1064nm Nd:YAG laser therapy functions in non-contact mode by delivering energy deep into the dermal layer to fundamentally alter the metabolic activity of scar tissue. Its primary physiological effects are the inhibition of keloid fibroblast proliferation and the closure of abnormal microvessels, which collectively reduce collagen production and visible redness.
The core mechanism of this therapy is a dual-action attack on the scar's biology: it shuts down the cellular "factory" producing excess collagen while simultaneously cutting off the vascular "supply lines" causing erythema.
Modulating Dermal Biology
Deep Dermal Penetration
The 1064nm wavelength is specifically utilized for its ability to bypass superficial layers and penetrate deep into the dermal layer.
This depth is critical because the pathology of keloids and hypertrophic scars lies deep within the skin, not just on the surface.
Inhibiting Fibroblast Proliferation
Once the energy reaches the dermis, it directly interacts with keloid fibroblasts.
The laser effectively inhibits these cells from proliferating, slowing the rapid growth characteristic of keloid formation.
Down-regulating Cytokines and Collagen
By altering fibroblast activity, the therapy triggers a down-regulation of cytokine levels.
This biochemical change suppresses the excessive production of collagen. Since collagen overproduction creates the bulk and rigidity of the scar, suppressing it is essential for flattening the tissue.
Vascular Targeting and Appearance
Closing Abnormal Microvessels
Beyond cellular modulation, the 1064nm wavelength targets the vascular structure of the scar.
The laser energy targets and closes the abnormal microvessels that typically proliferate within scar tissue to support its rapid growth.
Reduction of Erythema
These microvessels are responsible for the intense redness (erythema) often seen in active keloids.
By closing these vessels, the therapy significantly improves erythema, leading to a scar color that blends better with the surrounding skin.
Understanding the Mechanism Limitations
Non-Ablative Approach
It is important to recognize that this is a non-contact, physiological intervention, not a physical removal of tissue.
The laser does not "vaporize" the scar volume instantly; rather, it induces biological changes that result in a flatter scar appearance over time.
Target Specificity
The efficacy relies on the presence of the specific targets: active fibroblasts and abnormal vasculature.
Old, pale, and metabolically inactive scars may respond differently than red, active hypertrophic scars because the vascular target (hemoglobin) and cellular activity are less prominent.
Clinical Implications of These Effects
By understanding the physiological basis of 1064nm Nd:YAG therapy, you can better align treatment expectations with the biological reality of the scar.
- If your primary focus is reducing redness: The therapy is highly effective because it directly targets and closes the abnormal microvessels responsible for erythema.
- If your primary focus is flattening the scar: The treatment works by inhibiting fibroblast proliferation and suppressing collagen production, attacking the root cause of the scar's volume.
Ultimately, this therapy offers a non-invasive route to scar revision by biologically starving the tissue of the fuel and signals it needs to grow.
Summary Table:
| Physiological Effect | Biological Mechanism | Aesthetic Result |
|---|---|---|
| Fibroblast Inhibition | Slows rapid cell proliferation in the dermis | Flattens scar volume |
| Vascular Targeting | Closes abnormal microvessels and capillaries | Significantly reduces erythema (redness) |
| Cytokine Down-regulation | Reduces biochemical signaling for growth | Prevents further scar expansion |
| Collagen Suppression | Curbs the overproduction of collagen fibers | Softens scar texture and rigidity |
| Deep Dermal Penetration | Reaches the root of scar pathology | Long-term biological remodeling |
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References
- César Bimbi, Piotr Brzeziński. Combined treatment of keloids and scars with Nd:YAG 1064 nm laser and cryotherapy: Report of clinical cases. DOI: 10.7241/ourd.20202.8
This article is also based on technical information from Belislaser Knowledge Base .
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