Biomedical Engineering Reference
In-Depth Information
on the same day. Recovery times and discomfort may be greater
than if the lasers were used individually (Table 8.3).
Fraxel 1927-nm laser became available in a stand alone laser
platform. The 1927-nm wavelength is currently FDA approved
in the treatment of actinic keratosis.
The 1550-nm and 1927-nm lasers can be combined for
a “DUAL” resurfacing treatment. When combining the 1550-nm
and 1927-nm wavelengths, four passes of 1550-nm laser are
performed over the treatment area to target the dermis and
then four passes of 1927-nm laser are performed to provide an
epidermal treatment. Laser energies and TLs are set at a level
lower than if the lasers were used separately. Our experience has
taught us to use caution when treating with both wavelengths
Fractional 1440-nm Laser
The Clear and Brilliant system is a fractional diode 1440-nm
laser launched in May 2011. It is indicated for general skin
resurfacing. The laser has a fi xed spot size of 140 µm. Energy
can be delivered on a low (4 mJ), medium (7 mJ), or high level
(9 mJ). The depth of penetration ranges from 280 to 390 µm
depending on the energy level used. The low level setting cor-
responds to 4% coverage, the medium level to 7% coverage,
1500
Table 8.1
Fraxel 1550-nm Laser Treatment Settings
1250
Mild to Moderate Parameters
Pulse Energy
(Depth)
1000
Treatment Level
(Coverage)
Dermis
Indication
750
Fitzpatrick Skin Phototype I-III
General Resurfacing (Pigmented lesions, textural irregularities,
fi ne lines)
Face
500
250
10-25 mJ
4-8 (11-23%)
Epidermis
0
0 0 030
Eyelids (within orbital rim)
10-20 mJ
4-7 (11-20%)
40
50
60
70
80
Off-Face
10-25 mJ
4-7 (11-20%)
Pulse energy (mJ)
Deep Wrinkles, Acne Scars
Face 25-70 mJ 5-9 (14-26%)
Off-Face 25-40 mJ 4-8 (11-23%)
Melasma (Evaluate patient after each treatment. 2-3 treatments)
Face
Figure 8.6
Comparison of depths of 1550 nm vs. 1927 nm for depth of
thermal impact.
Table 8.2
Fraxel 1927-nm Laser Treatment Settings
6-15 mJ
5-8 (14-23%)
Surgical Scars
40-70 mJ
5-8 (14-23%)
Moderate Parameters
Pulse Energy
(Depth)
Fitzpatrick Skin Phototype IV-VI
General Resurfacing (Pigmented lesions, textural irregularities,
fi ne lines)
Face
Treatment Level
(Coverage)
Indication
10-25 mJ
3-7 (9-20%)
Fitzpatrick Skin Phototype I-VI
General Resurfacing
Face
Eyelids (within orbital rim)
10-20 mJ
3-6 (9-17%)
5-20 mJ
1-5 (20-40%)
Off-Face
10-25 mJ
3-6 (9-17%)
Deep Wrinkles, Acne Scars
Face
Eyelids (within orbital rim)
5-20 mJ
1-4 (20-35%)
25-70 mJ
4-7 (11-20%)
Off-Face
5-15 mJ
1-4 (20-35%)
Off-Face
25-40 mJ
4-6 (11-17%)
Fitzpatrick Skin Phototype I-III
Actinic Keratosis
Face 10-20 mJ 3-5 (30-40%)
Off-Face 10-20 mJ 2-4 (25-35%)
Source
: Adapted from Solta Laser Systems Operator Manual.
Melasma
Face 6-15 mJ 3-7 (9-20%)
Surgical Scars
40-70 mJ 4-7 (11-20%)
Source
: Adapted from Solta Laser Systems Operator Manual.
Table 8.3
Fraxel 1550-nm/1927-nm Dual Laser Treatment Settings
Moderate Parameters: 1550 nm
Moderate Parameters: 1927-nm
Pulse Energy
(Depth)
Treatment Level
(Coverage)
Pulse Energy
(Depth)
Treatment Level
(Coverage)
Indication
Total Coverage
Fitzpatrick Skin Phototype I-III
General Resurfacing
Face
10-25 mJ
3-5 (9-14%)
5-20 mJ
1-3 (20-30%)
(30-40%)
Eyelids (within orbital rim)
10-20 mJ
2-4 (7-11%)
5-20 mJ
1-3 (20-30%)
(30-35%)
Off-Face
10-25 mJ
1-3 (5-9%)
5-20 mJ
1-2 (20-25%)
(25-35%)
Fitzpatrick Skin Phototype IV-VI
General Resurfacing
Face
10-25 mJ
1-4 (5-11%)
5-20 mJ
1-3 (20-30%)
(25-35%)
Eyelids (within orbital rim)
10-20 mJ
1-3 (5-9%)
5-20 mJ
1-3 (20-30%)
(25-35%)
Off-Face
10-25 mJ
1-3 (5-9%)
5-20 mJ
1-3 (20-25%)
(20-30%)
Source
: Adapted from Solta Laser Systems Operator Manual.
