The 585 nm wavelength is primarily utilized for treating Port Wine Stains because of its precise alignment with the absorption characteristics of blood. This specific wavelength targets oxyhemoglobin, the red pigment in blood cells, causing targeted heating of abnormal vessels. By focusing energy on the blood vessels rather than the surrounding tissue, it allows for effective treatment while protecting the skin's surface.
The core principle at work here is selective photothermolysis. The 585 nm wavelength hits the "sweet spot" where energy is maximally absorbed by blood vessels in the dermis but minimally absorbed by the skin's pigment, ensuring the destruction of the lesion without causing surface burns.
The Science of Target Selection
To understand why 585 nm is the standard, you must understand how light interacts with biological tissues. The goal is to deliver energy to a specific target (chromophore) without scattering it elsewhere.
Targeting Oxyhemoglobin
The primary objective in treating Port Wine Stains is the coagulation of abnormal blood vessels.
Oxyhemoglobin, the oxygen-carrying protein in red blood cells, has a high absorption peak at 585 nm. When the laser hits this wavelength, the blood within the vessel absorbs the energy rapidly.
The Mechanism of Action
This absorption converts light energy into heat.
The heat damages the vessel walls, causing them to collapse and eventually be reabsorbed by the body. Because the absorption is so specific to oxyhemoglobin, the laser acts like a "smart bomb" for vascular lesions.
Protecting the Epidermis
A major challenge in laser dermatology is preserving the epidermis (the top layer of skin).
The epidermis contains melanin, a pigment that also absorbs light. However, the 585 nm wavelength is selected because it minimizes competitive absorption by epidermal melanin. This ensures the energy bypasses the skin surface and is reserved for the blood vessels beneath.
Depth and Penetration Capabilities
Beyond color absorption, the physics of the laser must account for where the problem lies physically within the skin structure.
Reaching the Dermis
Port Wine Stain vessels are located in the dermis, beneath the outer skin layer.
The 585 nm wavelength possesses sufficient penetration depth to pass through the epidermis and reach these dermal vessels. It strikes a balance between being short enough to be absorbed by red pigment and long enough to travel into the skin.
Enhancing Treatment Precision
Because the wavelength is tuned so specifically to the target depth and chromophore, collateral damage is limited.
This precision reduces the risk of scarring or texturing changes in the healthy tissue surrounding the Port Wine Stain.
Understanding the Trade-offs
While 585 nm is highly effective for vascular lesions, it is important to understand its limitations compared to other medical lasers, such as the Nd:YAG (1064 nm).
Penetration Limitations
While 585 nm reaches the dermis, it does not penetrate as deeply as longer wavelengths.
For context, a 1064 nm Nd:YAG laser can reach 2 to 3 mm into the dermis. If a vascular lesion is situated very deeply, the 585 nm laser may struggle to clear the deepest components effectively compared to the 1064 nm option.
Melanin Safety in Darker Skin
Although 585 nm minimizes melanin absorption, it does not eliminate it entirely.
Longer wavelengths like 1064 nm have significantly lower absorption by melanin. This makes the 1064 nm wavelength inherently safer for patients with darker skin tones, significantly reducing the risk of burns or post-inflammatory hyperpigmentation that can occur with shorter wavelengths.
Making the Right Choice for Your Goal
Selecting the correct laser wavelength depends on balancing the depth of the pathology against the patient's skin type.
- If your primary focus is treating superficial vascular lesions (Port Wine Stains): The 585 nm wavelength is the optimal choice due to its high peak absorption by oxyhemoglobin and precise targeting.
- If your primary focus is deep tissue or darker skin types: The 1064 nm wavelength is preferable as it offers deeper penetration (2-3 mm) and a higher safety profile regarding epidermal melanin.
By matching the wavelength to the biological target, you ensure the highest efficacy with the lowest risk of collateral tissue damage.
Summary Table:
| Feature | 585 nm Wavelength | 1064 nm (Nd:YAG) |
|---|---|---|
| Primary Target | Oxyhemoglobin (Blood) | Deep Tissue / Melanin Safety |
| Penetration Depth | Superficial to Mid-Dermis | Deep Dermis (2-3 mm) |
| Main Advantage | High peak absorption for vessels | Safer for darker skin tones |
| Ideal For | Port Wine Stains & Rosacea | Deep veins & Hair removal |
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References
- M.K. Loze, C. David Wright. Temperature distributions in laser-heated biological tissue with application to birthmark removal. DOI: 10.1117/1.1318217
This article is also based on technical information from Belislaser Knowledge Base .
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