411C. Raulin and S. Karsai (eds.), Laser and IPL Technology in Dermatology and Aesthetic Medicine, DOI: 10.1007/978-3-642-03438-1, © Springer-Verlag Berlin Heidelberg 2011

AAblative, 319–320, 324, 328

laser, 157, 158, 161–163, 307–317resurfacing, 289–293skin resurfacing, laser, 299–301wrinkle reduction, 70

Absorption, 23–26, 28, 30, 32, 33, 35Absorption spectra, skin chromophores, 228, 229Acne

classic lesions, 83infrared laser therapy, 91light-based therapies

description, 84PDT, 88–91photoexcitation spectrum, protoporphyrins, 84Propionibacterium, 84–87sebaceous glands, 87–88

traditional therapies, 83vulgaris, 73–77, 368–369

Acquired bilateral nevus of ota-like macules (ABNOM)description, 150nevus of Ota, 150QS ruby, 151

Actinic cheilitis, 165–166Actinic keratosis (AK), 166–167, 362–363Adenoma sebaceum, 43, 45, 46Adverse effects, 324, 327–3285-ALA. See 5-aminolevolinic acidAlbedo, 27Alexandrite laser, 348

quality-switched, 189, 194, 196, 197, 203Allergic reaction, 201, 202American Academy of Cosmetic Surgery, 379, 3805-Aminolevolinic acid (5-ALA), 69–72, 75–77Analgesia, 345, 347Angiofibromas, 43Angioma serpiginosum

arm, 282described, 281

Argon, laser, 43, 45, 46, 53Atrophic scars, 310, 314–315

ablative treatmentCO

2 laser, 180–181

pulsed Er:YAG lasers, 181description, 179fractional laser treatment

erbium-doped fiber laser, 181Mohs reconstruction, 1821,550-nm nonablative, 181photothermolysis, 181

laser treatment, 179nonablative treatment

devices, 180fractional lasers, 180

Azo compounds, 201, 206–208

BBasal cell carcinoma (BCC), 165, 167–169, 363–365Basaliomas, 45, 47Becker nevi, 63Becker’s nevus, 154Benign pigmented lesions

Becker’s nevus, 154café au lait patch, 153–154laser/light source treatment

ABNOM, 150–151freckles and lentigines, 147–149melanocytic nevi, 151nevus of Ota, 149–150

melasmadescription, 151pigment lasers/IPL, 152–153resurfacing lasers, 151–152treatment, 151vascular laser, 153

Benign tumors, 43–57Biopsies, 43, 48, 57Biostimulation, 28–29Birt-Hogg-Dubé-syndrome, 43–44Blaschko lines, 44Bleeding, pin-point, 195, 196, 200Blepharoplasty, 299, 302, 304Blood, 211–216, 218, 219Blow-off model, 32, 33Body modifications, 353Bowen’s disease, 365–366Business, laser surgery

FDAaspirin, 399CDRH, 400device safety, 400economists, 400–401

Index

412 Index

free market, 400fundamental idea, finance, 401manufacturing processes, 402medical devices, certification, 402sulfa drug, US

healthcarebenefits, regulations, 398FDA, 397incentive programs, 399mandates, 398–399nationalized system, 398physicians, 398“quality metrics”, 399“re-education sessions”, 399regulation, 397–398

quacksCAM, 404internet, 403“marketing”, 403–404“patent” medicine, 403traditional remedies, 404

reality checkFDA, 402–403healthcare system, 403intellectual property, protection, 403public needs, 403US healthcare, 402

success and happiness rules, 404

CCafé au lait patch

LP pigment laser, 154YAG laser, 153

CAM. See Complementary and alternative medicineCarbon dioxide (CO

2), 53, 300–302, 307–315

laser, 43–57, 289–292, 295, 300“Cavernous hemangioma”, 250–251Cavitation, 33–35CCDS. See Color-coded duplex sonographyCenter for Devices and Radiological Health (CDRH), 400Centering of the fiber, 221–222Cherry angiomas, 66Chromophores present in skin

hemoglobin, 229, 236melanin, 229, 236met-Hemoglobin, 229oxyhemoglobin, 229

Chrysiasis, 189, 206Clearance rate, 347, 348Coagulation, 307–313, 316, 317Cold air, 345–348Color-coded duplex sonography (CCDS)

correlation, 248encapsulation, eyeball, 263hypercapillarizations, 248hypervascularization, 250hyposonic swelling, skin, 268unaffected vessels, 262

Comedones, 73Commodification of medicine, 353Common viral warts, 286

Complementary and alternative medicine (CAM), 404Complications, 328, 333–343Compression bandage, 216, 217Congenital hemangioendothelioma

description, 251KHE

thermography, 254“wasp sting symptom”, 254–255

NICHand RICH, 252thermography, 253thrombocytes, 253

RICHand IH, 252regression, 252wrinkled skin, 253

“tufted angioma”, 253Consumer society, 351Contact cooling, 345–346Contactless cooling, 345–347Continuous wave (cw-Nd:YAG) laser

application modes, 270continuous ice cube cooling, transcutaneous, 271–278cooling procedures, 270fluid cooling cuvette, transcutaneous, 271high power densities, 270thermal conductivity, 269transcutaneous direct application, 270

Copper steam laser, 44Corneoscleral protective lenses, 300, 302, 303Costs, 223Crow’s feet, 70Cryogen spray, 346, 348Cryotherapy, 48, 51, 52, 56Curriculum, 378, 380Cysts, 54–57

DDCDs. See Dynamic cooling deviceDefinition of beauty, 354, 355Dentistry, 378Dermabrasion, 43, 48, 158, 161, 163Dermatology, 377, 378Desquamation, 71, 73Dies academicus, 378–380Diffuse redness, 61, 66–68, 77Diploma of Aesthetic Laser Medicine (DALM), 377–380Documentation, 333–335, 343Dual mode filtering, 65, 78Duplex US mapping, 214Dye laser, 43–47, 52–56, 347, 348

510-nm pigmented lesion, 189, 194, 197Dynamic cooling device (DCDs), 345Dyschromia, 63, 189–208

drug-induced, 189, 204–206

EEcchymosis rate, 218–220Eccrine hidrocystoma, 54–55Ecstatic vessels, 64, 78, 79Edema, 65, 66, 69–71, 76, 77

413Index

Educational standards, 377, 381Electrocautery, 45, 48, 51Electromagnetic radiation, 5, 6, 8Electronic transition, 23–25Endovenous laser ablation (EVLA), 211–213,

216–220, 223, 224Epidermal nevi, 44, 45, 47Epithelioma adenoides cysticum of Brooke, 45–46Erbium:Yttrium-Aluminum-Garnet (Er:YAG), 51, 300–303

laser, 43–48, 50, 52–57, 289–295, 300, 307–309, 311–315Errors in treatment, 348Erythema, 62, 65–71, 75–79Erythroplasia of Queyrat/Bowen’s disease, 168–169Ethics, 355EU Cosmetics Directive, 207, 208Eumelanin, 62, 78Evidence-based medical judgment, 377Exam, 378–380Excochleation, 50Eye protection, 39

FFacial telangiectasia, 347Facial telangiectasia treatment with

intense pulse light (IPL), 232–234multiplexing 595-nm and 1064-nm, 230, 231, 233, 234pulse dye laser (PDL), 230–231, 233

FDA. See Food and Drug AdministrationFibrous papule of the nose, 46Flash lamp, 37Flashlamp pumped pulsed dye laser (FPDL)

described, 287side effects, 287treatment

common viral warts, 286Molluscum contagiosum, 285

Fluence profile in skin tissuescattering effects, 228, 232wavelength effects, 227

Fluorescence, 71, 72Fluorescence controlled photodynamic photorejuvenation,

72–75, 77Food and Drug Administration (FDA)

aspirin, 399–400CDRH, 400device safety, 400economists, 400–401fundamental idea, finance, 401manufacturing processes, 402medical devices, certification, 402sulfa drug, US, 399

FPDL. See Flashlamp pumped pulsed dye laserFractional ablation, 307–317Fractional photothermolysis (FP), 307–310, 320,

321, 324, 326Fractional skin resurfacing, 301Freckles and lentigines

dark skin patients, 148–149IPL, 148long pulsed (LP) pigment lasers, 149QS lasers, 147

GGaussian beam, 11–13Genital warts

description, 286diagnosis, 286treatment, 286–287

Grafting, 308-nm excimer light, 157, 159–163

Grannuloma anulare, 325Great saphenous vein (GSV), 211, 212,

214–220, 224Greifswald University, 377–381Gynecology, 378

HHair

follicle, 78reduction, 125–144removal, 61–62, 77–79

“The Hall of Shame”, 407–409Halogenized hydrocarbons, 345, 346Halo nevus, 161Hamartomas, 43–44, 47Handpiece spotsize selection, 228, 238Hemangioendotheliomas (HEs)

description, 251KHE, 254NICH, 252–253RICH, 252“tufted angioma”, 253

Hemangiomas, 348chemical procedures, therapies

imiqiumod, 265interstitial corticoid crystals, 265interstitial magnesium seeds, 265sclerotherapy, 265

complications, 258congenital HE

description, 251KHE, 254NICH, 252–253RICH, 252“tufted angioma”, 253

congenital vascular tumorsclassification, 245–246precursor lesions, 247

growth pattern, 258infantile (see Infantile hemangiomas)initial phase, 248laser therapy

cw-Nd:YAG, 269–278FLPD, 266–267Nd:YAG, 267–269pulsed Nd:YAG, 269superselective systems, 266

localizationeyelid, 257perioral, 257

maturation phasedifferential diagnosis, 251gray regression areas, 250

414 Index

mechanical procedures, therapiescompression, 264embolization, 264ligation, 264

numberBNH, 255DNH, 255, 257

organsevaluation, vascular tumors, 256parenchymal, 255

physical procedures, therapiescryotherapy, 262laser, 262–264scarification techniques, 262X-ray, 263

proliferation phasecongenital, 248, 250hereditary glomangioma, 248hypercapillarizations, 248hyposonic tissue, 249spontaneous ulceration, 250volume and pale redness, 249

PWS, 247regression phase

differential diagnostic algorithm, 252fibrolipomatous transformation, 251hypopigmentation, 251VMs, 251

removalcomplications, 266residuals, 266

“strawberry hemangioma”, 245systemic procedures, therapies

antiangiogenesis, 265antiproliferative drugs, 265

Hemoglobin (Hb), 64, 67, 69, 75, 78, 79Hemorrhagic telangiectasia, 282Henyey-Greenstein, 26–27HEs. See HemangioendotheliomasHidradenoma, 51Hidrocystomas, 54–56Hirsutism, 77History of lasers, 3–5Hori’s macules. See Acquired bilateral nevus of ota-like

maculesHospitationes, 378, 379HPV-induced skin diseases

genital wartsCO

2 laser vaporization, 368

electrodessication/vaporization, 368PpIX, 368

vulgar wartsALA-PDT, 367irradiation, 367keratolysis, 367

Hyperpigmentation, 189, 195, 196, 200, 202, 204–206drug-induced, 189, 204, 206

Hypertrichosis, 77Hypertrophic scars

characteristics, 178laser treatment

darker skin patients, 178nonablative fractional photothermolysis, 179PDLs, 178

prevalence, 177–178Hypopigmentation, 157–163, 189, 195, 196, 200–202, 205

IIdentity of medicine, 351, 355, 356Idiopathic guttate hypomelanosis, 161Impression technique, 274Incompetence, 211, 212, 214, 215, 217, 219Indications, 333, 335–337, 340, 342Infantile hemangiomas (IHs)

CCDS, 248classification, 248initial phase

intracutaneous, 248, 249symptoms, 248venous malformation, 248

rapid progression, 247therapy principles

induction, regression, 260laser treatment, 262spontaneous course, 258, 260

Inflammatory dermatoses, acne. See AcneInflammatory linear verrucous epidermal nevus (ILVEN), 45Infrared (IR)

laser, 301, 302resurfacing, 289, 293–295

technologies, 303Initial squamous cell carcinoma, 365Ink

darkening, 198, 200, 203residual, 202, 208tattoo, 190, 196, 198, 201, 202, 206–208

Intense pulsed light (IPL), 125–131, 133–136, 138, 140–144, 289, 294–295, 301, 304

and heat, 86mild–moderate acne, 85–86PWS treatment, 243safety, 384treatment, 333–343

Interstitial puncture technique, 274, 276–277IPL. See Intense pulsed light

JJacket-tip laser fiber, 221, 222

KKaposi-like congenital hemangioendothelioma (KHE),

254–255Koenen tumors, 46, 47

LLaser, 125–144, 165–172, 319–328

alexandrite, 15, 17argon, 5, 9, 19CO

2, 17–18

design, 8–9, 11diode, 20–22dye, 19–20

415Index

Er:YAG, 15excimer, 5, 19, 20He-Ne, 19Ho:YAG, 15–16KTP, 14–16medical, 14–22modes, 10–14, 18Nd:YAG, 5, 9, 14, 15principle, 5, 8–9ruby, 5, 9, 17, 19surgery, 333–343Ti:Al

2O

3, 17

Tm:YAG, 16Laser therapy, hemangiomas

continuous wave (cw-Nd:YAG)application modes, 270continuous ice cube cooling, transcutaneous, 271–278cooling procedures, 270fluid cooling cuvette, transcutaneous, 271high power densities, 270thermal conductivity, 269transcutaneous direct application, 270

FLPDLdevelopment stages, 267, 268diffuse telangiectases, 266pulse length and, 268side effects, 267

Nd:YAG, frequency doubledadvantage, 268potassiumtitanyl-phosphate crystal, 267–268vascular ectasias and tuberous infiltrations, 269

principle, 266pulsed Nd:YAG, 269superselective laser systems, 266

LED technology. See Light-emitting diode technologyLEED. See Linear endovenous energy densityLeg telangiectasias, 64, 66, 67Leg vein treatment, 234–236

alexandrite laser 755-nm, 235diode laser 800-nm, 235multiplexing 595-nm and 1064-nm, 233Nd:YAG laser 1064-nm, 228, 233pulse dye laser 595-nm, 228

Leishmaniasis, 371Lentigo maligna, 170Lichen sclerosus, 369–370Light-based therapies

Propionibacterium acnesblue and red light, 85blue light, 84–85intense pulsed light, 85–86intense pulsed light and heat, 86532-nm KTP laser, 86–87PDL, 87photopneumatic therapy, 86porphyrins, 84red light, 85sebaceous follicle colonization, 84

sebaceous gland1,450-nm diode laser, 87–881,540-nm erbium:glass laser, 88

1,320-nm Nd:YAG laser, 88sebum, 87

Light-emitting diode (LED) technology, 289, 295Linear endovenous energy density (LEED), 211, 214, 216–218,

220–221, 223Liposome, 69, 71–72, 75, 77Liposuction surgery, 113–115, 120, 122Liquid nitrogen, 345–347Long-pulsed Nd:YAG, 43Lymphangioma circumscriptum, 281–282

MMaiman, T.H., 4, 5, 9, 17Malignant melanoma, 170Malignant tumors, 165–172Mantleoma, 43–44Manual compression, 211, 213–215, 219Master of Science degree course in Health and Aesthetics, 377Master of Science in Health and Aesthetics, 377, 379–381Mastocytosis, 46–47Maxillofacial surgery, 378Melanin, 61–64, 69, 77–79Melasma

description, 151and dyschromia, 324pigment lasers/IPL

bleaching agents, 152intense pulse light source device, 152toning, 152–153

resurfacing lasersfractional, 152YAG lasers, 151–152

treatment, 151vascular laser, 153

MEND, 322, 324, 328Microfractional skin rejuvenation, 321Microscopic, 320–322, 325, 328

epidermal necrotic debris, 322, 328treatment zones (MTZ), 320–322, 324–327

Microthermal zones (MTZs), 307, 308, 310, 312, 314Mid-infrared lasers, 322, 323, 325, 327Minocycline pigmentation, 325Molluscum contagiosum

cause and symptoms, 285treatment

CO2 laser and FPDL, 285

varieties, 285trunk, 285, 286

Monopolar RF, 302, 303Morbus Recklinghausen, 48Morphea, 369–370Motorized pullback, 220Mottled pigmentation, 69, 79Mucoid dorsal cyst, 55Mucoid finger cyst, 56Mucosal fibroma, 50

NNd:YAG laser

(532 nm), quality-switched, 191, 193, 196, 197, 202(1,064 nm), quality-switched, 193, 197–199, 201, 203–206

416 Index

therapyangiokeratomas, fordyce, 281hemorrhagic telangiectasia, 282pyogenic granuloma, 281venous malformations, 282

Neck skin tightening, 314Neodymium-doped Yttrium Aluminium Garnet (Nd:YAG)

lasers, 43, 47, 50, 54Neovascularization prevention, 232

imiquimod, 232rapamune, 232

Neurofibromas, 48Nevus depigmentosus, 157, 158, 161Nevus of Ota, 325

before and after treatment, 149fractional resurfacing, 150pigmentation, 149QS ruby, 150

Nevus sebaceous, 47Nevus unius lateralis, 44–45532 nm, 99, 1081,450-nm diode laser, 87–881,540-nm Erbium:glass laser, 88308-nm excimer laser, 157, 159–162632.8-nm helium-neon laser combined treatment, 162532-nm laser

and acne, 86Michaelsson acne severity score, 87

1,320-nm Nd:YAG laser, 88Noble laureates, 3–4Nonablative, 319–328

fractional photothermolysis, 320, 324resurfacing, 289, 293–295wrinkle reduction, 62, 69

Noninvoluting congenital hemangioendothelioma (NICH), 252–253

Normal mode ruby laser (NMRL), 151, 154

OOcclusion rate, 217Ophthalmology, 378Optical coefficients, 213Optical constants, 27Optical depilation, 77Optical fiber, 215Optical filter unit, 37Optomechanical breakdown, 62Oral leukoplakia, 170–171Organoid nevi, 43–57Otorhino-laryngology, 378Oxy-hemoglonin (HbO

2), 64, 67

PPaget’s disease, 171Pain, 216, 218–221, 223Papillomatous dermal nevi, 48Papillomatous dermal nevus, 47–48Parapsoriasis/Mycosis fungoides (MF), 171–172PDLs. See Pulsed dye lasersPDL vs. Nd:YAG spot size effects, 228, 230, 233PDT. See Photodynamic therapyPearly penile papules, 325

Periungual fibromas, 46Phacoma-toses, 43Pheomelanin, 78Photoacustic, 62Photodamage, 307, 310, 312–314, 316, 317Photodamaged skin, 62, 70Photodynamic photorejuvenation, 62, 69–75, 77Photodynamic therapy (PDT), 29–30, 34, 165–172, 301

action mechanism, 361adverse events, 90clinical effects

acne, 89response, 90traditional therapies, 90

dermatology, 358hematoporphyrin, 357–358light sources, 89

incoherent, 359irradiation, 360LED-system, 359–360Soret-band, 359tissue destruction, 361

nononcologic indications, therapeuticsacne vulgaris, 368–369cellular and subcellular level functions, 366cellular destruction, 366cosmetic, 370–371HPV-induced skin diseases, 367–368inflammatory skin conditions, 366leishmaniasis, 371morphea and lichen sclerosus, 369–370psoriasis vulgaris, 366–367

oncologic indications, therapeuticsAK, 362–364basal cell carcinoma, 364–365Bowen’s disease and initial squamous cell carcinoma,

365“photodynamic reaction”, 357photosensitizers

ALA and m-ALA, 88–89curettage, 358–359fluorescence, 358hematoporphyrin derivatives (HPDs), 358lesion specificity, 89meso-tetrahydroxyphenylchlorin (mTHPC), 359

singlet oxygen production, 88topical

cancerization field, 361–362hyperkeratosis, 361pustules, 362side effects, 361

Photon characteristics, 3, 5–8, 14–16, 19–21Photopneumatic therapy

mild-moderate facial acne, 86negative pressure, 86

Photorejuvenation, 61–75, 77, 319, 322, 323, 325Type I, 62–69, 71, 77Type II, 62, 69Type III, 62, 65, 70, 79Type IV, 62, 69–73

Photosensitizing, 70, 71Piebaldism, 157, 158, 162, 163

417Index

Pigmented disorders, 62–64Pigments

inorganic, 206, 207organic, 201, 206, 208polycyclic, 201, 206–208residual, 189, 193, 194

Planck’s law, 8Plasma skin regeneration, 289, 292–293, 295, 301, 302Plastic and reconstructive surgery, 378Poikiloderma of civatte, 62, 63, 324–325Poikiloderma of civatte treatment with

intense pulse light, 227–228pulse dye laser 585-595-nm, 228–229

Polarisation, 6, 12, 13, 21Polychromatic light, 37Port-wine stains (PWS), 67, 347

flash lamp pulsed dye laser treatmentface, 241pink and red lesions, 242site and nevus size, 242

infrared lasersmillisecond modes, 2423-ms alexandrite laser, 242–243Nd:YAG laser, 243

KTP laser, 242noncoherent light sources, 243

Postgraduate study, 381program, 377

Postinflammatory erythema, 324PpIX. See Protoporphyrin IXPrecancerous conditions, 165–172Precancerous lesions, 165, 166, 172Principle of selective photo-thermolysis, 38Propionibacteria, 73, 74Protoporphyrin IX (PpIX), 70, 71, 74Pseudocysts, 56Psoriasis vulgaris, 366–367Pulsed CO

2, 43–57

Pulsed dye lasers (PDLs), 43–47, 52–56hypertrophic scars, 178inflammatory lesions, 87Leeds acne score, 87rare vascular lesions, treatment, 281–282

Pulsed light, 302Pulse shape, 38Purpura, 66–68, 77Purpura threshold, PDL

long pulse PDL performance, 233multiple pulse effects, 231

PWS. See Port-wine stainsPyogenic granuloma, 281

QQ-switch, 13–14, 18Q-switched (QS) lasers, 157, 158, 161–163

disadvantage, 147IPL, 148ruby, 150

Hori’s macules, 150melanocytic nevi, 151

Q-switched ruby, 47, 50–51Quality standards, 377–381

RRadial emission, 222–223Radiation, definitions, 7–8Radiofrequency energy (RF), 302–304Rapidly involuting congenital hemangioendothelioma

(RICH), 252Rare vascular lesions

pyogenic granuloma, 281treatment

angioblastoma and spontaneous regression, 281angiokeratomas, fordyce, 281hemorrhagic telangiectasia, 282hereditary multiple glomus tumors, 281lymphangioma circumscriptum and angioma

serpiginosum, 281–282Nd:YAG laser therapy, 281, 282pulsed dye lasers, 281, 282venous malformations, 282

Reactionablation, 30mechanisms, 28photodisruption, 29, 33–35thermal, 30–32

Reflux, 212, 214, 215, 219, 220Regulation, tattoo colourant agents, 207–208Relaxation time, 30, 32, 33Remodeling, 319, 320, 322–324, 328Resonators, 8, 10–14, 19, 21Resurfacing laser

fractional, 152YAG lasers, 151–152

RF. See Radiofrequency energyRhinophyma, 48–50Rhytides, 324Rosacea, 67, 68, 75, 77Ruby laser, 45, 47, 51

quality-switched, 189, 190, 195–200, 203–206

SSafety/eye protection

attenuation, radiation, 390CDRH, 391classification, lasers, 386electromagnetic radiation, 383equipment and laser safety officer

EN 60825-1, 389organizations, 390

goggles, 388–389lasers and intense pulsed light sources

difference, 384energy and intensity, radiation, 385exposure time, radiation, 385optical power and monochromatic nature, 383parameters, 384–386radiant exposure, radiation, 385–386

LSO, 391–392maximal values and radiant exposure pulse duration, 390optical densities (ODs), 388–389photons absorption, 383radiation-induced damages, humans

absorption, chromophores, 386eyes, 387

418 Index

water, absorption, 387wavelength dependency, 388

recommendations, medical practice, 392scale numbers, goggles, 391scattered radiation, 387–388spectral ranges, electromagnetic radiation, 384warning signs, 392

Safety hazard, 38–39Salivary gland, 56–57Saphenofemoral junction (SFJ), 212, 214, 215, 217, 218Scarring, 189, 190, 200–204Scars, 319–328

atrophic, treatmentablative, 180–181description, 179fractional laser, 181laser, 179nonablative, 180

hypertrophic and keloidcharacteristics, 178laser treatment, 178–179prevalence, 177–178

posttreatment careablative, 185nonablative fractional resurfacing, 185PDL/Nd:YAG, 185sun protection, 184

preoperative patient evaluationmedical history, 184patient expectations, 184prior treatment, 183–184skin phototype and ethnicity, 184timing, 183

striae distensae/stretch markslaser treatment, 182–183stages, 181

Scattering, 24, 26–28mitigation, 232

Sebaceous hyperplasia, 52–53Seborrheic keratoses, 50–51Selective photothermolysis, 61, 62, 65, 66, 78Senile hemangioma, 237SFJ. See Saphenofemoral junctionSkin, 319–326, 328

fluorescence, 71, 72laxity, wrinkles, 314–315, 317resurfacing, 319, 325, 347, 348roughness, 70texture, 66, 67, 69, 71–72tightening, 309, 310, 313, 314

Small saphenous vein (SSV), 212, 214, 215, 218–220, 224Spider hemangioma, 236–237Steatocystoma multiplex, 55–56Stimulated emission, 3, 5–8, 21Strategies, 333Stretch marks. See Striae distensaeStriae distensae

laser treatmentablative fractional CO2, 183fractional photothermolysis, 182–183PDLs, 182

stages, 181

Studium generale, 379, 380Subsurfacing, 319–320, 328Sun protection, 43Syringomas, 45, 51–52Systemic isotretinoin, 83

TTattoo

amateur, 189, 190, 192, 195–199black, 190, 195–197, 206cosmetic, 196, 198, 207decorative, 189–202legal regulations, 207–208multi-coloured, 189, 196, 197, 208pigments, 192, 194, 196, 206–208single-coloured, 196traumatic, 189, 202–204whitening, 192, 197, 198, 206

Tattoo inks, 190, 201, 202, 206–208temporary, 189, 190, 192

Telangiectasias, 61, 62, 64–70Telangiectatic matting, 324Textural change, 195, 196, 202Thermal damage time (TDT), 66, 78Thermal protection, 345, 348Thermal relaxation time (TRT), 61, 62, 65, 66, 78Tissue ablation, 32–33Tissue coagulation, 309, 312, 317Tissue damage, 30, 31TLA. See Tumescent local anesthesiaTongue papillomas, 54, 55Training, 334, 377–380Traumatic mucous cyst (Traumatic mucous retention cyst,

mucocele), 56–57Traumatic mucous retention cyst, 56–57Treatment, 165–172

zones, 319, 320, 326, 328Trendelenburg positioning, 211, 213–216, 218, 219TRT. See Thermal relaxation time“Tufted angioma”, 253Tulip-shaped catheter, 221–222Tumescent anesthesia, 213–216, 224Tumescent local anesthesia (TLA), 114, 117Tumescent solution, 211, 214, 215, 219, 220

UUrticaria pigmentosa adultorum, 46, 47

VVacuum suction, 304Varicose veins, 211–224Vascular injury

dual wavelength effects, multiplex, 230multiple pulsing effects, 229, 231

Vascular laser, 153Vascular lesions, PWS. See Port-wine stainsVenous lake, 237–238Vibration transition, 23, 24Viral infections

common viral warts, 286genital warts, 286–287laser treatment

419Index

CO2, 287

FPDL, 287photothermic/photomechanic destruction principle, 287

Molluscum contagiosum, 285–286Visible light lasers, 289, 294, 295Vitiligo, 157–163

WWavelength, 211–213, 216, 223

device selection, 233, 237–238penetration depth, 227, 232

Withdrawal of the fiber, 220Wrinkle reduction, 61, 62, 69–74

XXanthelasmas, 52–54Xenon-chloride (XeCl) gas, 105

YYttrium-Scandium-Gallium-Garnet (YSGG) laser, 289, 290,

292, 295, 300–302, 308