Laser in Dermatology: Advanced Materials 3rd Semester

Laser in dermatology
Advanced Materials
3rd semester
Contents
• Radiometry
• Skin optics
• Laser-Tissue interactions
• Clinical laser systems
– Continuous wave and pulsed lasers
– Q-switch lasers
– Other new lasers
lasers in dermatology
Radiometry
• ”Continuous wave” laser:
The terme used to quantify the concentration of power in the laser beam is:
IRRADIANCE = laser output (W)/(π×r2)
• For pulsed laser or Q-switch laser we use:
FLUENCE = laser output × exposure time/(π×r2)
• The radius is related directly to the beam
Skin optics
•Four possible interactions:
• Reflection
•Absorbtion
•Scattering
•Transmition
•Only 4% to 7 % of light reflected by the skin

•The depth of penetration is inversely related to the wavelength
•Principal skin chromophore:- hemoglobin ,melanin ,intracellular water.
Skin chromophore spectrum
Laser-tissue interactions
• Laser light skin heat
• an increase of 5 to 10C,their is cell injury and inflammation.
• if it is above 60C their denaturation of protein.
• above 70C their is the denaturation of DNA.
• over 100C their vaporization of water.
• Heat conduction happens and heat the surrounding tissue
• Thermal Relaxation time: it is defined as the time it takes for a structure to cool half
the temperature it has been heated.
• Transition from specific to non-specific thermal damage occurs as the laser exposure
equals and then exceeds Tr .
Target size Tr
Microvessel 10µm 190µs
Blood vessel 200µm 5ms
Tattoo pigment 0,5-100µm 20ns-3ms

granule
melanosome 0,5-1,0µm 20-40ns
melanocyte 7µm 1µs

Type Laser Wavelength Output Absorption
(nm)
Visible Argon 488-514 CW hemoglobin
Copper bromide 511 Pulsed melanin
578 hemoglobin
Nd:Yag 532 Q-switch Melanin and
(doubled) tattoos
Dye 577-530 CW,pulsed hemoglobin
510 pulsed melanin
Krypton 521-530 CW melanin
568 CW hemoglonbin
Ruby 694 Q-switch Melanin and
tattoos
Near infrared Nd: Yag 1.064 Q-switch Melanin and
tattoos
Midinfrared CO2 10.600 CW and H2O
superpulsed
Carbone dioxide laser
• It emits light at 10600 nm in the infrared
• This wavelength is strongly absorbed by

intracellular and extra cellular water
• When defocused with an exposure time of

less than 1 ms, penetrates only to 20 to
30µm in skin.
• Excisional Mode:
• continuous beam surgical cutting tool

• irradiance of 50 to 100 000 W/cm2
• The zone of residual thermal damage is of 200 to 600µm.
• Vaporizational mode:
• Defocused to a larger spot size and lower tissue energy density

• Ablative tools to vaporize cutaneous lesions,for superficial ablation and reconturing of
large areas
• Superpulsed and Ultrapulsed Modes:
• It delivers a series of short,high density pulses of light of 200 to 1000 Hz separated

from one another by short pauses.
• This allows the tissue to cool,preventing thermal collateral damage
Argon Laser
• Continuous light
• It emitted a source of blue-green light with wavelength from 488 to 514 nm
• the source is continuous non specific heating some heat conduction occurs.
• At low energy ,melanin is the principal chromophore creating heat and thermal
damage in the epidermis.
• At higher energies, thermal damage can be detected to a depth of 0,6 mm, partly
from nonspecific heat dissipation, partly from heat conduction.
• Argon laser is used to treat skin diseases like A-V malformations, Hemangiomas, fine
veins, spider nevi and acne rosacea.
• Argon-Pumped tunable Dye Laser:
• The argon-pumped dye laser,energized by an argon laser,has a fluorescent organic

dye as the lasing medium.
• The wavelength is determine by the specific dye that is used.
• used for the yellow light at 577nm ,which coincide with the absorpion peak of
hemoglobin
• It can penetrate in 1,2 mm into the skin .The energy generated within erythrocytes by
these lasers is transferred to the endothelial cells ,resulting in selective
photocoagulation of vessels.
• It decrease the risk of scarring,pigmentary alteration and textural changes.
Argon Laser
• Argon-Pumped tunable Dye
Laser:
• treat vascular lesions like Portwine stains

and other hemangiomas. It is also used to
treat pigmented nevi.
• Long pulsed dye laser is used to treat fine

veins and blushing.
Copper vapor Laser
• Emit either green light at 511 nm
• Or yellow light at 578 nm
• It produces a train of pulses with repetition rate of 15000 per second
• Pulse duration of 20 to 40 ns.
• it is rapid enough to have similar effect as a CW laser.
• The 578 nm band coincide with the absorption peak of oxyhemoglobin
• It is used to treat vascular lesions (PWS) ,the 511 nm is used to target
melanin.
DIODE LASER
Diode lasers are semiconductor lasers.

It produces laser beam in the wave length of
800 nm
It is most popularly used for hair removal.
Diode lasers have been found to work well
on dark skin :Gallium Aluminum Arsenide
Semiconductor Diode laser, 810 nm.
diode laser in long pulsed mode is also used
for treatment of leg veins.
Flashlamp-Pumped pused Dye Laser:
• The lasing medium is a fluorescent organic dye dissolved in a liquid solvent and
housed in a transparent cell.
• Original wavelength 577 nm
• The cell containing the dye is surrounded by a flashlamp capable of producing a

pulse duration of 450 µs
• Tr: 200µs to 3000µs for vessels of a diameter of 10 to 40 µm.
• The penetration depth is 0,2 mm and can be extend to 0,5 to 1,2mm by increasing to
585 nm
• For PWS it treats children more efficiently than adults because of the small diameter
of vessels in children PWS.
Q-SWITCHED LASER:
• A)Q-switched ruby
laser:
• active medium is sapphire (Al2O3)
doped with chromium
• emits 694 nm red light,28 ns pulses
with very high energy
• treat benign pigmented lesions and all

tattoos: traumatic,amateur,cosmetic
and professional
B)Q-switched Alexandrite laser:
• It is chromium doped BeAl2O4 ,that can be

tune between 701 and 826
• usually operated at 755 nm,
• 50 to 100 ns pulse duration.
• The active medium is the impurity in the

crystal ,and it is pumped by a flashlamp
• .It remove green,blue and purple tatoos
Q-switched Neodynium:Yttrium-Aluminium-Garnet Laser:
• It emits energy in the near infrared range at

1064 nm.
• it can penetrates to a depth from 3 to 6 mm
into the skin.
• short,5-to 20 nanosecond pulses.
• The 1064 nm light is poorly absorbed by
melanin so their is less risk of producing
hypopigmentation.
• But it can be frequency doubled to produce
532 nm light by passing it through a
potassium titanyl phosphate crystal
sometimes called KTP crystal.
• At this wavelength it removes epidermal
pigments and red tattoos.
•Treatment of Facial Telangiectasia:
laser makes use of the principle of selective photothermolysis to coagulate abnormal blood vessels
while sparing the surrounding tissue.
laser emits a brilliant green light at 532nm, close to a major absorption peak of hemoglobin in blood.
The blood absorbs the laser energy more than the surrounding tissue, and by selecting a pulse width
less than the thermal relaxation time of the blood vessel, the blood vessel can be selectively
coagulated without damaging the skin.
Erbium:YAG laser:
• introduced in 1996
• primary tool for ablation of superficial skin
lesions
• emission wavelength of 2940 nm

• skin penetration of 1µm allows more precise
ablation with less thermal damage
• Pigment changes are less common ,making
it beneficial for highly pigmented individuals .
• Newer laser have longer pulse widths that
produce greater thermal damage and
perhaps more collagen contraction, new
collagen formation, and better hemostatis.
• Er:YAG laser ablates 5-20 µm of tissue per
laser pass at a fluence of 5 J/cm2
excimer laser
•Wavelength: 308 nanometers
•Pulse duration: 30 nanoseconds
•Spot size:3.2 centimeters square
• Repetition rate:Up to 200Hz
• Energy density: 3 microjoules/cm2
Before After one treatment

Psoriasis
Other lasers
• FEL
• Low-Power Helium : Neon Laser
• Laser for investigation:
– X-Ray laser
– The confocal scanning microscope ,with its
laser

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Laser in dermatology

•Only 4% to 7 % of light reflected by the skin

• if it is above 60C their denaturation of protein.

• above 70C their is the denaturation of DNA.

• over 100C their vaporization of water.

• Heat conduction happens and heat the surrounding tissue

Microvessel 10µm 190µs

Blood vessel 200µm 5ms

Tattoo pigment 0,5-100µm 20ns-3ms

melanocyte 7µm 1µs

• It emits light at 10600 nm in the infrared

• This wavelength is strongly absorbed by

• When defocused with an exposure time of

• continuous beam surgical cutting tool

• Defocused to a larger spot size and lower tissue energy density

• Superpulsed and Ultrapulsed Modes:

• It delivers a series of short,high density pulses of light of 200 to 1000 Hz separated

• It emitted a source of blue-green light with wavelength from 488 to 514 nm

• The argon-pumped dye laser,energized by an argon laser,has a fluorescent organic

• The wavelength is determine by the specific dye that is used.

• It decrease the risk of scarring,pigmentary alteration and textural changes.

• treat vascular lesions like Portwine stains

• Long pulsed dye laser is used to treat fine

Diode lasers are semiconductor lasers.

• Original wavelength 577 nm

• The cell containing the dye is surrounded by a flashlamp capable of producing a

• Tr: 200µs to 3000µs for vessels of a diameter of 10 to 40 µm.

• treat benign pigmented lesions and all

• It is chromium doped BeAl2O4 ,that can be

• usually operated at 755 nm,

• 50 to 100 ns pulse duration.

• The active medium is the impurity in the

• .It remove green,blue and purple tatoos

• It emits energy in the near infrared range at

• emission wavelength of 2940 nm

Before After one treatment

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