What are the risks of laser treatment around the genital area?

Doctor's Answer

Hello, thank you for your question. Lasers have been used to treat various conditions in the genitalia region.

Some examples of these are the removal of growths such as genital warts, lightening of genitalia skin that has darkened, improving mild urinary stress incontinence, as well as tightening lax vaginal walls that have lost elasticity due to childbirth, menopause or ageing. Depending on the condition you are looking to treat as well as your skin type, different lasers can be used which carry different degrees of risk.

Ablative lasers

Ablative lasers like CO2 (Cynosures’s MonaLisa Touch, Lumenis’ FemTouch) and Erbium:YAG (Asclepion’s Juliet), breach the surface of our skin before reaching deeper layers, therefore they are commonly used to remove superficial growths found in the genitalia. Because of this, recovery time is longer compared to non-ablative lasers and there is a higher chance of the treated area developing wound infection, scarring, and skin darkening or lightening. This is apart from more common side effects like redness, swelling, and discomfort.

The ablative process also stimulates underlying tissue to produce more collagen fibres over time. This is demonstrated in vaginal tightening, where lax vaginal walls can be tightened using a fractional ablative laser. Fractionation accelerates the healing process compared to a non-fractional ablative laser, in which a beam of the laser is broken up into thousands of small columns to effect microscopic injuries to the skin.

However, possible side effects such as vaginal canal infection, vaginal scarring, and pain may still occur when a fractional ablative laser is used, hence it is important to seek out a physician with expertise and knowledge in the procedure who is able to advise you.

Non-ablative lasers

Thankfully, not all tightening or resurfacing lasers are ablative – there are non-ablative options that can tighten deeper layers of skin without hurting the surface skin. Therefore, the likelihood of developing an infection, prolonged wound healing, and scarring when a non-ablative laser is used is greatly reduced.

With improved technology, non-ablative lasers have been developed to offer safer options when addressing laxity in the vaginal canal and pelvic connective tissues. Using a non-ablative Erbium:Yag laser with an ultra-long pulse width (FotonaSmooth SP, FotonaSmooth XS), laser shots are delivered into the vaginal wall and pelvic connective tissues without disruption to the vaginal lining. This generates vaginal tightening as a result of heat-induced collagen remodelling and growth in those areas.

When the bladder is better supported by stronger pelvic connective tissue, mild urinary stress incontinence which causes unintended urine leakage is improved. You may experience temporary side effects like swelling and a burning sensation in the region after the procedure, which subsides within a few days.

Apart from this, non-ablative lasers ranging from picosecond to long-pulsed options are also effective for lightening pelvic and private areas that have darkened due to age, irritation, or hormonal changes from pregnancy. Examples of such sensitive areas include the genitalia, armpits, breasts and areolar regions. These are challenging areas to treat as our body skin has a slower healing capability compared to facial skin, therefore they can be prone to stubborn pigmentation as well as treatment side effects.

By using non-ablative lasers, there is a benefit of minimal downtime, and the risk of undesirable side effects like redness and temporary skin darkening or lightening are greatly reduced in experienced hands with the appropriate laser and settings. Having said that, skin lightening can still be achieved if ablative lasers are used, albeit at a gentler setting.

Before ending off, post-treatment care is essential to maximise results and minimise risks as the genitalia is a delicate part of the body. You could be prescribed topical creams after the treatment, and it is essential to follow through with them. Other forms of post-treatment care include avoiding harsh products over the area or refraining from having sexual intercourse for several days. Please speak to your trusted doctor regarding your concerns for a more tailored consult and discussion of your condition. Hope this is helpful!

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