Roy Geronemus, MD Founder of Laser and Skin Surgery Center of New York, is considered a pioneer in laser medicine. He established the laser program at New York University Medical Center, where he served as chief of dermatologic and laser surgery for nine years. Dr. Geronemus is also a past president of both the American Society for Dermatologic Surgery and the American Society for Laser Medicine and Surgery. He received the Ellet H. Drake Memorial Award for outstanding contributions to laser medicine and the Leon Goldman Memorial Award for excellence in clinical laser research. He has had a front row seat to the energy-based device revolution in dermatology.
Dr. Geronemus took some time to talk to Practical Dermatology® about the amazing changes he has witnessed and what is still to come. (Spoiler alert: a laser cure for acne.)
When you first started practicing, what role did lasers or other energy-based devices have?
Roy Geronemus, MD: The first laser I used was the argon laser for the treatment of port-wine stains and other vascular conditions. Shortly thereafter, I began to use the fully ablative carbon dioxide laser for the removal of benign growths.
What has been the greatest innovation in these devices over your career?
Dr. Geronemus: Selective photothermolysis led to the pulsed dye laser, Q-switched laser, and picosecond lasers. Since 2004, the fractional lasers have also revolutionized rejuvenation and resurfacing.
How have these devices helped change lives?
Dr. Geronemus: Many birthmarks including port-wine stains can be completely removed during infancy. We like to use the term “done by one.” Many of these children have no recollection of ever having a birthmark.
What is possible today that wasn’t 10 years ago?
Dr. Geronemus: Advances include treatment of birthmarks during infancy, improved tattoo removal for green, blue, and yellow ink, CoolTone for muscle toning, CoolSculpting for fat removal, laser-assisted drug delivery for the improvement of pigmentation, scar correction, and actinic keratosis. The results continue to improve dramatically with new technology.
Are today’s lasers largely color blind?
Dr. Geronemus: No. One needs to pay special attention to patients who have darker skin phototypes by choosing the appropriate laser with the best possible parameters to maximize the therapeutic outcome in this subgroup of patients.
Where do you see this field headed?
Dr. Geronemus: I am optimistic that there will be dramatic changes in the future, including a possible cure for acne using lasers, improved lasers to treat pigmentation, and improved devices for skin tightening in a reliable fashion.
The use of devices for the treatment of medical conditions and laser-assisted drug delivery will expand and enhance the treatment of non-melanoma skin cancer.