Introducing DALASS: The Future of Tailored Laser Treatments
Traditional laser treatment approaches primarily rely on the Fitzpatrick Skin Type system, focusing predominantly on melanin as the key determinant in laser interactions. This method, developed in the 1970s, often overlooks the comprehensive interaction of laser wavelengths with the other two chromophores - haemoglobin and water. To address these limitations, Dr. Andy's Laser Aggressiveness Scoring System (DALASS) proposes a more holistic assessment for optimising cosmetic laser treatments.
Objective:
DALASS aims to enhance the safety and efficacy of laser treatments by helping professionals determine the most suitable laser settings based on individual skin conditions. This innovative system ensures that treatment results are maximised while maintaining the highest safety standards.
How It Works:
DALASS categorises skin based on three critical factors:
Skin Type (based on melanin content)
Skin Health (based on haemoglobin levels, indicating inflammation)
Skin Thickness (measured via ultrasound)
Using tools like Canfield VISIA for melanin and haemoglobin assessment, and ultrasound or Ulthera for measuring skin thickness, DALASS assigns a score for each category. These scores are then added to determine a total score, guiding the treatment approach.
Scoring System:
Skin Type I-VI (1-6)
Skin Health from no erythema to severe erythema (1-6)
Skin Thickness from > 4mm to < 0.5mm (1-6)
Treatment Guidance:
Based on the total score, DALASS categorises the treatment approach into three zones:
Green Light (Score 3-6): Ideal for aggressive laser treatments to maximise results.
Yellow Light (Score 6-12): Calls for extra caution measures. For example, more cooling involved for temperature control, lower repetition rates, and larger gaps between pulses.
Red Light (Score 12-18): Indicates the need for pre-treatment to control inflammation, which may involve topical treatments, intradermal injections, or specific types of lasers like the Pulsed Dye Laser or Long-pulsed Nd:YAG.
Real-World Applications:
DALASS is not just a theoretical concept; it's a practical tool with real-world applications. For instance, a 40-year-old Asian female came in to treat her melasma. During assessment, her skin type is 4, mild to moderate erythema, and thin skin (0.5-1 mm) due to over-cleaning. She would score a 13 on DALASS, placing her in the “Red Light'' category. This indicates the need to address inflammation before proceeding with treatments like PicoSure or PicoWay.
Conclusion:
DALASS represents a significant leap forward in personalised laser treatments, offering a structured, scientific approach to achieving optimal results. By considering individual skin characteristics, DALASS ensures that each treatment is as safe as it is effective, heralding a new era in cosmetic dermatology.