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A Conversation With … Dr. Lesley Hawley

Provider, Ozarks Dermatology Specialists LLC

Posted online

How did you learn about the specialized laser treatment you brought to Ozarks Dermatology a year ago?
While I was in a Navy training, it gave me the unique opportunity to use the lasers. We treated a lot of wounded warriors coming back from Afghanistan with substantial burn injuries, substantial scarring, from their amputations and from an (improvised explosive device) blast. The injuries are pretty horrific, but we had this state-of-the art technology. After my training years, I was the head of the laser department there at the [Naval Medical Center Portsmouth], Virginia, and treated lots of active duty and wounded warriors with the goal of returning them back to active duty. I loved to really improve people’s functional lives and to allow them to regain the ability to use their limbs and to stay in their prosthetic for long periods of time without injuries and the blisters.

How does the treatment work?
The one that I use for scars and for burn injuries is a (carbon dioxide) laser – it’s an ablative laser, meaning it breaks the skin surface when you shoot it. It drills micro holes into the skin surface, and it is ablating, or destroying, the scar tissue that’s become hardened. When you fire this laser, the holes penetrate and break up the scar tissue and then we use the laser assistant delivery of Kenalog, or steroid medicine, as well as other medicines. You drizzle that in through the holes, and it reduces inflammation and allows the body to heal itself and to heal it appropriately with good collagen.

Ozarks Dermatology claims it’s the only clinic in the Midwest that has this type of laser. Why bring it to Springfield?
We’re trying to raise awareness that this technology even exists and that this treatment is available. It’s an extremely successful treatment option for patients. It’s quick and they can just return to normal life after a 20-minute procedure. We are the only ones. Most of the time, this procedure is learned and performed on the coast. That hasn’t so much been available in the middle of the country. I’m returning back here to my roots offering that opportunity for healing in that way to the people of southwest Missouri and then Missouri proper. For scar patients, it takes more than one treatment – usually at least six treatments based about a month apart. I’d say I’ve probably performed close to 400, 450 treatments in the past year. I do get a lot of (Veterans Affairs) referrals.

What’s the cost of the equipment and the cost to patients?
The laser itself is around $225,000-$250,000. To the patient – because this procedure is not cosmetic, it’s strictly for functional improvement – it’s covered by most insurances, Medicare and Medicaid. It’s now considered a standard of treatment for burn patients post grafting and then for surgical scars or any type of scar that is restrictive or painful. As you see the cost of the equipment versus the reimbursement for the treatment, it’s not necessarily something most dermatologists would want to do as far as the price ratio. That’s not why I’m in dermatology. I’m here to serve and help people improve their daily lives. You see people regain function of use of their hand or able to live without pain every day in their limbs. That’s very rewarding.

How is technology changing dermatology?
It’s constantly changing. Even 10, 15 years ago, they had lasers certainly, but I don’t think anyone conceived of the lasers being able to be used for this form or purpose. This machine has been around for over a decade, but we’re just now figuring out new ways to use it. A lot of it is just our ability as physicians to really think outside the box –from a scientific perspective and what these machines are capable of and then translating that into treating a disease process.

Dr. Lesley Hawley can be reached at hawleynurse@ozarksdermatology.com.

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