Ultraviolet radiation is often considered a primary culprit for damaging skin health. However, it's not all bad, as light therapy using specific wavelengths of ultraviolet radiation has found applications in various skin conditions. Vitiligo is a skin condition that can see substantial improvement through consistent light therapy. 

Recently, the introduction of solid-state lasers into clinical practice, which can address the shortcomings of traditional equipment, has made treatments more efficacious and secure. I had the opportunity to meet with Director Bae Jungmin of Hill House Dermatology Clinic to delve into the details.

- Vitiligo is a skin condition that is relatively less recognized compared to other skin disorders. Please explain what it is.

Vitiligo is a condition in which melanocytes, the cells responsible for producing pigment called melanin, are destroyed, resulting in partial skin depigmentation. 

Melanin pigment is crucial in determining skin color and protecting the skin from UV radiation. When these melanocytes are damaged or destroyed, the skin loses its color, developing white patches.

While conditions like atopic dermatitis and psoriasis have garnered significant attention and seen the development of many new treatments, even in Western countries, vitiligo received less focus. In Western populations, where people generally have lighter skin, there was less emphasis on treating vitiligo.

Additionally, there was a prevailing perception that vitiligo was challenging to treat, which discouraged active intervention. Due to the low perceived necessity for treatment, research in this field progressed slowly.

- What is the current treatment approach? I'm particularly interested in when laser therapy (phototherapy) is administered.

Vitiligo is treated based on the size and progression of the lesions, which may include medication, phototherapy, and skin grafting surgery. 

The oldest standard treatment method is whole-body phototherapy. However, a challenge arose when vitiligo affected only specific skin areas, as whole-body phototherapy could result in unintended pigmentation or darkening of the entire body.

Fortunately, advances in laser technology have made it possible to treat the affected areas of vitiligo selectively with high-energy lasers. This has significantly improved the ease of vitiligo treatment. The depigmented areas can gradually recover their natural color by maintaining a proper treatment schedule and consistently undergoing laser therapy. 
The wavelengths used in these lasers for vitiligo treatment are generally painless and safe, making it possible for even young children to receive treatment comfortably and safely.

- Solid-state lasers have recently been providing considerable benefits to vitiligo patients. Specifically, what advantages can they offer?

Until now, the primary equipment used for vitiligo laser therapy was the excimer laser, which relied on gas. However, a drawback was the frequent need to replace and refill the gas, resulting in high maintenance costs. This made it demanding for individual clinics to acquire excimer lasers, reducing the accessibility of treatment for patients.

Fortunately, a domestic company called LASEROPTEK has developed a solid-state laser called the "Pallas Premium," which addresses these drawbacks. 

Its most significant advantage is that it achieves equivalent efficacy to traditional excimer lasers without gas, leading to lower maintenance costs. Now, even private clinics can easily acquire laser equipment, allowing many vitiligo patients to receive more convenient and safe treatment closer to home.

- What is the actual effectiveness of solid-state laser treatment?

While it varies from patient to patient, statistically, improvement for facial vitiligo is marked in approximately 6 to 7 out of 10 patients. About 4 to 5 out of 10 patients experience positive results for vitiligo on the body and limbs. In summary, laser treatment for vitiligo can lead to progress in about 6 to 7 out of 10 patients, while the remaining patients may explore other treatment options, such as surgery.

- Are there other skin conditions besides vitiligo that can be treated with solid-state lasers?

Solid-state lasers can be applied to various skin conditions; however, health insurance coverage is available for vitiligo and psoriasis in South Korea. Psoriasis, characterized by skin thickening, can significantly improve with approximately 2 to 3 months of treatment using solid-state lasers. 

While the effectiveness of solid-state lasers has been proven for atopic dermatitis and alopecia areata, health insurance coverage is not currently available for these conditions in South Korea, making treatment less accessible.

- It seems that eliminating the risk of side effects may not be possible. What are the potential side effects that can occur?

The wavelengths emitted by lasers are generally safe, and there is no reason to avoid treatment due to side effects. However, depending on the patient's skin condition, the laser's energy can vary, leading to skin becoming excessively red, developing blisters, or even causing burns. There is also the possibility of the treated area becoming darker. These side effects, though, typically improve naturally over time and do not pose significant long-term issues.

- What precautions should be taken during laser treatment to prevent side effects?

For vitiligo, visiting the clinic regularly and undergoing laser therapy at appropriate intervals is essential. Since the optimal energy level can vary for each patient, it's crucial to determine the energy intensity that works best for the individual. This is typically done by assessing it through charts and then conducting laser treatment at the precise settings that suit the patient.

- Are there any precautions to be taken in daily life after laser treatment?

There are not many things to be overly concerned about, but avoiding exposing the treated area to direct sunlight is advisable, especially when it's already received laser treatment. Excessive sun exposure can lead to the accumulation of more energy in the skin, potentially causing burns. While it may be easier to feel safe during winter, ultraviolet radiation is present year-round. Even in winter, applying sunscreen diligently and avoiding excessive sun exposure is essential.

Reported by InSun JangㅣTranslated by Jini Jung 다른기사 보기