Laser Surgery

Reviewed by: HU Medical Review Board | Last reviewed: February, 2022.

A laser is a narrow beam with a single wavelength of light.1 The high-intensity light is very powerful. This makes lasers useful for precise surgical work. They can be used instead of a scalpel to cut through tissue. Carbon dioxide (CO2) or argon lasers are used to remove skin lesions.1,2

Lasers can be used to remove a cancerous or precancerous lesion. They do this by vaporizing the top layers of skin.2,3 Lasers have several advantages over conventional surgery. Laser surgery is faster.2 It can be used to treat multiple lesions or lesions that are on delicate areas.2 It takes less time to heal from laser surgery and the risk of infection is lower.1 On the other hand, laser surgery is expensive and it is not available everywhere.2

Laser treatment is also called laser resurfacing. It is also used for cosmetic reasons.4

How is laser surgery performed?

Laser surgery is an outpatient procedure that takes about 1 hour. It should be performed by an experienced dermatologist or plastic surgeon.3,4 Your doctor will numb the treatment area with a local anesthetic. You also will take a sedative medicine.5

You will be given eye protection to wear during the treatment.6 Your doctor will aim the laser at the lesion. The laser heats and destroys the abnormal cells. Your doctor will use a wet gauze to wipe the vaporized lesion.6 If there is bleeding in the treated area, the laser will be used to stop it. Your doctor will bandage the treatment site.5

For what types of skin cancer is laser surgery used?

Laser treatment can be used for actinic keratosis, squamous cell carcinoma in the top layer of skin (in situ), and very thin basal cell carcinomas (BCC).1,7,8

Lasers can be useful for treating lesions on delicate locations, such as the eyelid.2 Laser treatment may help high-risk individuals avoid multiple surgeries.2 For example, a person with a weakened immune system may have many skin cancers in his or her lifetime. It may be desirable not to excise each lesion.2

What should I expect before, during, and after the procedure?

If you are considering laser treatment to treat skin cancer or precancer, you will need to meet with your doctor. You will discuss whether you are a good candidate for the procedure. Ask how the risks and benefits of laser treatment compares with other treatment options.

If you are a smoker, you will likely be instructed to avoid smoking for 2 weeks before and after the procedure.3 Your doctor may prescribe medications to take before your treatment. You may be instructed to discontinue some of your regular medications or nutritional supplements.

After your procedure, the treated area will be bandaged. Your doctor will give you instructions on how to care for the treated area. You will need to clean and apply ointment to the treatment area multiple times per day.3 The treated area will swell and itch.3 The old skin will slough and peel off about 1 week after the treatment.3 Your doctor may provide additional information or instructions regarding the procedure. You should follow your doctor’s instructions and talk to your doctor if you have any questions.

It can take up to 3 weeks for the treated area to heal.3 You will need to wear sunscreen with a sun protection factor (SPF) of 30 or more every day after the procedure.5

What are the risks of laser surgery?

The treated area will be red and may remain that way for up to 6 months.5 Other likely side effects include:

  • Pain
  • Swelling
  • Bleeding
  • Crusting

Skin discoloration is a more serious concern. People with darker skin tones may develop dark patches (hyperpigmentation).2 Hypopigmentation (white spots) is a possible but less common side effect.5

Laser treatment may reactivate the herpes simplex virus, causing cold sores to return. If you have a history of cold sores, your doctor may give you an antiviral medication to take before the procedure.

Laser surgery can result in scarring or infection, although the risk is lower than with conventional surgery.2

Mild side effects of laser treatment also include:5

  • Milia, little white cysts or bumps under the skin
  • Acne flare

What questions should I ask before laser surgery?

  • Are you a dermatologist? Are you a plastic surgeon?
  • Am I a good candidate for laser surgery?
  • How often have you done laser surgery?
  • What are the benefits of laser surgery for the treatment of this skin lesion?
  • How do the risks of laser surgery compare with the risks of other treatments for this condition?
  • What will the recovery be like? When can I return to normal activities?
  • How often should I have follow-up skin exams?

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