaired wound healing.

Various methods are available to treat acne scars, including injections and laser treatments.

Laser treatment:

Different lasers are used depending on the clinical findings. Vascular lasers are the method of choice for inflammatory acne and flat or hypertrophic reddened acne scars. Pigment-selective lasers are mainly used for post-inflammatory pigment shifts. Fractional ablative and non-ablative lasers are the treatment of choice for atrophic acne scars.

Fractional laser treatment can be combined with autologous blood therapy. Autologous blood therapy contains highly concentrated growth factors that accelerate the healing process. In this combination, a small amount of blood is taken, centrifuged and the growth factors isolated. After the laser treatment, several injections are made and the outer layer of the skin is treated, allowing it to penetrate the skin through the microchannels created by the laser. The benefits of this combination are improved skin renewal, accelerated wound healing with shorter downtime and stimulation of collagen production.

The number of treatments required depends on the severity of the scars and the individual skin condition. Generally, several sessions are required, often between 3 and 6, to achieve a significant improvement.

It is important to emphasise that the best strategy against acne scars is prevention. Early and appropriate treatment of active acne and avoidance of pimple manipulation can significantly reduce the risk of scarring.

Scars are the result of the natural healing of the skin after accidents, injuries, burns, surgical procedures or inflammatory skin diseases such as acne. Scars occur when the injury breaks through the junction between the epidermis and dermis and penetrates into the deeper layers of the skin.

Types of scars

There are various types of scars that differ in their appearance and formation. Pathological scars can basically be divided into three categories.

Atrophic scars are sunken and occur when too little connective tissue is formed. They are typical of acne or chickenpox and appear as dimple-like depressions.

Hypertrophic scars are raised and usually reddish in colour. They are caused by excessive connective tissue formation, but remain within the original wound boundaries.

Keloids are scars characterised by excessive growth of scar tissue beyond the edge of the wound. They initially appear as reddish connective tissue growths that become dark red and firm over time. They often occur in areas of the body where the skin is under tension, such as the ear, breastbone, shoulder or upper back. Keloids can cause various symptoms such as pain, itching and a feeling of tightness.

Laser treatment:

The treatment of scars includes various therapeutic approaches, with laser treatments playing an important role.

Modern fractional laser therapies have established themselves as an effective method for improving the appearance of scars. The fractional CO2 laser, for example, generates microscopically small heat columns deep into the skin. These targeted microdamages stimulate the skin's self-healing powers and promote the formation of new, normal collagen, which leads to a significant improvement in the appearance of the skin.

Laser treatment is particularly effective for various types of scars, including acne scars, surgical scars, accident scars and burn scars.

It offers the advantage of a painless treatment with a short recovery time and long-lasting results. Another advantage of laser treatment is that there is no long downtime and deeper layers of tissue can be reached.

In general, 3 to 6 laser treatments are required. For more complex cases or pronounced scars, more than 6 sessions may be necessary to achieve the desired result.

Syringomas are harmless, skin-coloured to yellowish nodules that usually appear in the eyelid area. They originate from sweat gland outlets in the skin and are often symmetrically distributed. Syringomas often have a genetic predisposition and mainly occur in middle-aged women.

Laser treatment:

We treat syringomas with an ultra-pulsed CO2 laser under local anaesthetic.

Immediately after treatment, there is slight reddening and swelling of the treated area, which usually lasts for about 24 hours. Small crusts form, which are an important part of the healing process and must not be scraped off. The healing process takes about 1-2 weeks and generally leaves no scars if carried out correctly.

The number of laser treatments for syringomas depends on the individual findings.

Tattoos and permanent make-up are permanent colour implants in the skin. While tattoos often represent decorative or symbolic motifs, permanent make-up (PMU) is used for cosmetic purposes, such as emphasising eyebrows or lips.

With PMU, the colour pigments are applied very superficially to the skin. The durability varies between 1 and 5 years depending on the body region. The main areas of application are eyebrows, eyelid lines, lip contours and scar corrections.

Traditional decorative tattoos, on the other hand, are applied deeper into the skin layers, last significantly longer and use more intense colour pigments. The main difference lies in the technique, depth and durability of the pigmentation.

In addition to the desired tattoo styles, there are special forms of tattoos with different causes of origin, which are created unintentionally by the penetration of foreign particles into the skin, e.g. after traffic accidents or explosion trauma (dirty tattoos), and remain on the skin as unwanted markings.

Iatrogenic tattoos are unintended side effects of medical interventions, e.g. due to drug residues (e.g. after extravasation of an iron infusion).

Laser therapy is by far the best and most gentle method for removing tattoos/permanent make-up.

Tattoo removal with laser

Laser tattoo removal is a modern procedure in which unwanted colour pigments are broken down using high-energy laser beams from an ultra-short pulsed laser without damaging the surrounding tissue. The pigment particles are then removed via the lymphatic system and the skin surface.

The complete and scar-free removal of a tattoo requires several treatments. Depending on the complexity of the design, around 5 to 10 sessions are required in standard cases and around 10 to 15 sessions for more complex tattoos. The exact number of treatments varies individually and depends on various factors such as the size of the tattoo, colour, colour intensity, pigment depth, anatomical location and the laser technology used.

In our clinic, we use modern picosecond laser technology, which is the gold standard today and offers decisive advantages. This technology works with extremely short energy pulses in trillionths of a second (picoseconds) and enables photomechanical destruction of the pigments. Compared to conventional QS lasers (nanosecond lasers), this means fewer side effects, more precise fragmentation and promotion of collagen regeneration with minimised risk of scarring.

An anaesthetic cream is applied before the treatment, which should be left on for at least 20-30 minutes.

Temporary redness, swelling, blisters and minor bleeding may occur after the treatment. It is important not to open the blisters and to avoid direct exposure to the sun for four weeks before and after the treatment and to ensure consistent sun protection with SPF 50+. For skin care, you can use wound ointment such as Cicaplast Baume.

You can usually go about your daily activities immediately after treatment.

Fractional radiofrequency technology is an innovative method of skin rejuvenation that differs from laser techniques but is similarly effective.

In this treatment, radiofrequency waves are used to move and heat the water molecules in the dermis (dermis). This targeted heating triggers a biological reaction cascade in which collagen and elastin are newly formed. The result is firmer, smoother and firmer skin with fewer wrinkles.

In contrast to laser technologies, which mainly treat the skin surface up to 1mm deep, fractional radiofrequency can stimulate skin tissue up to a depth of 3.5mm, including the subcutis. In some cases, both techniques can be combined to achieve optimal results.

The treatment is particularly suitable for contouring the face and smoothing the neck. On the body, it can be used in addition to the laser to improve scars or stretch marks.

For optimum results, several sessions are recommended at intervals of a few weeks.

To ensure patient comfort, an anaesthetic cream is applied one hour before the treatment.