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Nonablative Anti-Aging Laser Procedures
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Nonablative Laser Skin Rejuvenation Non-ablative laser systems target only the dermis, leaving the epidermis intact. The results are not as effective as with ablative laser resurfacing but the excellent safety profile and rapid recovery post-treatment have made these systems popular. These systems have been divided into 3 main groups, infrared lasers, visible light lasers (VLL), the pulsed dye laser (PDL). Laser can be operated in several modes. They are divided into either continuous wave mode (CW) or pulsed mode. The output of a laser may be a continuous constant-amplitude output (known as CW or continuous wave); or pulsed, by using the techniques of Q-switching, modelocking, or gain-switching. In pulsed operation, much higher peak powers can be achieved. Some types of lasers, such as pulsed dye lasers and vibronic solid-state lasers can produce light over a broad range of wavelengths; this property makes them suitable for generating extremely short pulses of light, on the order of a few femtoseconds (10-15 s). Q-switching, sometimes known as giant pulse formation, is a technique by which a laser can be made to produce a pulsed output beam. The technique allows the production of light pulses with extremely high (gigawatt) peak power, much higher than would be produced by the same laser if it were operating in a continuous wave (constant output) mode. Compared to modelocking, another technique for pulse generation with lasers, Q-switching leads to much lower pulse repetition rates, much higher pulse energies, and much longer pulse durations. The gain medium of a laser is a material of controlled purity, size, concentration, and shape, which amplifies the beam by the process of stimulated emission. It can be of any state: gas, liquid, solid or plasma. Examples of active laser media include:
gain medium and their respective operation wavelength (source: en.wikipedia.org)
For our purpose "Anti-Aging", the most commonly used wavelength is infrared (or red laser) as discussed in "nonablative light therapy". Infrared lasers and related systems utilize the wavelength range between about 1100 - 1800 nm. The relatively long wavelength allows it to penetrate relatively deeply - all the way to the lower dermis (the layer of skin where wrinkles reside) and make it useful for treating fine wrinkles and depressed scars. The infrared waves bypass the epidermis and are absorbed throughout the dermis, causing dermal heating. The immediate effect is heat-induced collagen contraction, which may cause mild and possibly short-term skin tightening and wrinkle reduction. More importantly, the longer-term effect is skin remodeling, --similarly to a number of other directed energy treatments, it triggers new collagen formation, leading to a longer-term improvement in wrinkles and some skin tightening, although individual responses vary significantly. Laser energy in the near- and mid-infrared locations on the spectrum is weakly attracted to melanin making it suitable for patients of all skin colors There are a variety of such systems on the market, including but not limited to the following: CoolTouch (Nd:YAG laser 1320 nm), SmoothBeam (diode laser 1450 nm), Erbium Glass laser (1540 nm), Titan (1100 - 1800 nm). An increasing body of evidence suggests that lasers in the mid-infrared range may be the best choice for safe nonablative anti-aging therapy on a wide range of skin types: the 1320-nm neodyminium:yttrium-aluminum-garnet (Nd:YAG) laser (CoolTouch) and the Long-pulsed 1064-nm Nd:YAG laser (Lyra, Laserscope, San Jose, California). Both the 1320-nm Nd:YAG laser and the 1064-nm Nd:YAG laser are coupled with a skin-cooling device.
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| Type | gain medium, wavelength/color, laser operating mode, pulse duration (pulse width) | Brand | indication (major) | indication (non-major) | Notes |
| *visible light laser (VLL) VLL |
Nd:YAG variable-pulse-width laser 532 nm (green) laser | Aura, DioLite | superficial facial vessels (small broken capillaries), redness, mild rosacea, uneven pigmentation. | less consistently effective for fine lines, small wrinkles and acne scars. | |
| Copper bromide 511 nm (green) and 578 (yellow) laser | YellowStar | green laser: superficial vessels, small spider veins, angiomas. Yellow laser: pigmented scars. | A combination of green and yellow are used to treat age spots and some other forms of hyperpigmentation. | Some experts report that copper bromide laser is less reliable than some other lasers used for similar problems. It is also said to require high operator skills | |
| VLL and pulsed dye laser (PDL) | Pulsed dye 585/595 nm yellow laser (595nm is the new model to replace old 585 nm model) | N-Lite (585 nm), Cynosure (585 nm), Candela (595 nm) | Particularly useful for vascular lesions, such as spider veins, port wine stains. | May also be useful for hyperpigmentation, fine lines and small wrinkles, scars and stretch marks | some pulsed-dye models, such as N-lite, have been marketed primarily as a treatment for fine lines and wrinkles. Indeed, 585 and 595 nm wavelengths reach the upper dermis and stimulate collagen synthesis and some skin remodeling. However, longer wavelength lasers capable of reaching lower dermis may be more effective for wrinkles |
| VLL (pulsed laser) | Variable-pulsed alexandrite 755 nm laser (red) |
GentleLASE, Apogee, and EpiTouch Plus. | Laser Hair removal (for dark hair only) (approved by FDA 1997) | also used to treat hyperpigmentation. | |
| Variable-pulsed AlgaAs diode 800 nm lasers ) (red) | LightSheer | Laser Hair removal (for dark hair only) | |||
| combination hybrid | Long Pulsed Laser hybrid system combining pulsed dye laser 595nm and Nd:YAG 1064 nm lasers | Cynergy | treat almost the entire range of facial rejuvenation problems | May be better as they properly distribute energy throughout the thickness of the dermis. However, it remains to be demonstrated in clinical studies whether such hybrid systems are indeed more effective for wrinkles than their constituent lasers | |
| Long Pulsed Laser hybrid system combining Nd:YAG lasers 532 nm and Nd:YAG 1064 nm lasers | Gemini | treat almost the entire range of facial rejuvenation problems | |||
| **Q-switched lasers (VLL and Infrared pulsed laser) | ruby 694 nm, alexandrite 755 nm, Nd:YAG lasers 532, Nd:YAG 1064 nm |
Quantum QS(Nd:YAG 1064 nm) | Hyperpigmentation, pigmentation irregularities, tattoos | Q-switched lasers are able to switch the beam on and off extremely quickly (in nanoseconds). This is very useful when trying to selectively target melanosomes because melanosomes absorb and release energy very quickly, much quicker that other skin structures | |
| infrared (1064 nm) | Long Pulsed Nd:YAG laser 1064 nm (infrared) | Lyra, Quantum DL, Starlux Lux1064 | Collagen Stimulation, treat facial wrinkles, leg veins, hair removal and shaving bumps. | ||
| Infrared Laser (1100-1800 nm) | (Mid)-infrared lasers: 1320nm Nd:YAG, 1450nm diode, 1540nm Er:Glass | including but not limited to CoolTouch (1320 nm), SmoothBeam (1450 nm), Erbium Glass laser (1540 nm), Titan (1100 - 1800). | Wrinkle treatment, skin remodeling; treatment of acne, acne scars, sebaceous hyperplasia. | see table below | |
| Nonablative fractional laser therapy | A special type of nonablative laser therapy using a technology which apply thousands of microscopic laser columns -treat a fraction of the skin at a time | Fraxel | Treatment of fine lines, small wrinkles, possibly medium wrinkles, pigmentation; improvement of skin texture. | treat a fraction of the skin at a time without affecting the surrounding tissue, instead of treating a contiguous area by traditional nonablative laser techniques |
**Q-switching has been used with lasers of different wavelengths. Shorter wavelength q-switched lasers, such as q-switched 532 nm Nd:YAG, are used mainly for hyperpigmentation located in the epidermis. These lasers should generally not be used in dark skinned individuals due to the risk of excessive loss of pigmentation. Longer wavelength q-switched lasers, such as such as q-switched 1064 nm Nd:YAG, largely bypass the epidermis and are used for deeper pigmentation disorders localized in the dermis (e.g. certain types of pigmentation under the eye). The intermediate wavelength q-switched lasers, such as 694 nm q-switched ruby, affects both epidermis and dermis and may be useful for thickly distributed pigmentation.
As far as skin is concerned, the key property of the near infrared waves is that they bypass the epidermis and are absorbed throughout the dermis, causing dermal heating. Dermal heating with infrared waves has both immediate and long-term effects. The immediate effect is heat-induced collagen contraction, which may cause mild and possibly short-term skin tightening and wrinkle reduction. More importantly, the longer-term effect is skin remodeling, which takes place for up to six month after the initial heating. This may lead to a longer-term improvement in wrinkles and some skin tightening, although individual responses vary significantly. On average, wrinkle improvements are moderate: small and medium wrinkles and acne scars (especially pitted ones) often noticeably improve. Deep wrinkles, especially those due to facial movement, are less likely to get much better.
Some of the infrared systems, such as CoolTouch and SmoothBeam, appear to reduce acne. It appears that the treatment reduces the size and activity of sebaceous glands, inhibiting the production of skin oil, one of the factors causative factors in acne.
| Product Name | laser medium | wavelength | price | FDA approval | manufacturer |
| CoolTouch | Nd:YAG | 1320 nm | |||
| SmoothBeam | diode | 1450 nm | |||
| Titan | 1100 - 1800 nm | 2004 | Cutera | ||
| Laser Genesis | |||||
| StarLux Laser |
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1064 nm
1540 nm |
Palomar Medical Technologies, Inc. |
Laser treatments have also become a popular means of treating both wrinkles and acne, particularly in the European and US markets. The latest development in that particular market is the rise of hand-held technologies that can be administered in the home. Companies marketing these kind of technologies include a partnership between Cynosure and Unilever and Palomar Medical Technologies. Several companies already see the potential of developing professional electrical treatments for home use. Both Procter and Gamble and L’Oreal taken on the market releasing light and laser based treatments for both hair removal and wrinkle reduction. Furthermore, the market development gets a mention in the upcoming HBA trade show’s conference program, when home-based laser and light systems, and the potential for formulating complimentary skin care products will be discussed.
NuLase Soft Touch Laser has been designed to penetrates the top layers of the skin, sending a message to our skin cells to produce more cellular energy, commonly called ATP. ATP (or: adenosine triphosphate) is the fuel our skin cells use for repair and rejuvenation. Increased ATP allows a faster acceptance of nutrients in cells. Research has shown that laser therapy can increase cellular ATP by as much as 150%, contributing to a better looking skin. The Soft Touch Laser's light penetrates the skin, stimulating cellular energy, rejuvenation and repair, for a youthful, smooth, and silky appearance. The Soft Touch Laser by Nulase emits a safe and gentle laser light that oscillates in a uniform parallel wavelength targeting and gently stimulating your skin cells to obtain an enriching and dynamic effect on the look of your skin. On average, most people will see a significant difference in the look of their skin within one or two weeks, in some cases after the first application and treatment:
The Soft Touch Laser does not cut, harm, burn or inflame the skin. The Soft Touch Laser leaves the skin refreshed with a rejuvenated feeling, therefore no pain is involved. In over 30 years of international research and studies, no side effects from this type of applied low level laser therapy was found.
Nulase Soft Touch Laser comes along with a topical skin care system that enhanced it. A patented Nano Delivery System is used to feed your skin cells with "specific nutrients" that react with light energy. If you feed your cells the right restorative nutrients and add low level laser, the result will be a beautiful new complexion.
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