1. Different lasers are used for different skin conditions - ablative CO2 and Er:YAG lasers for resurfacing, pulsed dye laser for vascular lesions like port wine stains, alexandrite laser for lighter skin. 2. The pulsed dye laser, which targets oxyhemoglobin, is the gold standard for treating port wine stains, with parameters of 585-595nm wavelength, 6-8 J/cm2 fluence, and 3ms pulse duration. 3. Lasers can be used to treat hemangiomas, with the pulsed dye laser at lower fluences of 6-7 J/cm2 effective for flat lesions under 2mm, and

1. Indications for different lasers

3. Ablative laser
Pigmented laser and tatto
Vascular laser
Non ablative and
surface rejuvenation
Fractional
photothermolysis

9. skin resurfacing .
co2 , Er:Yag
: water in epidermis and dermis
1- ( cosmetic)stimulated of collagen
2- (non cosmetic) remove hyperplasia

11. 1.5 J/cm2
compared with ( 4_5) J/cm2 for co2.
• The thermal relaxation time of 50 micro second
1 millesecond
• The thermal injury is less than co2

13. Co2 vs Er:YAG

14. • Target chrmophore: melanin .
• Melanin has a broad absorpation spectrum within the ultraviolet ,
visible and near infrared light range , the light absorption in
melanin decrease steadily with increasing wavelength , also there
are competing chrmophore, thus a window of opportunity is
between the wavelength of (630 _ 1100nm ) where the melanin
absorption exceeds that of Hb.
• As the absorption of melanin falls with a higher wavelength , a
higher fluence is needed

20. Vascular laser
Pulsed dye laser (585nm)(595nm)
Diode laser (800nm) (810nm)
Nd-Yag (1064 nm)

21. Vascular laser
Target tissue :oxyhemoglobin.
Oxyhemoglobin wave length absorption : 418( blue)
542(green) .585(yellow) 595 nm
The largest peak is at 418 nm; however,
this wavelength does not allow adequate penetration into the skin
wavelength : (585) (595) nm
Pulsed dye laser

25. The pulsed dye laser (PDL) is generally considered to be . the gold
standard in the treatment of PWS
.Pulsed dye laser( 585 : 595 nm )
Several factors, including the patient’s age and Fitzpatrick
skin type, anatomical location, size, composition, and color
.influence the response of the PWS to the PDL
The best response of the PWS to the PDL in face
Early treatment of PWS
has been shown to have better outcome

26. Port wine with pulsed dye
laser parameter) )laser
(585)Wave length
6~8 j/cm2 which may be then increased by 0.5 to 1 j/cm2 at subsequent visit, if
tolerated without adverse effect
Influence
3 mille secondPulse
duration
7~10mmSpot size
30 to 50 ms is used with a delay of 30 to 50 ms before the laser
pulse.
cryogen spray
cooling
Purpre not grayish 7j/cm2Endpoint
8~12 sessions , session each 4weakSessions

29. The current goal of laser therapy for hemangiomas is complete or
partial clearance of the lesion.
Laser parameters are selected based on the depth and size of blood
vessels comprising the lesion.
Since the PDL has very limited penetration into the dermis, only the
treatment of flat matured or early, pre-proliferative red hemangiomas
less than 2 mm in thickness is realistic with this laser.

30. lower fluences, between 6 and 7 J/cm2 using585-nm
PDL and between 9 and 12 J/cm2, or using a 595-nm
PDL, and longer pulse durations of 1.5 to 20 ms
incombination with cryogen cooling, may result in
clinical efficacy with lower risks of complications .
Treatments can be undertaken at 2-week intervals, with
most hemangiomas requiring 1 to 2 treatments for complete re-
epithelialization

31. The KTP laser has also been evaluated for treatment of small
superficial hemangiomas. Using a 5-mm spot size, influence of 20
J/cm2, and pulse duration of 50 ms, improvement, in terms of
cessation of growth, regression, and complete resolution were found to
be slightly less likely than those results achieved with a short-
pulsed (0.3 to 0.45 ms) 585-nm PDL. However, purpura,
crusting, blistering, and transient hyperpigmentationare also
less prevalent compared to the PDL laser

33. •(0.1 : 0.2 mm) pulsed dye laser 585 nm or 595 nm .
•(0.2: 0.4 mm ) alexendrite 755 nm .
•(0.5: 1 mm ) ND:YAG (1064) .
•UPTO 3 PULSE .
•PULSE Duration is 3 ms .
•Suitable cooling between pulse and other

49. 2- alex (755 nm ) for fair hair and light
skin.