Lasers and intense pulsed light (IPL) association with cancerous lesions

Caerwyn Ash,Rebecca Whittall,Louise Tooze,Jaymie Phillips,Godfrey Town

doi:10.1007/s10103-017-2310-y

Caerwyn Ash, Rebecca Whittall + Show 3 more

Open Access

https://doi.org/10.1007/s10103-017-2310-y

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Abstract

The development and use of light and lasers for medical and cosmetic procedures has increased exponentially over the past decade. This review article focuses on the incidence of reported cases of skin cancer post laser or IPL treatment. The existing evidence base of over 25 years of laser and IPL use to date has not raised any concerns regarding its long-term safety with only a few anecdotal cases of melanoma post treatment over two decades of use; therefore, there is no evidence to suggest that there is a credible cancer risk. Although laser and IPL technology has not been known to cause skin cancer, this does not mean that laser and IPL therapies are without long-term risks. Light therapies and lasers to treat existing lesions and CO2 laser resurfacing can be a preventative measure against BCC and SCC tumour formation by removing photo-damaged keratinocytes and encouraged re-epithelisation from stem cells located deeper in the epidermis. A review of the relevant literature has been performed to address the issue of long-term IPL safety, focussing on DNA damage, oxidative stress induction and the impact of adverse events.

Highlights

The development and use of lasers and light for medical and cosmetic procedures based on the principle of selective photothermolysis [1] has increased exponentially over the past two decades
Sorg et al determined that high-peak intensity visible light applied to the skin, with the wavelength, pulse duration and fluence parameters described, did not result in Thymine Dimer production, a key marker of DNA damage whose formation has a direct link to an elevated risk of skin cancers
The use of photodynamic therapy and Intense pulsed light (IPL) systems in the treatment of Actinic keratosis (AK), Basal cell carcinoma (BCC) and Squamous cellcarcinoma (SCC) is supported by studies concluding that their application is safe and effective

Summary

Introduction

Following the first demonstration of a functional laser device in 1960, it was not until the early 1990s that their use in the medical field became commonplace. Sorg et al determined that high-peak intensity visible light applied to the skin, with the wavelength, pulse duration and fluence parameters described, did not result in Thymine Dimer production, a key marker of DNA damage whose formation has a direct link to an elevated risk of skin cancers. Zastrow et al established that exposure to visible wavelengths did result in ROS production by irradiating tissue with direct sunlight, including UV, removing the UV component through the use of a suitable filter In this case, Zastrow identified that approximately 50% of the ROS production in the skin was from wavelengths greater than 430 nm, later determined that the dominant spectral band in the visible region being between 410 and 490 nm. It could be argued that the Mellemkjaer study follow-up period was less than the average time to cancer formation quoted in the Kowal-Vern review, the Lindelof study was of sufficient duration and power to highlight any causal relationship between the burn and tumour formation

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