Defects Fade Away Surgical Uses Continue to Grow

If there's something about your body you don't especially like, you might consider zapping it with a laser.

First used for medical purposes in the 1960s, lasers can now make unwanted wrinkles, leg veins, stretch marks, acne scars - even tattoos - fade, if not disappear.

Some of these incredibly precise wonder tools even can silence snorers, improve near-sightedness and make the lives of terminal cancer patients easier, experts say.

"We've been using lasers in ophthalmology for the last 20 years, but there continue to be advances," says Earl R. Crouch Jr., chairman of ophthalmology at Eastern Virginia Medical School in Norfolk. "It is still a surgical procedure, but without a knife."

An acronym for Light Amplication by the Stimulated Emission of Radiation, the laser is particularly well-suited for use in medicine because of its ability to produce a specific color, or wavelength, of focused light.

When a laser beam is aimed at skin, its light energy is absorbed only by water or pigments in the targeted cells. Red and green light, for example, are absorbed by tattoo pigments and by melanin, the pigment found in freckles, age spots and hair.

"You can make laser light very small and precise," says Michelle D. Shinn, a staff scientist in the accelerator division of the Thomas Jefferson National Accelerator Facility in Newport News. In addition, the intensity and duration can be varied, Shinn says, allowing lasers "to go where a regular light beam can't."

That also lets them go where surgeons can't - or won't - go with standard scapels. In addition, outpatient laser treatments, which cost between several hundred and a few thousand dollars, tend to be cheaper and less time-consuming than inpatient surgeries.

IN HAMPTON ROADS, local ear, nose and throat specialist Geoffrey Bacon uses a laser to treat people who snore. Common snoring can occur when the uvula - the soft, fleshy thing that hangs down from the middle of the soft palate above the back of the tongue - vibrates during sleep. During the 10-minute laser-assisted uvula palatoplasty, or LAUP, procedure, a physician uses a laser to trim and reshape the uvula.

The outpatient procedure is designed as a serial treatment, meaning patients may need several laser sessions before they are cured.

The treatment, Bacon says, is relatively painless - "like having a bad sore throat" - and has cured about 90 percent of the 25 patients he has treated.

The best part? There's no bleeding or expensive hospital stay. Plus, the treatment can do wonders for marital harmony.

"A lot of habitual snorers have literally been kicked out of the room by their spouses," Bacon says. "After this, a lot of them get to go back."

The downside? Health insurance rarely covers cosmetic surgeries like LAUP because they treat only minor inconveniences, not major problems.

But laser treatments also can help patients with life-threatening diseases such as cancer.

For example, photodynamic therapy, or PDT, is a relatively new laser treatment for patients with advanced esophageal cancer - which in the past has required major surgery, chemotherapy or radiation treatment. Although the treatment is by no means a cure, it can improve a patient's remaining days, says Alvin Zfass, director of endoscopy at Virginia Commonwealth University's Medical College of Virginia.

First, a physician injects a light-sensitive drug, Photofrin, that's absorbed throughout a patient's body - but mostly in fast-growing tumor cells. Then a laser is focused on the tumor, and together the light and drug work to destroy the cancerous cells without harming surrounding tissue.

Zfass says someday the treatment also may be used to treat patients with skin, heart and eye diseases.

Meanwhile, patients who want to look younger and prettier have lined up for laser resurfacing treatments at the Hampton office of plastic surgeon Mark Kanter. The treatment essentially zaps off the top layers of wrinkled or acned skin, revealing fresh layers. An alternative to chemical peels and dermabrasion - a bloody procedure in which skin is essentially "sanded" off - the laser treatment tends to have more consistent, better-looking results, Kanter says.

"The laser just puffs it away," he says. "It vaporizes the cells in the immediate area of the laser beam."

DESPITE THEIR BENEFITS , lasers can burn, scar or damage tissue irreparably if used incorrectly, says David McDaniel, assistant professor of clinical dermatology and plastic surgery at EVMS. He is also director of The Laser Center in Virginia Beach.

In addition, some laser treatments aren't always effective. For example, laser resurfacing does't work well for people with dark skin.

"You can't treat really dark, ethnic skin," he says. "It turns the skin white and it can be permanent."

And unlike most other laser treatments, which are low-risk and low-pain, some forms of laser therapy - such as the old style "hot laser" resurfacing treatments used to remove wrinkles and acne scars - can have significant side effects, such as pain, infection, redness and swelling, says McDaniel.

"You've got to be careful when you go in for any of these laser treatments," he says. "Make sure that the person who is doing the work knows what he's doing."