Professional Documents
Culture Documents
Abraham Arimuko
• Selective photothermolysis.
• Non Specific chromophore removal.
Pigmented laser, indication
• Correct diagnosis.
• Realistic expectation.
• Caution in darker skin.
Education / communication
• Laser Indication
• Procedure
• Limitation of the laser
Treatment Algorithm
• Anasthesia.
• Eye protection / laser safety
• Determine parameter
• Handpiece position : perpendicular / distance.
• Overlap
• Post op care
• Follow up
QS 1064-nm Nd:YAG 3 5–8
Nevus of Ota QS 694-nm ruby 6.5 5–6
QS 755-nm alexandrite 3 6.5
QS 1064-nm Nd:YAG 3 5.0
Table 3.5. Most effective Q-switched lasers for different tattoo ink colors
Table 3.6. Response of pigmented lesions and tattoos to various lasers and light sources
Pigmented Lesions Tattoos
Epidermal Mixed Dermal Amateur Professional
510-nm pigment lesion pulsed dye laser +++ + + ++ +++
(red colors)
532-nm Q-switched Nd:YAG laser +++ + + ++ +++
(red colors)
694-nm Q-switched ruby laser +++ + +++ +++ +++
(green color
755-nm Q-switched alexandrite laser +++ + ++ +++ +++
(green color
1064-nm Q-switched Nd:YAG laser ++ + +++ +++ +++
Intense pulsed Light source +++ + +
• Painfull
• Repeated procedures
• Transient side effect
• Post laser care
• Downtime
Pigmented laser, Melasma
532
Yellow poor
1064
Table 3.6. Response of pigmented lesions and tattoos to various lasers and light sources
Pigmented Lesions Tattoos
Epidermal Mixed Dermal Amateur Professional
Pigmented andlesion
510-nm pigment tattoo
pulsed dye laser,
laser response
+++ + + ++ +++
(red colors)
532-nm Q-switched Nd:YAG laser +++ + + ++ +++
(red colors)
694-nm Q-switched ruby laser +++ + +++ +++ +++
(green colors
755-nm Q-switched alexandrite laser +++ + ++ +++ +++
(green colors
1064-nm Q-switched Nd:YAG laser ++ + +++ +++ +++
Intense pulsed Light source +++ + +
• Pain
• Alteration in pigmentation : Hyper / hypo
• Thermal injury
• Scarring
• Darkening of tattoo pigment.
VASCULAR LASER
Vascular laser
History
Vascular laser
Port Wine Stain Treatment
■ Argon Laser
• Goals :
• Adequate heat diffusion, from light absorbing
melanizied hair bulb to surrounding follicle.
• Preserve the epidermis
Hair removal
• Operation Setting :
• Wave lengths : chromophore à pigment of hair
• pulse durations : longer than Q Switched
• Fluences : higher better, caution surrouding tissue heating
• spot size. : preference lager
• Cooling. : protect epidermal layer.
SKIN REJUVENATION
Rejuvenation,
• Beam :
• Cutting : focused
• Ablate : unfocused, lower power
Epidermal Dermal
Actinic keratosis Adenoma sebaceum
Condyloma acuminatum Angiofibromas
Epidermal nevus Granuloma faciale
Keratosis follicularis Hidradenitis suppurativa
Neurofibroma
Lichen sclerosis
Pearly penile papules
Porokeratosis
Pyogenic granuloma
Verruca plantaris
Syringoma
Verruca vulgaris
Trichoepithelioma
Xanthelasma
Take home message
• Important :
• Education
• Patient expectation
• Pre / post treatment
• Best result : combined therapy.
• Each laser has the advantage and limitation.
Terimakasih