The primary purpose of using 70% ethanol is to prepare the skin surface biologically and physically to maximize treatment success. It serves to thoroughly remove surface oils, debris, and microorganisms, effectively sanitizing the area while simultaneously altering the skin's surface properties to allow for precise laser interaction.
By eliminating surface barriers like oil and dead skin, 70% ethanol does more than sanitize; it reduces skin impedance and light reflection to ensure that both topical anesthetics and laser energy penetrate the target tissue uniformly.
Optimizing Optical Physics
To understand why simple cleaning isn't enough, one must look at how laser light interacts with surface contaminants.
Minimizing Light Reflection
The skin's natural oils and dead cells create a reflective barrier. If left intact, these substances can scatter light waves, preventing them from reaching the deeper dermal layers where scar remodeling occurs.
Enhancing Transmission Efficiency
70% ethanol effectively degreases the skin, stripping away these barriers. This optimization ensures that photons traverse the skin surface efficiently rather than bouncing off it.
Promoting Uniform Absorption
When the surface is free of irregular patches of oil and debris, the laser energy is absorbed evenly across the treatment area. This prevents "hot spots" or untreated zones, leading to a more consistent clinical outcome.
Physiological Benefits
Beyond the physics of light, ethanol preparation alters the biological state of the skin to improve safety and comfort.
Reducing Skin Impedance
The presence of lipids (fats) and oils increases the skin's resistance, known as impedance. Ethanol lowers this impedance, which facilitates the effective penetration of topical anesthetics applied before the procedure.
Infection Control
The most immediate biological benefit is antisepsis. By eliminating surface microorganisms, ethanol significantly prevents potential infections that could arise when the laser breaches the skin barrier.
Understanding the Trade-offs
While 70% ethanol is the standard for preparation, it is critical to acknowledge the safety protocols required when using it in conjunction with energy-based devices.
The Flammability Risk
Ethanol is highly flammable. It is imperative that the solution is allowed to evaporate completely before the laser is activated to avoid the risk of surface burns or fire.
Potential for Irritation
Because ethanol is a solvent that strips natural oils, it can lead to temporary skin dehydration or irritation. This is a necessary trade-off to ensure the laser energy is not impeded by those same oils.
Making the Right Choice for Your Protocol
Proper skin preparation is a balance between thorough cleansing and patient safety.
- If your primary focus is treatment efficacy: Ensure rigorous degreasing to remove all oils, as this minimizes light scattering and guarantees the laser energy reaches the target depth.
- If your primary focus is patient safety: Verify that the skin is completely dry after application to eliminate flammability risks while maintaining a sterile field.
The goal is to create a pristine, low-impedance canvas that allows the laser to perform exactly as engineered.
Summary Table:
| Function | Benefit to Laser Treatment |
|---|---|
| Surface Degreasing | Reduces light scattering and reflection, ensuring photons reach target tissue. |
| Antisepsis | Eliminates microorganisms to prevent infection post-laser breach. |
| Impedance Reduction | Lowers skin resistance to improve the penetration of topical anesthetics. |
| Uniform Absorption | Removes debris to prevent "hot spots" and ensure consistent energy delivery. |
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References
- Arezoo Jahanbin, Seyed Mohammad Ali Raisolsadat. Fractional CO2 laser treatment for post-surgical lip scars in cleft lip and palate patients. DOI: 10.1007/s10103-019-02819-z
This article is also based on technical information from Belislaser Knowledge Base .
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