Dermatology relies on a diverse array of laser types and wavelengths, ranging from visible green light to far-infrared radiation, to treat distinct skin conditions. The most common systems include frequency-doubled YAG (532 nm), Krypton ion (568 nm), Ruby (694 nm), Alexandrite (755 nm), Nd:YAG (1064 nm), Er:YAG (2.94 μm), and CO2 lasers (10.6 μm).
Core Insight: The effectiveness of a dermatological laser is determined by its absorption properties. Specific wavelengths are chosen because they are readily absorbed by specific targets—such as haemoglobin in blood or melanin in pigment—allowing clinicians to treat the issue while minimizing damage to the surrounding skin.
The Visible Light Spectrum
Lasers in this range are typically used for surface-level targets and pigments.
Frequency-Doubled YAG (532 nm)
This laser produces green light. It is created by passing a standard YAG beam through a frequency-doubling crystal.
Because it operates at 532 nm, it is highly absorbed by red pigment. This makes it a primary choice for treating vascular lesions and red targets.
Krypton Ion (568 nm)
Operating in the yellow portion of the spectrum, the Krypton ion laser emits at 568 nm.
Similar to the 532 nm laser, this wavelength is selected for its specific absorption characteristics regarding blood and vascular structures.
Ruby Lasers (694 nm)
The Ruby laser emits red light at 694 nm.
This wavelength penetrates deeper than green light. It is historically significant for treating pigmented lesions and removing dark tattoo ink.
The Near-Infrared Spectrum
Lasers in this category penetrate deeper into the dermis and are standard for hair removal and deeper pigmentation.
Alexandrite Lasers (755 nm)
The Alexandrite laser operates at 755 nm.
This wavelength offers excellent absorption by melanin. It is widely used for hair removal and treating pigmented lesions.
Nd:YAG Lasers (1064 nm)
The Nd:YAG laser emits at 1064 nm.
This wavelength penetrates deeply into the skin tissue. It is versatile, capable of treating deeper vascular lesions and is safer for darker skin types during hair removal due to lower melanin absorption compared to shorter wavelengths.
The Mid to Far-Infrared Spectrum
These wavelengths are primarily absorbed by water, making them effective for skin resurfacing and tissue ablation.
Er:YAG Lasers (2.94 μm)
The Erbium:YAG laser operates at 2.94 micrometers (μm).
This wavelength is highly absorbed by water molecules in skin cells. This high absorption allows for precise ablation (removal) of tissue with minimal thermal damage to surrounding areas.
CO2 Lasers (10.6 μm)
The Carbon Dioxide (CO2) laser emits at 10.6 micrometers.
This is a powerful ablative laser. It is used for deep resurfacing, treating wrinkles, and removing benign skin growths.
Operational Modes and Delivery
The physical interaction with the skin changes based on how the energy is delivered, not just the wavelength.
Q-Switched Operation
Q-switched lasers deliver energy in extremely short, high-power pulses (nanoseconds).
This mode is essential for breaking up tattoo ink or pigment without heating the surrounding tissue.
Continuous and Quasi-Continuous Wave
Some treatments require a steady stream of energy rather than a burst.
Continuous-wave (CW) or quasi-CW modes are used when thermal coagulation (heating) is the goal, rather than the mechanical shattering effect of a Q-switched pulse.
Understanding the Trade-offs
While laser specificity is powerful, it introduces significant operational constraints.
Absorption vs. Penetration Depth
There is an inverse relationship between absorption and depth. Wavelengths that are highly absorbed by a target (like 532 nm) expend their energy quickly at the surface. They cannot treat deep-rooted conditions.
Conversely, wavelengths that penetrate deeply (like 1064 nm) may have lower absorption coefficients for the target, requiring higher energy levels to be effective.
Target Specificity Risks
Using the wrong wavelength can lead to unintended damage. For example, a wavelength highly absorbed by melanin must be used with extreme caution on darker skin tones to avoid surface burns or hypopigmentation.
Matching the Laser to the Treatment
The choice of laser is dictated by the depth of the pathology and the target chromophore.
- If your primary focus is Vascular Lesions: Utilize 532 nm or 568 nm lasers, as these wavelengths are strongly absorbed by haemoglobin.
- If your primary focus is Hair Removal or Pigment: Select 755 nm (Alexandrite) or 1064 nm (Nd:YAG) lasers for their ability to target melanin and reach the hair follicle.
- If your primary focus is Skin Resurfacing: Choose 2.94 μm (Er:YAG) or 10.6 μm (CO2) lasers, which rely on water absorption to vaporize or ablate tissue.
Success in laser dermatology relies on selecting the precise wavelength that maximizes absorption by the target while preserving the integrity of the surrounding tissue.
Summary Table:
| Laser Type | Wavelength | Primary Target | Main Clinical Application |
|---|---|---|---|
| Frequency-Doubled YAG | 532 nm | Haemoglobin (Red) | Vascular lesions, surface pigment |
| Alexandrite | 755 nm | Melanin | Hair removal, pigmented lesions |
| Nd:YAG | 1064 nm | Deep Tissue/Melanin | Deep hair removal, dark skin tones |
| Er:YAG | 2.94 μ m | Water | Precise skin ablation, resurfacing |
| CO2 | 10.6 μ m | Water | Deep resurfacing, wrinkle removal |
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