Removal of keratoma by laser

Laser removal of skin neoplasms is a popular method today for getting rid of moles, papillomas, warts, keratomas, and other types of skin diseases associated with atypical development or growth of tissue cells. So, for example, laser removal of keratomas is used for all types of this formation, while cryodestruction or cauterization with current gradually fade into the background, and are used for small keratomas, and only of a benign nature. The impact of the laser is so effective that it destroys all or almost all of the affected cells, reducing the likelihood of recurrence to the minimum possible.

Keratoma: what is it and why does it appear

In a normal state, two interconnected processes constantly occur in the human epidermis – the death and exfoliation of the surface layer of cells, and the formation of new layers located one under the other. As the upper dead cells of the epidermis fall off as a result of mechanical action on the skin, younger cells located in the layer below are exposed in it, and so constantly. At the same time, the number of new emerging cells corresponds to the number of dying ones.

If the balance of these natural processes is disturbed, the formation of tumor formations of a different nature occurs. So, a keratoma grows due to a large number of epidermal cells – keratocytes, while the cells themselves do not undergo any changes, that is, the neoplasm is not malignant.

As for the reasons for the appearance of such a failure, and, accordingly, the formation of a keratoma, while medicine cannot give an unambiguous answer to the question of what exactly it generates or provokes. It is reliably known that exposure to ultraviolet rays is quite aggressive and even oncogenic for the skin, and, probably, it can be a catalyst for the formation of keratomas. There is even such a variety of this neoplasm – a solar keratoma. However, it is clear that this factor is not the only decisive one. The processes of skin regeneration are affected by various diseases, lifestyle, nutrition, and interaction with various toxic and carcinogenic substances throughout life.

Outwardly, a keratoma may look like a mole or a wart, it is colored yellow, brown, gray or brown, and its surface has a characteristic roughness and bulge. Horny keratoma is shaped like an animal horn, protrudes significantly above the skin, and has a gray or brown color.

Neoplasms can have a single character, or form in groups, more often appear on the face, back, chest, arms, a little less often on the abdomen and lower extremities.

What is the essence of the laser method of treatment of skin diseases

The appearance of the laser as a physical phenomenon became possible after Albert Einstein developed the theory of the interaction of matter and radiation at the beginning of the 20th century. It traced the ideas of the possible creation of quantum radiation amplifiers and generators of electromagnetic waves.

The first ruby ​​laser was designed by the American scientist Theodor Meiman in 1960. The laser wavelength was 0,69 μm. At the same time, for the first time, the properties of the laser were used to destroy human hair follicles. This event became the starting point in the history of laser surgery, medicine, and cosmetology.

Laser removal of keratoma refers to both medical and cosmetic procedures. Special devices with a nozzle that generate a directional laser beam are equipped not only in hospitals and private medical institutions, but also in the offices of cosmetologists and dermatologists.

The medical device used in the process, using the properties of light rays and a special system of mirrors, generates a laser beam. By directing it to the affected area, the doctor ensures that the neoplasm cells burn from its top to the deepest layers. At the same time, coagulation of the blood vessels damaged in the process occurs, which eliminates the risk of opening bleeding.

After treating the tumor in this way, a barely noticeable scar remains in its place. The duration of the wound healing period is rarely more than 3-4 weeks. There is virtually no risk of wound infection during the procedure.

In the field of laser surgery, lasers with high radiation power are used, due to which they can cause significant heating of biological tissue, which contributes to its evaporation or cutting. Such an intervention, although considered surgical, is minimally invasive.

Thanks to modern laser devices and systems, during the operation it is possible to provide:

• dry work area;
• effective non-contact and contact vaporization and destruction of biological tissue;
• minor damage to surrounding tissue;
• cupping of lymphatic and blood vessels;
• effective hemostasis;
• high sterility of the process;
• the possibility of combining the procedure with laparoscopic and endoscopic measures.

Indications and contraindications for the procedure

A distinctive feature of keratomas among most skin neoplasms in humans is that not every tumor requires mandatory medical intervention and removal. Usually, doctors recommend, if a patient has neoplasms of any nature on the body, periodically visit a dermatologist for prevention purposes, for example, once or twice a year. This measure is sufficient to prevent the degeneration of benign tumors into malignant ones, or, if the process has already begun, to detect it in time.

As for the indications for laser removal of keratomas, the main among them is a keratoma, which is dangerous, that is, it has the likelihood of degenerating into a cancerous tumor. The main symptoms that should alert a person:

• peeling;
• itching;
• pain in the keratoma;
• darkening of its surface;
• falling off of a keratoma, after which a bleeding wound remains.

In such cases, you should immediately contact a dermatologist or oncologist.

It should be noted that laser removal, along with surgical and radio wave, is the most preferred method of treating malignant keratomas, in contrast to cryodestruction or electrocoagulation, since the latter do not provide the proper removal of cancer cells.

In addition, laser destruction can also be performed in cases where the keratoma does not pose any threat to the patient’s health, but it is a clear cosmetic defect, that is, removal can be prescribed at the request of the patient.

A contraindication to the procedure may be:

• pregnancy;
• the general serious condition of the patient;
• acute infectious or inflammatory processes in the body;
• some psychiatric illnesses.

If a person has an inflammatory or infectious lesion in an acute form, it is necessary to first remove the exacerbation, after which it will be possible to perform an operation to remove the keratoma.

Pregnant women are traditionally advised to avoid any intervention in the body while they are carrying the baby. Of course, if the situation is critical and does not tolerate delay, the procedure for removing the tumor with a laser can be prescribed as an exception, however, if possible, it is better to postpone it until the baby is born.

Preparation and implementation of the procedure for laser removal of keratoma

Before the doctor determines the date of the laser intervention, the patient will need to pass some tests:

• general blood and urine analysis;
• coagulogram;
• PCR for hepatitis and HIV.

In some cases, the doctor who will perform the operation may require the results of an electrocardiogram, as well as biochemical parameters of the blood.

Women in the state of the first trimester of pregnancy must definitely inform the doctor about this.

Laser removal of keratoma is usually not carried out in the summer, when solar activity is very high, except in exceptional cases, if it is not possible to postpone the procedure until autumn. If the patient is scheduled for removal of the neoplasm with a laser, for two weeks before it, sun exposure should be avoided before the procedure. It is also recommended to refuse to visit the solarium.

The implementation of laser removal is possible only after consulting a dermatologist, in some cases an oncologist. Often, the resulting “cut out” biomaterial is subsequently sent for histological analysis.

To date, laser surgery uses several types of laser systems, the action of which is based on the evaporation of fluid from the body of tumor cells, as a result of which they die.

A carbon or CO2 laser produces infrared radiation that has a length of 10600 mn. The laser beam evaporates the liquid in the tissues of the neoplasm, destroying it. Such a laser can leave noticeable scars due to the fact that it has the highest traumaticity of all types of lasers.

Erbium laser has a shorter wavelength – 2940 mn, due to which its efficiency exceeds the carbon laser by about 12 times. With its help, removal of keratomas can occur with less trauma to nearby tissues.

A pulsed dye laser works somewhat differently – it has a selective effect on oxyhemoglobin, which causes the destruction of capillaries in the tissue. The procedure in this case is almost completely painless, as well as the absence of rough scars after it.

Usually the process occurs without anesthesia, however, the doctor may suggest local anesthesia before starting to reduce pain for the patient.

The surface that is subject to laser exposure must be carefully treated with an antiseptic, and alcohol-free preparations are usually used, since it has combustible properties. If a keratoma is removed on the face or on the head, the hair must be hidden under a special protective cover to prevent ignition.

Using the nozzle of the laser apparatus, the doctor directs the laser beam at the keratoma, destroying it from top to bottom. At the same time, it depends only on the qualifications of the doctor whether all the affected tumor cells will be removed. If the formation is removed from the skin of the face or hands, the physician must be especially careful not to turn the site of the keratoma into a cosmetic defect.

The total duration of the procedure is no more than 10-15 minutes if the patient has several keratomas that need to be removed.

One procedure is usually enough to successfully get rid of the formation – the likelihood of recurrence after laser removal is about 8-10%. However, if the keratoma reappears in the old place, it will need to be removed again.

wound care technique

After the laser destruction of the keratoma, a characteristic dark brown crust forms in its place. It covers the surface of the wound, and under it the process of tissue healing is actively taking place. Ripping off or combing the crust is strictly prohibited, as this opens the access of pathogens to the wound until the need for it disappears – then it disappears by itself. The first two days it is not recommended to wet the wound site.

Postoperative care includes the following rules: once or twice a day, the procedure site must be washed with water and baby soap, after which it is necessary to treat the surface with antiseptic preparations and healing ointments. Next, a sterile gauze bandage is applied to the wound. If possible, it is better not to use a band-aid, as it restricts air from entering the wound, thereby slowing down its healing.

Full recovery of the skin occurs after 4-6 weeks. During all this time, it is forbidden to visit the bathhouse, sauna, swim in pools or open water. Exposure to ultraviolet rays is also undesirable, and not only during postoperative recovery, but also in the next 6-8 months, in order to avoid recurrence of keratoma, therefore it is better to forget about the beaches and the solarium for a while, and go out into the street in clothes or a headdress that covers the affected area, and treat it with a sunscreen with a high UV filter value.

Possible complications and consequences of laser intervention

Laser surgery of neoplasms can leave scars – small and inconspicuous, or larger if the keratoma was originally large. In addition, patients note the appearance of tissue numbness in the place where the tumor was removed.

Such manifestations are natural consequences of the procedure.

It is necessary to pay attention to some dangerous symptoms of poor-quality destruction of the tumor, for example, the appearance of redness around the crust formed after removal, severe itching or a rash at the site of the keratoma.

If the crust has fallen off on its own, and under it a sore that has not healed for a long time is found in the form of a red spot with a heterogeneous surface, it is necessary to visit a dermatologist as soon as possible.

In addition, allergic reactions or dermatitis may develop around the site of the procedure, due to the constant wearing of a bandage, as well as the use of various ointments on the skin. At the first manifestations of dermatitis or allergic rashes, it is necessary to stop treating the site with any drugs, and also contact a dermatologist.

Advantages of laser surgery over other keratoma treatments

Physicians who work with skin neoplasms and are engaged in their reduction note that laser destruction has a number of undeniable advantages over other methods of treating keratomas. It is made without contact, so the risk of infection of the wound during the removal of the tumor is extremely small. Controlled exposure to biotissues with a laser beam leaves small and barely noticeable scars in most cases. Subject to all the rules for caring for the affected area of ​​the skin, recovery after the procedure is quick and without discomfort. The process itself is almost painless for the patient.

The likelihood of complications after surgery is also extremely low. Relapses occur only in 8-10% of all cases of keratoma removal.

Laser removal of skin neoplasms, including keratomas, is prescribed by doctors almost as often as surgical removal. Its high efficiency, together with low trauma to humans, makes the procedure permitted not only for adults, but also for children. In order to get a referral for the procedure, you need to visit a doctor – a dermatologist or oncologist, and possibly pass some tests. Carrying out laser removal of keratoma occurs in an outpatient clinic, as well as in private medical institutions – at dermatologists and cosmetologists.