Personal Laser Technique

The wide array of nonablative rejuvenation devices allows us to individualize treatment based on patients' specific concerns. If vessels and pigment are the main issues, we start by targeting the chromophore most bothersome to the patient. Subsequently, we use the system which would best treat the most prominent residual chromophore. For the pulsed dye lasers, using the largest spot size with the highest fluence at a pulse width that is just subpurpuric provides the best results. Typical PDL settings include a 10-mm spot size with 7-7.5 J/cm2 and a 6-ms pulse width. Occasionally, we will increase the pulse width to 10 ms to avoid purpura if the patient is on some form of anticoagulant therapy. One pass is performed for nonablative rejuvenation, whereas additional pulses may be needed to treat discrete vessels, if present.

For mild, diffuse erythema, especially when lentigines are also present, we start with an IPL device, as it will target both melanin and hemoglobin. IPL sources vary depending on the flash lamp and the cut-off filters used. The spot size is usually set, but the pulse width can be varied by time per pulse and spacing between 1 and 3 pulses.

Although a 585-nm, 350-ms PDL is used for wrinkle reduction, the low utilized fluences of

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