laser 28th September 2016


European Academy of Dermatology and Venereology

Dr Firas Al-Niaimi was honoured to speak at this year’s EADV (European Academy of Dermatology and Venereology) congress on 28th September 2016 in Vienna. With his huge passion and extensive knowledge in laser dermatology, it was a clear choice for Dr Al-Niaimi to talk about his special areas of interest.

The presentation covered two topics: Laser Complications and Laser Assisted Drug Delivery.

Laser Complications

Dr Al-Niaimi was inspired to discuss laser complications due to the huge increase in the use of lasers in dermatology and cosmetic treatments worldwide. He based his presentation on his publication in the Journal of Cosmetic & Laser Therapy, and his first point was to define what we mean by ‘complications’; this is the undesired events that occur as a result of laser treatment without intention. To be clear, complications are not to be confused with the transient effects of laser treatments. Common laser complications and undesired effects include:

  • Contact dermatitis
  • Infection
  • Superficial burns and excessive crusting
  • Hypopigmentation
  • Prolonged/Persistent erythema
  • Paradoxical tattoo darkening
  • Scarring

When discussing these complications, Dr Firas touched on how to distinguish minor from major complications, and also temporary effects as opposed to permanent.

It is also important to discuss how these complications may occur. Dr Firas explained that we can separate reasons for laser complications in to three main areas: The Practitioner, The Device and The Patient. Dr Al-Niaimi went into these areas in detail and explained the possible outcomes:


  • Poor training
  • Wrong settings
  • Little understanding of clinical endpoints


  • Calibration failure
  • Beam profile (hot spots)
  • Cooling failure


  • Tanning
  • Poor compliance
  • Risk factors that have not been disclosed to the practitioner

This part of the talk was finished with Dr Al-Niaimi’s personal tips gained from vast experience on how to avoid, prevent and recognise the early, ominous signs of laser complications.

Laser Assisted Drug Delivery

This part of Dr Firas Al-Niaimi’s talk was also based on one of his publications that can be found in the Journal of Lasers in Medical Sciences. Get article here.

Dr Firas began by explaining that Startum Corneum (the skin’s main barrier) is the most superficial layer of the skin and is an effective, rate-limiting step in drug penetration. Certain drugs and cosmeceuticals cannot penetrate this barrier with ease.

With fractional, ablative lasers, we can create columns of injury to the skin, which allows for controlled channels of delivery for drugs or cosmeceuticals that can therefore reach deeper targets within the skin and result in enhanced efficacy.

Dr Firas went on to present the current evidence that laser assisted drug delivery provides enhanced results for the following conditions, using his own research and experience in this technology:

  • Pre-malignant skin cancer
  • Keloids
  • Atrophic scars
  • Haemangioma

There are possible limitations to laser assisted drug delivery; ablative laser treatments can obviously carry the risks of side-effects and complications; the availability and cost of this technology can be a limitation for some practitioners; and long term safety data for these methods still needs to be established.

Dr Firas concluded that laser assisted drug delivery allows treatments to ‘bypass’ the stratum corneum, enhancing drug penetration and therefore results. Topical therapies that were once limited by lesional thickness on the dermis may also be amenable to this treatment.

To find out more about Dr Firas Al-Niami, his talks and publications, please visit his website:

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