Laser Therapy for Wound Healing
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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.
Before
After
Before
After
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.
Referenced Product:
1. LightPod Neo®, Aerolase
Image Credit:
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.
Comments
Reimbursement and FDA approval
I am interested to see if there is any CPT code or reimbursement for this procedure or if it is covered by private health payers?
Also is the laser FDA approved for wound healing or are you working off label using it in such a treatment?
I would have like to have seen the photos after each treatment not just before and after, and did you do any debridement or treat with anti microbial dressings?
There is not enough clinical data here to suggest this to be an approved adjunctive therapy in wound management. Is there a website to visit?
Work in Progress
Hello RHome,
To my knowledge the only FDA approval for low joule therapy for any skin issue is for toenail fungus. Since the nail is an appendage of the skin, I believe laser could in effect be used to treat tinea pedis and other cutaneous fungal infections, which can be ulcerative...that being said application of this therapy for wound healing is entirely off label, but I recently lobbied Blue Cross Blue Shield of Oklahoma to cover laser therapy for a complex case of Hidradradenitis Suppurativa and was approved. The logic was that laser is already utilized for hair removal and aesthetics to rejuvenate the superficial layers of the skin by increasing dermal collagen. I believe with hair follicle removal, increased collagen deposition via NO induction, neovasculogenesis and fibroblast replication , the laser would have antiseptic and regenerative properties respectively for wound bed maturation at the very least...I think it's management of biofilm at ablative levels of energy will help with keratinocyte migration as well.
I think this adjunctive therapy can be offered for wound healing at a very low cost...10$ per sqcm per treatment.
There are CPT codes that are
There are CPT codes that are reimbursed by both private payers and Medicare. It is FDA approved. I don’t know what you mean by photos after each treatment instead of before and after. The website to visit is www.Aerolase.com.
Cold Diode Laser Systems for Wound Healing
I want to support/endorse use to cold diode laser for wound healing! I am looking for investor partners to roll out a laser assisted wound care brand under my umbrella The WISH Clinic. I have an affiliation with a laser manufacturer here in Colorado. Please contact me for inquiries, 720-560-0887 or info@thewishclinic.org.
Look me up on Linkedin Traci A. Kimball MD PC
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