Nd:YAG (neodymium-doped yttrium aluminium garnet) is a crystal that is used as a laser medium for solid-state lasers.
Nd:YAG laser has a wavelength of 1064 nm and has the capability to reach deeper layers of skin tissue than other types of lasers.
In Q-switched mode, Nd:YAG produces 2 wavelengths, one in the infrared range (1064 nm) and a second beam of 532 nm wavelength which is useful for superficial skin lesions. Q-switching refers to the technique of making the laser produce a high intensity beam in very short pulses
How does neodynium YAG laser work?
Lasers work by emitting a wavelength of high energy light, which when focused on a certain skin condition will create heat and destroy diseased cells.
What is neodynium YAG laser used for?The following skin disorders can be treated with Nd:YAG laser beams.
A) Vascular lesions
- Spider and thread veins in the face (cheek, temporal region, nasal dorsum, forehead) and legs.
- Vascular birthmark (capillary vascular malformation)
- Varicose veins
- Facial veins (telangiectasia)
- Haemangioma (vascular tumour)
B) Pigmented lesions
- Brown age spots (solar lentigines)
- Naevus of Ota, naevus of Ito
- Mongolian spots,
- Hori naevus
C) Hair removal
- Light pulses target the hair follicle, which causes the hair to fall out and minimises further growth.
- Nd:YAG laser may be used for hair removal in any location including underarms, bikini line, face, neck, back, chest and legs.
- Nd:YAG laser is generally ineffective for light-coloured (blonde/grey) hair, but effective for treating dark (brown/black) hair in patients of Fitzpatrick types I to III, and perhaps light-coloured type IV skin.
D) Tattoo removal
- Blue, grey and black tattoos can be removed with a Q-switched Nd:YAG laser (1064 nm wavelength).
- The colour of the tattoo and the depth of the pigment influence the duration and the outcome of the laser treatment.
- Laser treatment involves the selective destruction of ink molecules that are then absorbed by macrophages and eliminated.
E) Onychomycosis (Fungal Nail)
- Onychomycosis is a common nail disorder caused by fungal pathogens.
What does the laser procedure involve?
The patient must wear eye protection (an opaque goggles) throughout the treatment session. Treatment consists of placing a hand piece against the surface of the skin and activating the laser. Many patients describe each pulse feeling like the snapping of a rubber band against the skin.
Topical anaesthetic may be applied to the area but is not usually necessary.
Skin surface cooling is applied during all hair removal procedures.
Immediately following treatment, cooling mask or ice pack will be applied to soothe the treated area.
Care should be taken in the first few days following treatment to avoid scrubbing the area, and/or use of abrasive skin cleansers.
During the course of treatment patients should protect the area from sun exposure to reduce the risk of postinflammatory pigmentation.
Are there any side effects from neodynium YAG laser treatment?Side effects from Nd:YAG laser treatment are usually minor and may include:
- Pain during treatment (reduced by contact cooling and if necessary, topical anaesthetic)
- Redness, swelling and itching immediately after the procedure that may last a few days after treatment
- Rarely, skin pigment may absorb too much light energy and blistering can occur (this settles by itself)
- Changes in skin pigmentation. Sometimes the pigment cells (melanocytes) can be damaged, leaving darker (hyperpigmentation) or paler (hypopigmentation) patches of skin
How many laser treatments can I expect?
- Depending on the type of pigmentation lesion, treatment can range from 3 sessions up to 10 sessions.
- Maintenance therapy may be needed for severe cases.
- Vascular lesions
- Treatment time depends on the form, size and location of the lesions as well as the skin type.
- Small red vessels can usually be removed in only 1 to 3 sessions.
- Several sessions may be necessary to remove bigger veins and spider veins.
- Hair removal
- In general, patients have 2 to 6 treatments, approximately every 4 to 6 weeks
- Patients with darker skin types may require more treatments.
- Tattoo removal
- The colour of the tattoo and the depth of the pigment influence the duration and the outcome of the laser treatment for tattoo removal.
- Multiple sessions (5 to 20 sessions) spaced at least 7 weeks apart may be required to attain favourable results.
- In general, patients have 4 treatments at monthly intervals.