Why Choosing The Right Laser Is Key – And Where To Start

Aesthetic procedures are getting more popular as technology advances, and more people are looking for less invasive ways to tackle skin issues and regain their youthful look. Lasers are able to provide significant results with minimal invasiveness, becoming an indispensable part of the beauty industry.

L-A-S-E-R

The word laser is actually an acronym, which stands for light amplification by stimulated emission of radiation. A laser is a single-wavelength source of high-energy light. What makes a laser light unique is the 3 properties it has: monochromatic, coherency and directional.

Monochromatic: Light produced by the laser is of a single wavelength and energy. This allows precise targeting within the specific area while sparing surrounding skin tissues.

Coherency: The waves of light are in phase with each other, instead of producing many wavelengths. A laser beam that is highly coherent can be more precisely focused.

Directional: The beam of light has very low divergence, and the light produced is spatially narrow. For instance, light from a conventional source like a light bulb diverges and spreads in all directions while a laser beam can be focused on a very small spot size.

Not all lasers are the same

The properties mentioned above make laser light suitable for therapy purposes. Lasers can treat an extensive number of conditions, from skin resurfacing, pigmentation, wrinkle reduction, acne scars, vascular conditions and more. But why are there different types of laser?

While you may notice there are numerous laser brand names available today, lasers may be classified according to the wavelength of the emitted light, the lasing medium employed, and the pulse duration.

Wavelength

Different lasers with various wavelengths (colours of light), measured in nanometers (nm), target different skin issues. The shorter wavelengths are the ultraviolet, which enables more superficial penetration; and the longer wavelengths are the infrared which allows deeper penetration. This also means different lasers can produce specific colours that are specifically absorbed by different tissues of the body.

Some lasers focus on brown spots and pigmentation – breaking down the melanin in the skin to minimise the appearance of dark spots. Others focus on red broken capillaries or acne scars. A combination of lasers may be recommended to treat all the problems you have.

Mode of delivering the laser

Inside the laser device, the lasing medium is the substance or energy source that produces the laser beam. This could be: liquid (dye), solid (ruby crystals, Nd:Yag, alexandrite crystals) and gas (CO2, argon, krypton).

Pulse duration

This refers to how quickly the energy is delivered to the tissues. The pulse duration, or pulse width, is the time measured across a pulse. It refers to the time it takes to deliver energy to the treatment area.

Pulsed laser systems produce high-energy laser light in ultrashort pulse durations with long interpulse time intervals. These can be long-pulsed or short pulsed such as the nanosecond and picosecond laser systems¹. Longer pulse durations are used to heat and penetrate deep into the dermis while short pulses can minimise the thermal damage to surrounding tissues.

Energy delivery also differs depending on the skin concern. Ultra-short pulses of picoseconds and nanoseconds can help remove tattoos and clear pigmented lesions, as compared to milliseconds for hair root and capillaries².

Ultra-short pulses like the picosecond laser achieve pigment clearance with a photoacoustic effect as compared to the photothermal effect of a nanosecond laser. As such, the risk of post-inflammatory hyperpigmentation is lower with a picosecond laser than a nanosecond laser, and this is especially pertinent when treating darker skin tones.

The different types of laser

One laser is not the be all and end all, so we need to consider the different wavelengths and pulse duration to determine how well it can treat what is required.

One other way of classifying the lasers is by separating them into these two categories: ablative and non-ablative. Ablative lasers target water in the skin to remove and vaporise the top layers of tissue. Non-ablative lasers work deeper in the skin without vaporisation by channelling heat-induced injury to various depths. As a result, there is a lot less downtime for non-ablative laser treatments as the surface skin is not removed.

Here are some of the common types of lasers used in aesthetics:

Pulsed dye lasers have wavelengths of 585nm that emit short bursts of high-intensity yellow light, best used to target vascular problems such as port wine stains, rosacea, telangiectasias and red scars from acne or surgery.
Nd:YAG (neodymium-doped yttrium aluminium garnet) lasers typically have a wavelength of 1064nm and are highly popular in aesthetic treatments. They release an infrared light that is absorbable by water, melanin and haemoglobin, and are best suited for pigmentation such as brown age spots, blood vessels that are deeper and have a larger calibre, hair removal, and wrinkles. They can also come in Q-switched nanosecond or Pico laser forms for tattoo removal.
CO2 (carbon dioxide) lasers emit invisible infrared light at a wavelength of 10,600nm, and are used to remove thin layers of skin with minimal heat damage. They are commonly used for treating wrinkles, photodamage, scars and other benign skin growths like warts and keloids.

Fractional lasers

What then is a fractional laser? A fractional laser just means that the laser is able to deliver heat and light in a pixelated fashion, targeting a fraction of the skin at a time.

Bridging the gap between ablative and non-ablative laser techniques, the laser beam is delivered in tiny, deep columns into the skin so that the area can be treated intensively while the surrounding healthy tissue which is intact helps to heal the wound. This results in a lower downtime than their non-fractionated counterparts. Fractional lasers can again be sub-classified as fractional ablative or fractional non-ablative lasers.

As such, an ablative CO2 laser can be delivered in a full ablative mode, or in a fractionated mode as well. Likewise, a non-ablative picosecond laser can also have the ability to deliver light energy in a fractional mode. These modalities are often used for facial rejuvenation to improve wrinkles, sun damage and acne scarring.

Choosing a laser treatment for you

This has been intended to share a breakdown into some of the science and jargon behind lasers, and provide basic information on the modalities that are available to you. Having a significant understanding of lasers is key to helping you choose the right laser treatment for your skin concerns.

It is also wise to seek treatment from a skin dermatologist who has experience operating a range of lasers and how they can customise the treatments.

At Angeline Yong Dermatology, our dermatology clinic offers a full spectrum of medical-grade laser devices that can work individually or synergistically to produce desirable results. Dr Angeline Yong is dedicated to listening to patients’ concerns and preferences before customising a suitable and bespoke personalised treatment regime.

With over 15 years of medical practice, Dr Yong has the knowledge and experience to carry out a range of medical, surgical and cosmetic dermatologic treatments including laser treatments like the Picosure laser – a picosecond laser that delivers ultra-short pulse bursts of energy in trillionths of a second. Effective for acne scars and pigmentation, it can shatter the targeted particles without harming the surrounding skin tissue and stimulate collagen to improve wrinkles.

Whether you have one or multiple skin concerns, like uneven pigmentation, acne scars or wrinkles, finding the right laser treatment to address your needs is a consultation away at AYD!

Reference:
1. Husain Z, Alster TS. The role of lasers and intense pulsed light technology in dermatology. Clin Cosmet Investig Dermatol. 2016;9:29-40. Published 2016 Feb 4. doi:10.2147/CCID.S69106
2. Patil UA, Dhami LD. Overview of lasers. Indian J Plast Surg. 2008;41(Suppl):S101-S113.

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Why Choosing The Right Laser Is Key – And Where To Start