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Q-Switched ND:Yag Laser

Nd:Yag meaning NeoDymium: Yttrium Aluminium Garnet crystals.

It uses a solid lasing medium & delivers short high energy pulses.

 

Spot size : 6mm.

 

Green colour does not respond to Nd:Yag lasers.

It has longer wavelengths & hence deeper penetration, hence less melanin absorption.

 

Clinical Indications of a Q-Switched Nd YAG Laser:

Pigmented lesions:

 

For Epidermal lesions-532 nm

 

For Dermal lesions-1064nm

  1. Lentigens: 1-2 sessions required with a frequency at 532nm
  2. Café-au-lait macules
  3. Freckles
  4. Mangolian spots

Division of pigmented lesions-

  1. ACQUIRED
    1. Drug induced
    2. Post inflammatory
    3. Hormonal 
  2. According to Location Of Pigment
    1. Epidermal
    2. Dermal
  3. Causation of Pigmentation
    1. Nevoid
    2. Hereditary
    3. Acquired

Treatments used:

  • Topical application
  • Chemicals peel
  • Microdermabrasion

But lesions like nevus, tattoos freckles etc can’t be removed by these.

Hence this resulted in devising an ideal laser / light system which effectively targets skin melanin with variable spot sizes, different wavelengths & variety of effective cooling devices without damaging surrounding skin .

  • Three wavelength bands are most useful for treating pigmented lesions : green, red and infrared.
  • Dark colours like black, blue and green with 1064-nm wavelength
  • Brighter colours like red, orange and yellow with 532-nm wavelength

Hence in brief we say for the lasers to have effect sufficient wavelength, right pulse duration and sufficient fluence is required.

 

Other indications include:

  1. Photoageing
  2. Melasma
  3. Tattoo: 
    1. Professional tattoos
    2. Amateur tattoos
    3. Cosmetic tattoos
  4. Non Ablative skin resurfacing for wrinkles & acne scars.
  5. Laser assisted Hair reduction.
  6. Vascular lesions

Post laser signs

There is immediate -
1. Redness

2. Inflammation.

3. Frosting& later Scab formation.

 

If the penetration is deeper & long time exposure leads to bleeding, which slows the healing leading to scarring either (hypopigmentation or hyperpigmentation).

 

Complications:

  • Physical urticaria
  • Minute petechiae
  • Rebound hyperpigmentation
  • Acniform eruption
  • Whitening of fine hair

Management of complications:

Hypopigmentation: Fluence should be reduced; treatment interval doubled





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