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Types of Laser and Their Uses

With the so many laser and non-laser light sources around, clinicians must choose carefully which hair-removal device to use depending upon the skin and hair characteristics of the client. This article explains the nuances of using laser to remove hair and details the specifics of particular laser systems.

Medical Laser Classifications

Lasers used for medical purposes have low outputs of energy and power; therefore they have been classified as ANSI (American National Standards Institute) Class 2, 3, or 4 lasers. Most medical use laser devices are categorized by the Food and Drug Administration (FDA) as Class II or Class III medical devices.

Laser Types

The first laser-assisted hair-removal device was made commercially available in 1996. Since then Food and Drug Administration (FDA) has approved 15 laser systems. The main systems are ruby, alexandrite, diode, and neodymium:yttrium-aluminum garnet (Nd: YAG) lasers and intense pulsed light sources. The specifications are:

Ruby Laser:

FDA has given approval to three ruby lasers (694-nm wavelength) for hair removal purposes:

Epilaser/E2000 (Palomar, Lexington, MA). The E2000 (Palomar) employs a sapphire cooled hand piece (Epiwand) to protect the epidermis during laser irradiation. A single pulse of 3 milliseconds or a twin pulse can be utilized, the deciding factor would be skin type or hair thickness of the client to be treated.

EpiPulse Ruby (Sharplan/ESC; Needham, MA). This system utilizes triple-pulse technology with 10-millisecond interval between pulses. The treatment of darker skin types is possible with this synchronized pulsing technology. A thick layer of cooled transparent gel must be used to cool the target treatment area during this procedure.

RubyStar (Aesculap Mediteo, Irvine, CA). It is a dual mode ruby laser. This contact skin cooling method cools the target area during the procedure.

Alexandrite Lasers:

Several long-pulsed alexandrite lasers (755 nm) have been approved by FDA for hair removal. They are:

Apogee series (Cynosure, Chelmsford, MA). In the Apogee system pulse durations are between 5 and 40 milliseconds and fluences are up to 50 J/cm2.

Epitouch ALEX (Sharplan/ESC, Needham, MA). The Epitouch Alexandrite employs a 2-millisecond pulse duration, spot sizes of 5 to 10 mm, and fluences of 10 to 25 J/cm2. A cooling gel is smeared on the skin before treatment, and a scanning device is utilized to treat larger body-surface areas.

GentleLase (Candela; Wayland, MA). The gentlelase laser system makes use of 3-millisecond pulse duration, spot sizes of 8 to 18 mm, and fluences ranging from 10 to 100 j/cm2. It also utilizes a dynamic cooling device to protect the epidermis.

Diode Lasers:

An extremely high-powered (2900-W) diode laser (LightSheerXC, Coherent, Santa Clara, CA) has been approved by the FDA for permanent hair reduction. This laser operates at 800 nm, has pulse widths between 5 and 100 milliseconds, a 12 _ 12-mm spot size, a 2-Hz repetition rate, fluences between 10 and 60 J/cm2, and a patented contact cooling device (ChillTip).

Q-Switched Nd:YAG Laser (1064 nm):

A high-powered, 1064-nm Q-switched Nd:YAG laser (MedLite IV, Conbio, Dublin, CA) is now available for hair removal. The longer wavelength of this laser allows treatment of darker skin types.

Long-Pulse Nd:YAG Laser (1064 nm):

Several long-pulsed Nd:YAG lasers (1064-nm wavelength) have been approved by the FDA for hair removal or laser treatment of darker skin types. The long-pulsed Nd:YAG lasers have deeply penetrating 1064-nm wavelengths. The reduced absorption by melanin at this wavelength requires higher treatment fluences to damage hair adequately.

The poor absorption by melanin at this wavelength coupled with an epidermal cooling device makes the long-pulsed Nd:YAG laser a safe treatment option for patients with the darkest skin phototypes.