Lasers:
State-of-the-Art in Dermatology
by Sybil Maimin
Ever wonder what happens to Westinghouse (now Intel) Science
Talent Search winners? Well, one, Dr. Arielle N.B. Kauvar,
board certified dermatologist and a fellow of the American
Academy of Dermatology and the American College of Mohs Micrographic
Surgery and Cutaneous Oncology, and a Westinghouse finalist
in 1980, is on the cutting edge of the development and use
of lasers in the treatment of cosmetic and non-cosmetic skin
problems. Dr. Kauvar worked in an immunology lab while in high
school and based her Westinghouse project on her study there
of the movement of white blood cells. Also tempted by a possible
future in art, she took art history courses, painted, and did
free-lance illustrating while a student at Princeton, but spent
her summers doing immunology. At Harvard Medical School, where
she continued her work on white blood cells, the lab focused
on skin immunology, leading her to the specialty of dermatology.
Her journey of self-discovery continued during a residency
at New York University Medical Center where, experiencing the
satisfactions of working directly with patients, she decided
on a career that combines her interests in research (lasers),
art and aesthetics (improving skin appearance), and taking
care of people (private practice). A fellowship in Mohs micrographic
surgery, which allows the removal of skin cancer with microscopic
control, and laser surgery put her in the forefront of her
field. Involved in the development of modern laser technology
and practice, she continues to be a pioneer in its many uses.
She lectures, teaches, and writes about the procedure and is
preparing a comprehensive textbook, Principles and Practices
of Cutaneous Laser Therapy, to be published this year.
The first medical laser, created in 1960 to remove birthmarks,
was successful but often left scars. In 1983, a laser was developed
which eliminated marks without damaging surrounding skin, based
on a concept known as selective photothermolysis. There are
currently about 30 different types of medical lasers, each
designed to treat specific problems and skin types. The machines
are extremely expensive and, because of explosive development
in the field, become obsolete in two to three years. Dr. Kauvar
has 10 of the newest lasers in her office, one of a handful
of dermatologists in the country able to offer a wide range
of personalized treatment options with the most appropriate
machine available.
Lasers have many dermatologic uses. Non-cosmetic applications
include removal of birth marks (can be done at birth) and precancerous
skin growth. Psoriasis and inflammatory skin disease can be
treated. Lasers that target blood vessels can eradicate port
wine stains and spider leg veins. Scars can be reduced or removed,
and a recently approved machine can attack acne. Dr. Kauvar
sees infants and children and believes the psycho-social benefits
of early intervention are compelling. Cosmetic uses include
rejuvenating and resurfacing the skin and removing sun spots,
age spots, blood vessels and tattoos. A laser can remove hair.
New and popular are non-ablative lasers that are even less
invasive than the standard machines.
Dr. Kauvar has not encountered obstacles
as a female in medicine. Her mentors (Dr. Joel Schwartz,
whom she worked with on her Westinghouse project, Drs. Rudolf
Baer and Jeanette Thorbecke, who supervised her lab work
during college summers, and Dr. Rox Anderson, “a fascinating
man” who is a pioneer
in lasers) have all encouraged her. They and other teachers
were “fundamentally important to [her] intellectual development
and analytical skills.” When she began, there were few
women in Mohs surgery; today about half of all dermatologists
are female. Her hours are long but she encounters few emergencies
in her practice, allowing planned time with her physician husband
and three children. Smart, focused, and excited about being
at the cutting edge of medical lasers, she sees a future where
patients around the globe will benefit from treatments undreamed
of in the past.#
Dr. Kauvar is president-elect of the
Dermatologic Society of New York.
Dr. Kauvar’s office is at 994 Fifth Avenue, 212-249-9440.
