Mechanism of action Pigment, Vasculature, & Rejuv

Question 1

Mechanism of Laser/IPL for Vasculature ?

Answer 1

• Laser/IPL targets haemoglobin (protein found in RBC)
• There are 2 types: Oxyhaemoglobin (pink/red tone) and Deoxyhaemoglobin (blue tone)

Selective Photothermolysis:
- Photonic/Light energy gets absorbed by haemoglobin in blood vessels = thermal response (70 degrees)

Extend theory:
- Heat diffused from the erythrocyte (RBC) to vessel lumen (vessel walls) and endothelial cells = denatures vessel wall structure
-Laser/IPL induces Primary (initial step in coagulum within vessel) and Secondary Haemostasis (Formation of fibrin mesh to stabilise platelet plug)
- Blood vessel contracts and clotting seals off.
- Eventually gets cleared from macrophages or collapses

Question 2

Mechanism of Laser for pigment (Short pulse)?

Answer 2

• Targets melanin
• Melanin is found inside melanosomes organelles

Short pulse
- Light energy gets absorbed by the pigment in melanosomes = heat response
- Heat creates pressure within walls of melanosomes = shatter in smaller fragments
-High temperatures = vibrational mechanical damage (acoustic waves) of melanosomes.
Macrophages eat fragments and removed via lymphatic system

• in order for photonic energy is confined to the melanosome, the pulse duration needs to be less than or equal to a short TRT (Thermal Relaxation Time) of the melanosome

Question 3

Mechanism of Laser for Rejuvenation?

Answer 3

• Targets to water
• Photons get absorbes by water molecules = vibrational changes
• Higher the absorption of wavelength selection = stronger the interaction of photonic energy with water molecules =
• Increase temperature = changes biological effect within tissue
• Biological effects: 60-80 Degree Celsius
  protein denaturation, coagulation, and subsequence necrosis
  collagen denaturation

Question 4

Mechanism of IPL for Pigment?

Answer 4

• Target melanin
• Melanin is found in melanosome organelles
• Long pulse duration is too long which exceeds the TRT, the energy cant be locked in/ or confined in the melanosomes = diffusion of heat throughout the keratinocyte = destruction of keratinocytes with melanosomes inside
• Signals the basal layer (body) replace the damaged ones (rapid keratinocyte differentiation) = push damaged skin cells up (micro-crust) of necrotic keratinocytes and shed (7-10 days)

Question 5

Mechanism of Laser for Pigment (Long pulse)?

Answer 5

• Targets melanin
• Melanin is found inside melanosomes organelles
• Long pulse duration is too long which exceeds the TRT, the energy cant be locked in/ or confined in the melanosomes = diffusion of heat throughout the keratinocyte = destruction of keratinocytes with melanosomes inside
• Signals the basal layer (body) replace the damaged ones (rapid keratinocyte differentiation) = push damaged skin cells up (micro-crust) of necrotic keratinocytes and shed (7-10 days)

Question 6

Laser/IPL devices for Pigment and their wavelengths?

Answer 6

• IPL (560nm)
  (500nm-1200nm)
• LP Potassium-titanyl-phosphate (KTP) (532nm)
• Q-Switched Potassium-titanyl-phosphate (KTP) (532nm)
• Q-Switched Ruby (694nm)
• Alexandrite (755nm)
• Q-Switched Alexandrite (755nm)
• Q-Switched Neodynmium:Yttrium-Aluminium-Garnet (1064nm)
• Laser Toning (for pigmentation) (1064nm)

Fractional Photothermolysis (for pigmentation)
- Non-Ablative Fractional Laser

• Non-Ablative Fractional Laser: (ER (ERBIUM): GLASS 1550nm)
• Ablative Fractional Laser
  Er:YAG (2940nm)
• CO2 (Carbon dioxide) (10600nm)

Question 7

Laser/IPL devices for Vasculature and their wavelengths?

Answer 7

• KTP (532nm)
• IPL (560nm-590nm)
• ILS (500nm-1200nm)
• Pulse Dye Laser (585nm/595nm)
• Nd: Yag (1064nm)
• Lumenis M22 IPL – Notch Filter Not Filters: (530nm-600nm) (900nm-1200nm)

Question 8

Laser/IPL devices for Rejuvenation and their wavelengths?

Answer 8

Water absorption bands: 970nm, 1200nm, 1450nm and 1950nm
- Cutera Laser genesis (1064nm, 0.3 millisecond) Infrared

Fractionals
- Ablative lasers (wavelength above 2000)
-Er:YAG 2940nm
-Er:YSGG 2790nm
-CO2 10,600nm

• Non-Ablative lasers (wavelength below 2000nm)
  -1410nm
  -1440nm
  -1550nm (Er:Glass)
  1565nm
  -1927nm (Thulium)

Laser toning

Question 9

Laser/IPL devices for Post Acne Erythema and their wavelengths?

Answer 9

Lasers (targets oxyhaemoglobin)
- Long pulse (millisecond): KTP (532nm), PDL (585nm/595nm), Nd: YAG (1064nm)
- Non ablative fractional laser (NAFL) modalities

ILS filters (targets oxyhaemoglobin)
- Filters: 515nm, 560nm, 590nm
M22 vascular filter

Question 10

Laser/IPL devices for Striae Distensae and their wavelengths?

Answer 10

Striae Distensae:
- Vascular lasers: PDL, KTP, Nd:YAG