By Aletha Tippett MD
It would be interesting to know how many people reading this blog have tried laser therapy for wound healing. I suspect not many, and that is unfortunate because laser therapy can be a wonderful adjuvant for wound healing.
My first exposure to laser therapy for wound treatment was in reading about the application of cold laser therapy that some therapists were using. I have a cosmetic laser1, but this particular one can be dialed down to a cold laser setting. It is not necessary to use only the high-joule (energy fluence) settings as used for hair, vein or tattoo removal.
Laser Applications in Wound Treatment
Cosmetic lasers are used for many treatments: hair removal, tattoo reduction, scar revision, photo-rejuvenation, vein reduction, and acne. Using cosmetic laser devices for wounds is not generally known. The only lasers used in wound care have been cold lasers by some therapists. Having a cosmetic laser that can be adjusted to cold laser levels enables that laser device to be used for wounds, in addition to cosmetic procedures. That is what was done in my wound patient cases where laser treatment was administered as an adjunctive therapy . A cosmetic laser was used at 4 joules, a remarkably low energy level for a cosmetic laser. Actually, for me, that is the reason I purchased this particular laser device because it could be used at the very low levels.
Some years ago after I bought my cosmetic laser, I used it for wounds treating at 4 joules with a 6mm spot, one pass. The results were phenomenal. Since then I have tried different settings on the laser device in treating wounds, most recently 11 joules, 6mm spot, three passes. Some doctors have found good results with this protocol, but I must say my results were not as good as with 4 joules, 1 pass. Wounds healed at the higher joules, but did not heal as rapidly or as cleanly.
Figure 1: Plantar ulcer before receiving adjunctive laser therapy treatment.
Figure 2: Plantar ulcer after 6 treatments using 650-microsecond laser at 4 joules, 1 pass.
Figure 3: Plantar burn injury before receiving adjunctive laser therapy treatment.
Figure 4: Plantar burn injury after 1 treatment using 650-microsecond laser at 4 joules, 1 pass.
Stimulating Wound Healing
If you have access to a low-joule laser, please do not hesitate to try it to stimulate wound healing. How does a laser stimulate wound healing? It is not known for sure, but I believe the processes produces nitric oxide, which has a known impact on cellular activity and response in the healing of wounds. Certainly the laser stimulates collagen production, an essential protein in wound healing. Here are two pictures series of wound healing with laser treatment. Of course, laser therapy is not the only treatment for a wound, it is an adjuvant, something that can help and improve wound healing. I have also used the laser therapy device with a 2mm spot, 127 joules to ablate a wound that needed reduction, then switching to a healing mode once the wound had improved.
1. LightPod Neo®, Aerolase
Aletha Tippett, MD. Used with permission.
About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.