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## LASERS - **Contraindications:** photosensitivity, accutane, suspicious lesions, current tan, dark Fitz types with certain devices, HIV/AIDS, Hepatitis B or C, lupus, pregnancy, history of keloids, recent or ongoing exfoliating treatments, hirsutism - **Safety** - The lens of the eye can magni...

## LASERS - **Contraindications:** photosensitivity, accutane, suspicious lesions, current tan, dark Fitz types with certain devices, HIV/AIDS, Hepatitis B or C, lupus, pregnancy, history of keloids, recent or ongoing exfoliating treatments, hirsutism - **Safety** - The lens of the eye can magnify the laser energy by 100,000 times - Ablative = the removal of part or all of the epidermis - Skin cooling can be in the form of cryogen spray, forced air cooling, or chilled tips - Laser should never be performed under the eyebrow - Patients should always receive a medical evaluation, and Fitzpatrick type should always be evaluated before choosing a service ## Light Processes - **Photothermal (light/heat)** - Most treatments create a photothermolysis reaction where the chromophore absorbs the laser energy and is transformed into heat which will kill the target. - **Photomechanical/Photoacoustic** - In these forms laser devices are engineered to have extremely short pulse durations (q-switch) which will explode a target (tattoo ink). - **Photomodulation** - Process using light devices to trigger a photobiochemical response; involves using low-level light energy to modulate/ activate cellular metabolism (LED therapy) - **Photorejuvenation** - nonablative process using laser or light devices to produce an increase in collagen and elastin, improve vascular and pigmented lesions - **Photodynamic therapy** - is a stand-alone treatment that uses a combination of light (LED or IPL) with aminolevulinic acid (ALA). Used to treat Actinic Keratosis, acne and enhanced facial rejuvenation. ## Wavelengths - **Alexandrite 755nm** - Chromophore = melanin - **Nd:YAG 1064nm** - Chromophore = blood - **Diode 810nm** - Chromophore = blood - **CO2 10,600nm** - Chromophore = water ## Chromophores (Targets) - Hemoglobin/Oxyhemoglobin (blood, vein, telangiectasia) - Melanin/Pigment (Freckle, Sun damage, dermal papillae) - Water (Intercellular fluid) ## Qualities of LASER light - **Phototoxic** - tissue reaction that occurs in the skin when combining ALA with a light therapy