The Long Pulse mode represents a critical shift from surface-level resurfacing to deep tissue reconstruction. While standard laser modes often focus on vaporizing the top layer of skin (epidermal ablation), the Long Pulse mode extends the duration of energy delivery to conduct heat directly into the deeper dermal layers.
Core Takeaway: For severe acne scars, surface treatment alone is insufficient. The Long Pulse mode is essential because it generates a controlled thermal effect that penetrates deep into the dermis. This deep heat is the catalyst for remodeling the dermal matrix and stimulating neocollagenesis (new collagen production), which physically restructures the skin to smooth both atrophic (pitted) and hypertrophic (raised) scars.
The Mechanism of Deep Tissue Remodeling
Moving Beyond Surface Ablation
Standard laser pulses are often short and high-power, designed to strip away the epidermis. The Long Pulse mode, however, focuses on thermal conduction. By maintaining contact with the tissue for a longer period, the laser allows heat to diffuse downward into the dermis rather than being expended entirely on the surface.
Triggering Neocollagenesis
The primary biological requirement for fixing severe scars is the synthesis of new collagen. The deep, sustained heat provided by the Long Pulse mode triggers a healing response within the dermal matrix. This process, called neocollagenesis, tightens the skin structure and fills in the depressions characteristic of atrophic scarring.
Multi-Dimensional Coverage
To achieve uniform results, practitioners often utilize a strategy of multiple passes. By applying the laser in horizontal, vertical, and diagonal patterns, the thermal energy is distributed evenly. This cumulative heating ensures that the entire scarred area—not just the center of the beam—receives the energy needed for regeneration.
Precision and Energy Control
The Role of Dwell Time
"Dwell time" refers to the specific duration the laser energy interacts with the tissue. Long Pulse mode maximizes this dwell time to prioritize thermal diffusion over immediate tissue vaporization. This allows the practitioner to bypass the risks of excessive surface damage while still treating the root of the scar.
Customizing for Severity
The flexibility of pulse duration allows for a customized balance between ablation and heat. For severe scarring, the practitioner can adjust the dwell time to ensure the thermal damage is sufficient to break down scar tissue without compromising the integrity of the surrounding skin.
Understanding the Trade-offs
Balancing Ablation and Thermal Diffusion
While Long Pulse is vital for depth, it is not a standalone solution for all skin textures. Short pulse durations are better suited for immediate ablation (removing surface roughness), while long dwell times focus on internal restructuring. An effective treatment plan must balance these to avoid overheating the tissue while still achieving smoothness.
The Nuance of Hypertrophic Scars
While the primary goal is often to build collagen for pitted scars, Long Pulse modes (specifically in lasers like the Nd:YAG) have a different application for raised (keloid) scars. In these cases, the long pulse targets blood vessels to induce hypoxia (lack of oxygen). This effectively inhibits excessive collagen production, reducing the volume of the scar.
Making the Right Choice for Your Goal
When evaluating laser treatments for acne scarring, understanding the role of pulse duration helps manage expectations regarding recovery and results.
- If your primary focus is filling deep, pitted scars: You require the thermal remodeling of the Long Pulse mode to stimulate new collagen production deep in the dermis.
- If your primary focus is reducing raised, red scars: You may benefit from Long Pulse energy targeting vascular structures to reduce blood flow and shrink scar volume.
- If your primary focus is surface texture only: A shorter pulse or ablative mode may be sufficient to polish the epidermis, though it will not correct deep structural issues.
The Long Pulse mode is not just a setting; it is the fundamental tool for converting a cosmetic surface treatment into a structural repair of the skin's foundation.
Summary Table:
| Feature | Standard Short Pulse | Long Pulse Mode |
|---|---|---|
| Primary Action | Surface ablation (vaporization) | Deep thermal conduction |
| Target Depth | Epidermis (surface) | Dermis (deep tissue) |
| Biological Effect | Stripping damaged layers | Stimulating neocollagenesis |
| Primary Use Case | Surface texture & pigmentation | Deep pitted scars & structural repair |
| Healing Mechanism | Epidermal regrowth | Dermal matrix remodeling |
Elevate Your Clinic's Results with BELIS Advanced Laser Systems
To achieve true structural skin repair for your clients, you need equipment that masters the balance of ablation and thermal diffusion. BELIS provides professional-grade medical aesthetic equipment designed exclusively for clinics and premium salons. Our advanced laser systems—including CO2 Fractional, Nd:YAG, and Pico lasers—feature precision Long Pulse modes to tackle the most challenging acne scars and skin concerns.
Why Partner with BELIS?
- Comprehensive Portfolio: From body sculpting (EMSlim, Cryolipolysis) to facial rejuvenation (HIFU, Microneedle RF).
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Ready to upgrade your treatment capabilities? Contact us today to discuss your equipment needs!
References
- Rui Yin, Michael R. Hamblin. Combination ALA‐PDT and ablative fractional Er:YAG laser (2,940 nm) on the treatment of severe acne. DOI: 10.1002/lsm.22219
This article is also based on technical information from Belislaser Knowledge Base .
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