Pulsed Dye Laser Therapy

1. Is Pulse Dye Laser really the best noninvasive wart treatment?

2. Are there differences in Pulse Dye Lasers?
YES!! Pulse Dye Lasers must be regularly maintained in order to work properly. This means replacing costly dye packs that provide the mechanism for the laser to work efficiently. This also means caring for the lenses and hand pieces properly and not excessively jarring the laser when transporting the unit. There are companies that I have used in the past that rent Pulse Dye Lasers. These outfits are not, in my experienced opinion, maintaining their lasers properly which results in failed treatments.

3. Why would a pulse dye laser treatment fail?
Treatments will fail if proper debridement is not performed prior to treatment with the laser. Debridement of thick skin must be very close to healthy skin in order to expose the skin and blood vessels to the laser.
Treatments will almost always fail if the laser is improperly maintained or has weak output due to dye level, mechanics or dirty lenses. I personally have experience with this. When pulse dye first became available, the lasers were well maintained and results were very consistent. During a 3 year period, lasers that were transported to my office were not working well. Lower output, poor focus of lenses and mechanical breakdown were much more prevalent, resulting in failed treatments (and much frustration).
The purchase of my own Pulse Dye Laser dramatically increased successful outcomes to the point of completely restoring my opinion of Pulse Dye as being the best noninvasive treatment for plantar warts.

4. How many treatments should I have before I see a difference?
It may take more than 3 visits to resolve the problem due to the viral nature of the problem. Treatments are generally two or four weeks apart while the warts are thoroughly debrided before each treatment.

5. What is debridement?
Debridement is the shaving of thick skin often seen making up the wart. It also refers to the shaving of the dried scab that forms after successful pulse dye treatments.

6. Does pulse dye laser hurt?
Pulse Dye power is measure in Joules. At 6 Joules, the laser begins to snap and burn for the second that it is applied. After each pulse, you should experience a mild hot sensation on the area.

7. Does the laser leave a mark?
Yes. A purple mark must be seen almost immediately after the pulse if the laser is to be effective. As the days go by after treatment, the purple mark will turn into a dark purple scab which can be shaved off on the next visit. Note: if you don't see purple marks, then the laser power is too low, the laser is inefficient or improper debridement was performed prior to treatment.

8. Do doctors ever use anesthesia to numb the area before treatment?
Yes. If the doctor feels that the laser will cause too much discomfort to the patient do to the number to warts or area treated, then a local anesthetic may be used.

9. How can I find a list of doctors that own there own lasers with good maintenance records?
I will be posting a link to a site that has the names and locations of doctors, by state that own there own lasers.

10. Can I run after my treatment?
Yes. The great advantage this technology is not only that it works very well, but also that the patient can run on the day of treatment. This does not mean that the patient will not feel some soreness in the area. There is often some tenderness. But there is no harm or risk in running or playing sports after treatment.

11. Can my young child have pulse dye treatment?
Yes. Children may find it scary at first but will respond well often at lower power (5 Joules or less)

12. Are there topicals that can make the procedure painless?
No. Topicals are not necessary and don't work. The best anesthetic is xylocain which can be administered by a derma jet.