Lasers treat a wide range of skin conditions and are also one of the best ways to give your skin a non-surgical rejuvenation. Dr Saleem Loghdey, Dermatologist and MOHS surgeon talks to us about lasers and how they work, specifically the PICO PLUS, one of the most effective lasers on the market from Advanced Cosmeceuticals.
Trish: Hello, listeners. I’m here today with Dr. Saleem Loghdey. Did I say that right?
Saleem Loghdey: Yes, that’s perfect.
Trish: Oh, lovely. And he’s a dermatologist and MOHS surgeon … that’s M-O-H-S surgeon … that’s based in Miranda. And until I knew that, I didn’t even know what a MOHS surgeon was, so I might even ask him about that today. We’re going to have a bit of a chat about the PicoPlus laser, which Dr. Loghdey uses in his practise. So I heard him talk at a symposium on Monday night and it was really, really interesting. So, we’re going to have a bit of a chat today.
Saleem Loghdey: Thank you. Thanks very much and thanks for having me on your podcast.
Trish: Lovely, thanks for joining us. I have got a couple of questions. Can you just tell us a bit … I know there’s a lot of lasers around at the moment. What impressed me as a consumer when I saw your talk is the fact the PicoPlus laser actually reduces the treatment time, as in the times you have to go to have treatments done. And sometimes it’s a one-off treatment, as well. Tell us a little about that.
Saleem Loghdey: The Pico lasers have been a recent advance in laser technology. They were initially made for tattoo removal, but we’ve realised not that they have other benefits. We can treat various skin conditions a lot better than we could with previous laser technology. Specifically, things like pigmentation. Hormonal pigmentation like melasma, sunspots. Post-inflammatory pigmentation we can all treat with this. And these are things that are pretty difficult to treat with the older technologies.
The advantage of the Pico laser system is that the down time seems to be a lot less than with the previous technologies. And yo can also treat darker skins a lot safer. For me, that was the most important thing is the safety aspect of it. Patients wanting treatment done, they don’t really want to have a long down time and long recovery. And the Pico system allows us to do that.
Trish: Yeah, because I myself have dark skin. A little bit like yours, actually. Not too dark, but it’s darker than the average skin. So I don’t get laser, because I tend to get pigmentation … spots here. And so this would be okay for someone like me?
Saleem Loghdey: Absolutely. In fact, this would be my go-to treatment for patients with pigmented lesions and who have darker skin type. Sort of your more olive or Mediterranean skin type. And then even darker. A lot of our patients from India and the sub-continent and Asia would benefit from this laser and fine that the chances of side effects are a lot less than with other systems.
Trish: Right. And one thing, I noticed that … I’ll get my little notes up here … I noticed that there’s four wavelengths. And for anyone … I’ve just started to understand this myself. So there’s lasers and there’s lasers. So this laser, actually, you can use four different wavelengths, which means that you can do different things with the one laser because the wavelengths get changed for different treatment. I’ve never understood that before, but I’m starting to understand that now.
So can you tell us what the four versatile wavelengths are and the indications for each one, if you don’t mind?
Saleem Loghdey: Sure. So, just a bit of background. With the different wavelengths, that essentially allows us to tackle certain conditions at different levels in the skin. And as a general rule, the longer the wavelength, the deeper the laser goes. And that will allow you to treat deeper lesions in the skin.
As you know, in the skin, you’ve got different layers. You’ve got the epidermis. We’ve got the dermis. And then we’ve got collagen. And then we’ve got a fatty layer, and then we’ve got muscle below there. So essentially, with the different wavelengths, you can target each of those depths.
Now, the PicoPlus has got four wavelengths, which makes it very versatile. It’s got the 532 wavelength, which we can tackle things on the first layer of the skin known as the epidermis. And specifically pigmented lesions like freckles or solar lentigos. And the next wavelength is the 660. Sorry, there’s also a 595 laser. The 595 laser is a laser that’s very … that wavelength is very good for blood vessels. But because the Pico system is a system that has a very, very fast pulse duration, this wavelength we would only use for really facial redness, post-inflammatory redness, but we wouldn’t use it specifically to target blood vessels. Because that you need a longer pulse duration for.
So the 595 wavelength is mainly for post-inflammatory erythema and flushing. Then the next wavelength is the 660 wavelength. That is also for pigmented lesions, which are slightly deeper than the pigmented lesions on the surface of the skin. Also, it’s a really good wavelength when the pigmented regions are not very dark. Because lasers tend to treat darker lesions better than lighter lesions. So with the 660, we can tackle those pigmented lesions that are not very dark.
Lastly, the 1064 wavelength, that is the wavelength that goes the deepest and that allows us to treat deeper pigmented lesions and conditions where the pigmentation process may be in the collagen or the dermal layer of the skin, such as dermal melasma. And then obviously, those different wavelengths can also be used to treat different tattoo colours.
Trish: Okay. So when you’re doing tattoo, it’s the 1064 wavelength?
Saleem Loghdey: THat’s for black tattoos and your dark tattoos. But for example, for coloured tattoos, which is becoming more of a trend, you need all wavelengths to tackle that. There’s no single wavelength that can attack or treat different colours of tattoos. You need different wavelengths.
For example, the 532 wavelength will be good for your red tattoo. The 660 would be good for your greens, and the 595 would be good for the sky blue, which is a difficult colour to treat.
Trish: And yellow, too?
Saleem Loghdey: Yeah, you can treat yellow, as well. One colour that you might struggle with, and most laser systems tend to struggle with this, is your purplea.
Trish: So if you’re going to get a tattoo, don’t get purple ones.
Saleem Loghdey: Try and avoid your blues and your greens, your light green, as well.
Trish: Right, okay. That’s great advice.
So, I know for a fact that the device actually has four hand pieces. And the exclusive new dual focus dots hand piece. So there’s five pieces in total. Can you tell us a little bit about what each one is for?
Saleem Loghdey: So there’s actually six hand pieces. We’ve discussed those four hand pieces, which each one is a different wavelength. And then the other two hand pieces are what we call fractionated hand pieces. They break up the laser beam into smaller laser beams. Really, the fractionated hand pieces are last to enhance all our treatments with the others…
But they also have their own role in that they are good for rejuvenation of the skin, building up collagen. They are good for difficult conditions to treat like big pores, fine lines, stretch marks. They are really good for that. And when it comes to rejuvenation, the good thing about those hand pieces is that we can do it without the patients having a lot of downtime. It’s what’s termed cold rejuvenation, because it doesn’t cause much heat in the skin like previous laser systems. So your recovery time is a lot quicker.
Trish: I was watching those before and afters that you had of the treatment for the pores. And I have big pores myself anyway, so of course I’m going to notice that. It was quite surprising. Was that just one treatment or was is something that you have a few of?
Saleem Loghdey: Yeah, you generally have a few of them. Roughly three to four weeks apart, two to three treatment sessions will improve pore size.
Trish: That’s great.
Saleem Loghdey: Yeah, absolutely.
Trish: And just one other thing. So, PicoNano, because this is a PicoNano, isn’t it? Is that right?
Saleem Loghdey: Yeah.
Trish: What does that mean?
Saleem Loghdey: Nano and Pico refers to the, what we call the pulse duration of the laser. And the pulse duration is literally how quickly the laser beam fires into the skin and switches over. That’s the pulse duration. So a Pico system means the laser does it a lot quicker than the Nano system. And basically, that allows you to target things and have very little collateral damage to surrounding skin.
It allows you to tackle things like pigment well and things that have what we call a short thermal relaxation time or stress relaxation time. And those terms are quite technical. The Pico and Nano systems are our fastest firing lasers.
So before we had Pico systems, we only had the Nano systems. Another name for Nano systems are Q-switch lasers. And those Q-switch lasers was primarily used for pigmentation and tattoos. But the problem was, they weren’t very effective. You could treat some conditions relatively well. I wouldn’t say superbly. And you would often need lots of treatments to achieve your result. Especially when it came to tattoo removal.
Trish: Yeah, I’ve got a couple of ladies in our group, and one had the Q-switch laser and she had 13 treatments with it and it still wasn’t gone. And one had the Pico and she actually had it completely gone within three sessions.
Saleem Loghdey: Exactly.
Trish: That’s the kind of difference that we’re looking at, isn’t it?
Saleem Loghdey: Yes.
Trish: All right.
Saleem Loghdey: And just to kind of put it into context, the Pico laser would fire its beam a thousand times faster than a Nano laser.
Trish: Right, okay. So basically, it treats pigment removal, which is like tattoo removal. Rejuvenation, as well. A bit of a laser facial toning, as well.
Sorry about the screaming baby. We’re in one of these rooms and there’s a little baby outside.
Sorry, laser, facial toning, also melasma. That’s rebound melasma, as well?
Saleem Loghdey: Yeah, so that’s sort of the hormonal pigmentation that women tend to get more than men, commonly around pregnancy. Sometimes if they are on a contraceptive it can flare. But some can also bring it often. And it tends to be an ethnic genetic tendency to that.
Trish: So say, for example, if someone like pregnant and they’ve got dark underarms or they’ve got dark spots on their body that come out during pregnancy, this would be perfect for that?
Saleem Loghdey: Look, the dark underarms is most likely a different condition. But the melasma tends to be more on the face.
Trish: Okay. Well, that’s so, so interesting. So basically, less treatments, few more indications that it can treat, and–
Saleem Loghdey: More effective. And naturally. Because you’re having these treatments that cost. It’s beneficial to the patient. And then patients recover quicker. It basically allows us to treat conditions more effectively, quicker, and more safely.
Trish: Too easy. Thank you so much for your time. And so, you’re here at Miranda. Anywhere else?
Saleem Loghdey: Mainly Miranda where I do my laser treatments and my general dermatology and MOHS surgery. And then I also practise at-
Trish: Oh, what it MOHS surgery?
Saleem Loghdey: MOHS surgery is a technique invented a long time ago in the 1950s in America by a surgeon called Frederick Mohs. And he developed a technique to remove difficult skin cancers like on your nose, your eyes, your lips, your ears. The technique allows us to remove skin cancers without wasting normal skin. And really trace the roots of the cancer, get it out. And that allows us to have the highest cure rate. A 98-99% cure rate.
Also, because you’re only taking out the cancer and not wasting normal skin, you’re wound is smaller. And that will allow you to fix it easier. So give you a better cosmetic result. And that’s all done in one process, one step on the time, So we take out the cancer, fix it up on the same day. And there’s no concern that the patient has to wait for the pathology result a week later, because we do it on the day. So the patient knows if we tell them, “The cancer’s removed. It’s clear,” that’s it. It’s very streamlined. It’s really the gold standard to remove difficult skin cancers on the face,
Trish: That might have to be our next article.
Saleem Loghdey: Yes, absolutely.
Trish: Awesome. Well, thank you so much for time. So much appreciate it. And listen, so if you wanted to get in touch with Dr. Loghdey, you can Google him or you can just look up … the name of the clinic is Integrated Health-
Saleem Loghdey: Specialist Healthcare.
Trish: Integrated Specialist Healthcare. So, I-H-H-C in Miranda. Otherwise, you can drop us an email to email@example.com, and we’ll put you through. So thank you so much.
Saleem Loghdey: Pleasure. Thank you for having me.