Pulsed Alexandrite Laser Research Articles

Timing and Efficacy Evaluation of 755-nm Long Pulse Alexandrite Laser and 2% Carteolol Hydrochloride Eye Drops Co-Treatment for Thicker Superficial Infantile Hemangioma.

Superficial Infantile hemangioma (SIH) is the most common type of IH. Some studies have shown the efficacy of 755-nm long pulse alexandrite laser (LPAL) and topical 2% carteolol hydrochloride (C-HCL) eye drops for the treatment of SIH. This article retrospectively analyzes the safety and efficacy of 755-nm LPAL combined with 2% C-HCL eye drops for treating thicker SIH, and explores the optimal treatment time for SIH. This study included 2-5 mm thick SIH patients who received co-treatment of 755-nm LPAL and 2% C-HCL eye drops. The SIH patients were divided into 3 groups based on their age and IH growth curve: ≤ 1 month (≤ 1M), 1-3 months (excluding 1 month; 1-3M), and 3-12 months (excluding 3 months; 3-12M). There was no difference in efficacy between the ≤ 1M and the 1-3M group, and were both better than the 3-12M group. Furthermore, there was no difference in the average number of treatments between the ≤ 1M and 1-3M groups and were both less than the 3-12M group. There was no significant difference in the incidence of adverse reactions between the groups. Compared with the ≤ 1M and 1-3M groups, the 3-12M group indicated more permanent skin lesions after the treatment. It was revealed that co-treatment with 755-nm LPAL and 2% C-HCL eye drops is safe and effective against thicker SIH. Compared with the 3-12M group, ≤ 3 months can achieve better efficacy, requires a shorter treatment time, less likely to leave permanent skin lesions such as scars. Moreover, patients with no proliferation can be observed to 1 month.

Study the effect of the different doses from the laser on Staphylococcus aureus Bacteria growth in vitro

Background: Laser is a novel physical therapy technique used to treat various conditions, including wound healing, inhibition of bacterial growth, and postoperative wounds. High-power pulsed alexandrite laser therapy is one of the most prevalent forms of laser therapy, which is a noninvasive method for treating various pathological conditions, thereby enhancing functional capacities and quality of life. It is a modern medical and physiotherapeutic technology. Generally, the Alexandrite laser emits infrared light with a wavelength of 755 nm, allowing it to propagate and penetrate tissues. Objective: This study focused on the application of a high-power pulsed alexandrite laser in vitro to evaluate the effect of a pulsed alexandrite laser on antibiotic-resistant bacteria utilizing varying exposure times, pulse durations, and laser fluencies to determine which dose is more effective on S. aureus bacteria. Method: The laser used in this study was the alexandrite laser which was considered a pulsed laser and had the following parameters: The wavelength was 755 nm, the beam diameter was (14 mm), the exposure times varied (30, 60, 90) seconds, the laser fluency (5, 10, 15 and 20 J.Cm-2). The study was carried out after the bacteria were diagnosed as being antibioticresistant. They were exposed to different doses of Alexandrite laser. Three samples of bacteria were exposed to laser beams for 30 seconds with a 5ms pulse duration and with a laser fluency of 5J/cm2, and this process was repeated with laser fluencies of 10, 15, and 20. This procedure was repeated using exposure times of 60sec and 90sec. As well as, this process was repeated by exposure with 30 sec, 60 sec and 90 sec exposure times, 10ms and 20ms pulse durations and with different laser fluencies 5, 10, 15 and 20J/cm2, separately. Results: A significant reduction (p = <0.0001) in the mean values of the colony was observed with the increase of laser fluency doses compared with control at the same pulse duration. A significant reduction (p = <0.0001) in the mean count of the colonies was observed in the comparison between two laser fluences at the same pulse duration. In conclusion, the exposure times, pulse durations and laser fluencies of pulsed alexandrite laser showed an effect on the mean count of the colonies of S aureus bacteria and determined the effective dose. Keywords: laser, Staphylococcus aureus, Bacteria growth

In Vitro Assessment of the Effects of Varying Dosages of Alexandrite Laser on the Development of Staphylococcus Aureus

Background: This study aimed to apply a high-power pulsed alexandrite laser in vitro, the researchers tested different exposure periods, pulse lengths, and laser fluencies to see which dosage was most successful against S. aureus bacteria, which had developed resistance to many antibiotics. Method: Three bacteria samples were exposed to laser beams for 30 seconds with a 5ms pulse duration and a laser fluency of 5J/cm2. The process was repeated with laser fluencies of 10, 15, and 20. Results: The study was carried out by using different doses of Alexandrite laser. Results: There are significant differences (p = 0.05) in the mean number of bacteria colonies exposed for 30 and 60 seconds at any laser fluencies utilized in the present investigation. Except for the 15 J.cm-2 laser fluency; there was a statistically significant difference (p < 0.001) between 60 sec and 90-sec exposure durations. Conclusion: In conclusion, the exposure periods, pulse durations, and laser fluencies of pulsed alexandrite laser were found to have an influence on the mean colony count of S aureus bacteria and to establish the effective dose.

LD-Pumped Watt-Level SESAM Passively Q-Switched Alexandrite Laser

Alexandrite lasers are attractive choices for 700-800 nm band, and they are necessary in many applications. A red laser diode (LD) pumped watt-level passively Q-switched Alexandrite laser with a semiconductor saturable absorber mirror (SESAM) is presented. A continuous wave (CW) laser with an average power of 2.5 W was obtained. Customized SESAMs were employed to enable a 749.6-nm pulsed Alexandrite laser with an average power of 0.904 W, a repetition rate of 20.27 kHz, and a pulse energy of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$44.59\mu \text{J}$ </tex-math></inline-formula> , when the pump power was 26.5 W. To the best of our knowledge, this is the highest average power from SESAM passively Q-switched Alexandrite laser, which is one order of magnitude higher than previous reported results.

Synthesis of copper nanoparticles by laser ablation

The synthesis of copper nanoparticles using a pulsed alexandrite laser is demonstrated. The laser operated in a free generation mode with a pulse duration of about 250 μs. The copper target was placed in distilled water and glycerin. The obtained colloidal solutions were investigated by dynamic light scattering, and the deposited structures were studied by atomic force and electron microscopy. The concentration of nanoparticles depended on the power of the laser radiation, the scanning speed and the exposure time. The smallest particles size was obtained at a frequency of 5 Hz at a wavelength of 750 nm. Colloids obtained in distilled water contain copper nanoparticles, which oxidize over time.

Usefulness of picosecond pulse alexandrite laser treatment for nevus of Ota.

Recently, novel picosecond pulse duration lasers (ps-lasers) have been developed for the treatment of multicolored and recalcitrant tattoos, and safety and efficacy have been reported. We therefore hypothesized that ps-lasers could be an alternative treatment for dermal pigmented lesions. We performed a retrospective review to evaluate the efficacy and safety of the ps-laser for nevus of Ota. A retrospective photographic review of 15 patients with nevus of Ota was performed (ages from 10 months to 65 yr). The patients were treated in the Ohshiro Clinic with a picosecond-domain 755 nm alexandrite laser (ps-Alex laser) from June 2015 to August 2017. Improvement was evaluated as the percentage of pigmentation clearance comparing the baseline findings with those at 3 months after the final treatment using a four category grading scale: Poor, 0-24%; Fair, 25-49%; Good, 50-74%; and Excellent 75-100% improvement. Adverse events were also assessed. All patients obtained clinical improvement ranging from fair to excellent. All 5 patients whose primary treatment was the ps-Alex laser obtained excellent in 2-3 treatment sessions (average 2.5 sessions), and the average total treatment span was 10.0 months. Treatment with the ps-Alex laser caused transient hyperpigmentation followed by improvement to complete resolution at 3 months of follow-up. Our results suggest that 755 nm ps laser treatment is efficacious for the treatment of nevus of Ota with minimum adverse events.

The effective treatment of bleeding angiokeratomas associated with Anderson–Fabry disease using long pulsed alexandrite laser

The effective treatment of bleeding angiokeratomas associated with Anderson–Fabry disease using long pulsed alexandrite laser

外用局所麻酔剤リドカイン・プロピトカイン配合クリームのレーザー脱毛時における有用性の検討

外用局所麻酔剤リドカイン・プロピトカイン配合クリームのレーザー脱毛時における有用性の検討

Acral acanthosis nigricans (acral acanthotic anomaly).

A 28-year-old female, apparently healthy and thinly built, presented with mildly itchy hyperpigmented hyperkeratotic plaques on her feet since three years. There were no systemic features suggestive of diabetes or other endocrinopathies associated with acanthosis nigricans (AN). She was not on any medication prior to onset of lesions. On examination, multiple well-defined hyperpigmented, hyperkeratotic plaques were present on the dorsum of several toes in a bilateral symmetrical manner [Figure 1]. Other skin sites, the scalp, palms, soles and mucosae were spared. Routine blood investigations, fasting and postprandial blood sugar and routine urine analysis were within normal limits. The liver enzymes, thyroid hormones and growth hormone were within normal range. Serum leptin and insulin level estimation could not be done as these were not available in our institute. Radiographic examination of the chest, skull and hands did not reveal any abnormality. Abdominal and pelvic ultrasonography was non-contributory. Biopsy of the skin showed hyperkeratosis, papillomatosis, increased pigmentation of the basal cell layer and mild acanthosis, with a sparse inflammatory infiltrate of mononuclear cells in the upper dermis [Figure ​[Figure2a2a and ​andb].b]. These histopathological findings were consistent with the diagnosis of AN. A final diagnosis of acral AN was made, considering clinical and histopathological findings. Figure 1 Hyperpigmented hyperkeratotic plaques on dorsal surface of toes Figure 2 (a) Hyperkeratosis, acanthosis, papillomatosis and sparse mononuclear cell infiltration in dermis (H and E, ×40) (b) Higher magnification (H and E, ×100) AN is a common presentation in the out-patient department and usually affects the neck, axillae, groin, inner aspects of the thighs, flexor and extensor surface of the elbows and knees, dorsal joints of the hands, umbilicus and anus. Schwartz has categorized the entity into the following eight types: benign, malignant, associated with obesity, syndromic, unilateral, drug induced, mixed and acral.[1] In acral AN, also called as acral acanthotic anomaly, the lesions are localized to the knee, ankle, phalangeal joints and tarsophalangeal joints.[1] It is apparently more common in persons with a dark complexion and affects acral areas without prominent affection of axilla and other flexures.[2] The clinical significance of acral AN is ambiguous and more studies are needed to settle this issue. According to Schwartz, this type of AN essentially occurs in healthy black people and does not, on its own, call for a vigilant work-up of those afflicted; for the possible presence of an internal malignancy. However, recently it has been reported in association with dermatofibrosarcoma protuberans, non-Hodgkin's lymphoma[3] and gastric adenocarcinoma.[4] Diagnosis is mostly clinical and can be confirmed by histopathology. In the majority of cases, improvement of the skin lesions is the primary concern of patients presenting to dermatologists. Treatment of its underlying condition often results in improvement of AN. The type occurring with obesity usually improves with weight loss. Etretinate, metformin, tretinoin, calcipotriol, urea, salicyclic acid, CO2 laser ablation and long pulsed alexandrite laser therapy have been reported as successful treatments in individual cases.[1,2]

Refractory Port Wine Stains (PWS): Long Pulsed Alexandrite Laser as an Option

Introduction: Port wine stains (PWS) are congenital vascular malformations. Pulsed dye laser (PDL) is the treatment of choice till now, although many lesions do not respond completely. One of possible options is long pulsed alexandrite laser. Some literatures confirmed its efficacy. The aim of the present study is to determine the efficacy of this laser as an option in treating refractory PWS in Iranian patients. Methods: Patients with refractory PWS lesions that did not respond to at least six PDL sessions were included if they had no history of Isotretinoin consumption in past year, history of keloid or hypertrophic scar formation, active infection in laser site and if they were not pregnant. All patients signed an informed consent. Alexandrite laser with fluences from 36-40J/Cm 2 , 12 mm spot size, 3 ms pulse duration and dynamic cooling device tuned to 50/50 ms was used in three successive sessions to treat lesions. All patients photographed before each session and after 8 weeks from the last sessions. Then, pictures were rated by two blinded dermatologist rater to determine degree of response based of visual analog scaling from score 1(below 25% response) to score 4 (more than 75% response). Results: A total of 20 patients comprised of 12 males and 8 females with mean age of 23 years were included. 35% (7 patients) had score of 1, 35% (7 patients) had score of 2, 25% (5 patients) had score of 3 while one patient (5%) reached score 4. No serious side effect was observed. There was no significant relationship with age, gender and size of lesions and response rate. Conclusion: It seems that considering a conservative approach, long pulsed alexandrite laser may be an effective option in treating refractory PWS lesions. Although future studies

Alexandrite Laser for the Treatment of Port Wine Stains Refractory to Pulsed Dye Laser

The 755-nm ms pulsed Alexandrite laser (MSPAL) has been reported to be successfully in the treatment of port wine stains (PWS) that are refractory to pulsed dye laser (PDL). This was a prospective pilot study to assess the degree of improvement after a series of treatments with a MSPAL for hypertrophic, nodular, and macular PWS refractory to PDL. Treatment was administered to the PWS using the 755-nm MSPAL at settings of 3-ms pulse duration, 8- to 12-mm spot, 40 to 60 J/cm(2), and dynamic cooling of 60/40. Patients received a series of two to four treatment session, given at 6- to 8-week intervals. The eight patients in this study had undergone a mean of 25.9 treatment sessions with PDL over 8.8 years. The number of MSPAL sessions required for significant improvement of PWS ranged from two to four (mean 2.6). From before treatment to 2 months after treatment, the mean score decreased from 3.2 to 1.4 for skin color (56.3% mean improvement, 95% confidence interval (CI)=53.2-59.4%), from 2.5 to 1.0 at (60.0% mean improvement, 95% CI=55.9-64.1%) for skin texture, and from 3.2 to 1.3 (59.4% mean improvement, 95% CI=56.2-62.6%) for overall cosmetic outcome (all p<.05). In this pilot study, PDL-resistant PWS responded significantly to a series of MSPAL treatments. Given the potential for adverse effects and narrow therapeutic index, treatment with conservative parameters and close observation of tissue response are essential.

Raman-shifted alexandrite laser for soft tissue ablation in the 6- to 7-µm wavelength range

Prior work with free-electron lasers (FELs) showed that wavelengths in the 6- to 7-µm range could ablate soft tissues efficiently with little collateral damage; however, FELs proved too costly and too complex for widespread surgical use. Several alternative 6- to 7-µm laser systems have demonstrated the ability to cut soft tissues cleanly, but at rates that were much too low for surgical applications. Here, we present initial results with a Raman-shifted, pulsed alexandrite laser that is tunable from 6 to 7 µm and cuts soft tissues cleanly—approximately 15 µm of thermal damage surrounding ablation craters in cornea—and does so with volumetric ablation rates of 2–5 × 10−3 mm3/s. These rates are comparable to those attained in prior successful surgical trials using the FEL for optic nerve sheath fenestration.

Uncommonly reported side effects of hair removal by long pulsed‐alexandrite laser

To provide retrospective clinical review of some uncommonly reported side effects of long-pulsed alexandrite laser treatment for hair removal. Two hundred and fifty female patients suffering from hirsutism of the face were subjected to treatment by long pulse alexandrite laser for a maximum of 15 sessions per patient at 5- to 7-week intervals. Apart from the commonly reported side effects of pigmentary changes, occasional blistering and rare scarring, other untoward effects have been observed. These include - among others - de-novo growth of hair outside the area treated by laser, potentiation of co-existing vellus hair in the treatment area, induction or aggravation of acne, rosacea-like rash, premature grayness of hair, tunneling of hair under the skin, prolonged diffuse redness and edema of the face, focal hypopigmentation of the lip, angular cheilitis, allergic reaction to the cooling gas, and inflammatory and pigmentary changes of pre-existing nevi. Although the efficacy of long-pulsed alexandrite laser seems unmistakable, the short- and long-term untoward effects of such treatment have yet to be carefully delineated and the underlying mechanisms are yet to be adequately clarified.

Optimal pulse durations for the treatment of leg telangiectasias with an alexandrite laser

Determine optimal settings using a long pulse 755 nm alexandrite laser in the treatment of superficial leg veins. STUDY DESIGN\ Fifteen patients with Fitzpatrick skin types I-III with telangiectasia ranging from 0.2 to 1.0 mm were enrolled. Spot size varied from 3 to 6 mm. Pulse durations ranged from 3 to 100 milliseconds. For each pulse duration, test sites were performed to determine threshold radiant exposures using persistent bluing and/or immediate stenosis (closure) as the clinical endpoint. Test sites were re-evaluated 21 days later. Optimal settings, those that resulted in the greatest clearance with minimal side effects (pain, purpura, epidermal damage, pigment changes), were used to treat a larger area of like-sized vessels. Follow-up evaluations were conducted 12 weeks after a single treatment using the optimal setting. Polarized digital photographs were obtained at each visit. Improvement was determined by blinded evaluation of pre/post-treatment photographs. Fourteen patients completed the study. Radiant exposure thresholds for immediate vessel changes depended on vessel diameter, with larger radiant exposures required for smaller spot sizes and smaller vessels. The average threshold radiant exposure for closure was 89 J/cm(2). The optimal pulse duration was 60 milliseconds for most of the patients. With this pulse width, clearance approached 65% 12 weeks after a single treatment. Transient hyperpigmentation occurred in four patients. Increasing the pulse duration improved epidermal tolerance and decreased the likelihood of purpura. By lengthening the pulsewidth beyond 3 milliseconds, a long pulse alexandrite laser achieves satisfactory clearance with an improved side effect profile.

Comparative evaluation of long pulse alexandrite laser and intense pulsed light systems for pseudofolliculitis barbae treatment with one year of follow up

Background:Existing remedies for controlling pseudofolliculitis barbae (PFB) are sometimes helpful; however the positive effects are often short lived. The only definitive cure for PFB is permanent removal of the hair follicle.Aims:Our aim was to compare the efficacy of the Alexandrite laser with the intense pulsed light system in the treatment of PFB and to follow up the recurrence.Methods:Twenty male patients seeking laser hair removal for the treatment of PFB were enrolled in this study. One half of the face was treated with the long-pulse Alexandrite laser and the other half was treated with the IPL system randomly. The treatment outcome and any complications were observed and followed up for one year.Results:All patients exhibited a statistically significant decrease in the numbers of papules. Our results showed that the Alexandrite-treated side needed seven sessions to reach about 80% improvement, while the IPL-treated side needed 10-12 sessions to reach about 50% improvement. During the one year follow up period, the Alexandrite-treated side showed recurrence in very minimal areas, while the IPL-treated side showed recurrence in bigger areas.Conclusions:Our results showed that both systems might improve PFB but Alexandrite laser was more effective at reducing PFB than IPL.

Comparison study of a long‐pulse pulsed dye laser and a long‐pulse pulsed alexandrite laser in the treatment of port wine stains

Background: Port wine stains (PWSs) are commonly treated by the pulsed dye laser. Recently, a long‐pulse pulsed alexandrite laser was used to treat bulky vascular malformations. Objective: In the present study, we compare the efficacy and complications of the long‐pulse pulsed dye laser (LPPDL) and the long‐pulse pulsed alexandrite laser (LPPAL) in the treatment of PWSs. Methods: Eleven patients with Fitzpatrick skin types III–IV were enrolled in this study. One section of each patient's PWS was treated with LPPDL and another section was treated with LPPAL. The patients' PWSs were evaluated for efficacy of elimination of erythema and for treatment‐related side effects. Results: Both LPPDL and LPPAL treatment are effective in the treatment of PWSs. Hyperpigmentation was seen in two areas treated with LPPDL and in three areas treated with LPPAL. Hypopigmentation was seen in one area treated with LPPAL, but not in any of the areas treated with LPPDL. There was no scarring. Conclusion: LPPAL works best with hypertrophic, purple PWSs, while LPPDL yields better clinical improvements with the flat, pink PWSs. Targeting of deoxyhemoglobin, deeper penetration, and higher fluence may explain the effectiveness of LPPAL in purple, hypertrophic PWSs. However, there is a risk of dyspigmentation when using the LPPAL.

Laser depilation and hygiene: preventing recurrent pilonidal sinus disease

Pilonidal sinus disease of the natal cleft is a painful and debilitating condition which often recurs despite multiple surgical undertakings. We describe the long pulsed alexandrite laser for hair depilation and the role of personal hygiene, which is often overlooked when treating this disease, as an adjunct to preventing recurrent pilonidal sinus disease. A review of 14 patients who underwent laser hair depilation in the natal cleft following pilonidal sinus surgery. The majority of patients had recurrent disease and had undergone numerous surgical procedures (range 1-5, mean 2.07) All patients were given advice regarding meticulous personal hygiene at the time of consultation. 12 patients received the full course of treatment (three treatments, 6-weekly) followed by 'top-up' treatments as required (mean number of treatments 3.9). None of the patients developed recurrent disease at 1-year follow up and, to date, none have required further surgery. Laser hair depilation is a useful adjunct in preventing the recurrence of pilonidal sinus disease and should be offered routinely to all patients. This coupled with patient education regarding personal hygiene reduces the risk of developing recurrent pilonidal sinus disease.

Retrospective analysis of efficacy on permanent hair removal by long pulsed Alexandrite laser

目的 评价长脉冲翠绿宝石激光对人体不同部位永久性脱毛的疗效.方法 用Gentle LASE脉冲激光对身体各部位进行脱毛,回顾性分析达到永久性脱毛效果的298个部位的脱毛情况.结果 5次脱毛后,四肢、腋窝脱毛率平均为82.50 %～94.00 %,男性腮部和女性唇周平均分别为82.50 %、85.00 %;而4次脱毛后,发际、骶部脱毛率平均分别为92.56 %、94.87 %.男性腮部和女性唇周5次脱毛后,脱毛率分别与其他各组之间两两比较差异均有统计学意义(P＜0.05);而男性腮部和女性唇周之间,以及其他各组之间两两比较,差异均无统计学意义(P＞0.05).脱毛后,各部位毛发再生延迟,且随脱毛次数增加而延迟时间愈长(r为0.33～0.80).男性腮部和女性唇周总脱毛次数较多,平均分别为8.00次和7.31次,次数多于其余各部位,效果差异有统计学意义(P＜0.05),其余7组脱毛次数平均为3.25～4.83次,各组之间比较,差异无统计学意义(P＞0.05).总不良反应发生率为7.38 %.结论 长脉冲翠绿宝石激光对四肢、腋窝、发际脱毛效果较好,疗效优于女性唇周和男性腮部;随脱毛次数增多毛发再生延迟。

A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women

Although there are a multitude of therapeutic modalities for removing unwanted facial hair in women, there is very little information on using the newer medical treatment approaches in combination. This study was designed to determine whether topical eflornithine can enhance the efficacy of laser hair removal. This was a randomized, double-blind, placebo-controlled, right-left comparison study of eflornithine cream combined with laser treatment versus laser alone for treating unwanted hair on the upper lip in women. All subjects underwent treatment to the entire upper lip with a long pulse alexandrite laser (10-40 ms pulse duration) at fluences of 7 to 40 J/cm(2). Laser treatments were performed every 4 weeks for up to 6 sessions. Each patient also applied either eflornithine or placebo cream twice daily to each side of the upper lip in a double-blinded manner. Subjects were evaluated for safety by recording adverse events and for efficacy via (1) investigator global scoring, (2) patient self assessment, and (3) hair count analysis. Both treatment modalities were well tolerated by the 31 evaluable patients. All 3 outcome measures showed significantly better results in favor of eflornithine plus laser versus laser treatment alone. At the end of the study, complete or almost complete hair removal was achieved in 29 of 31 (93.5%) of the eflornithine-laser-treated sites versus 21 of 31 (67.9%) for the placebo cream-laser-treated sites (P = .021, McNemar test). Statistically significant differences in favor of eflornithine were likewise demonstrated at the final assessment through blinded patient grading (13/31 patients [41.9%] thought that the eflornithine was superior to placebo, P = .029, Poisson regression) and hair count analysis (P < .01, paired t test). This is a single-center study that did not determine whether the differences noted above last beyond 6 months. On the basis of both investigator and patient assessments and hair count analysis, we have demonstrated that the addition of eflornithine to laser hair removal results in a more rapid and complete reduction of unwanted facial hair in women when the combination is used for up to 6 months.

Vascular lasers and IPLS: Guidelines for care from the European Society for Laser Dermatology (ESLD)

Dermatology and dermatologic surgery have rapidly evolved during the last two decades thanks to the numerous technological and scientific acquisitions focused on improved precision in the diagnosis and treatment of skin alterations. Given the proliferation of new devices for the treatment of vascular lesions, we have considerably changed our treatment approach. Lasers and non‐coherent intense pulse light sources (IPLS) are based on the principle of selective photothermolysis and can be used for the treatment of many vascular skin lesions. A variety of lasers has recently been developed for the treatment of congenital and acquired vascular lesions which incorporate these concepts into their design. The list is a long one and includes pulsed dye (FPDL, APDL) lasers (577 nm, 585 nm and 595 nm), KTP lasers (532 nm), long pulsed alexandrite lasers (755 nm), pulsed diode lasers (in the range of 800 to 900 nm), long pulsed 1064 Nd:YAG lasers and intense pulsed light sources (IPLS, also called flash‐lights or pulsed light sources). Several vascular lasers (such as argon, tunable dye, copper vapour, krypton lasers) which were used in the past are no longer useful as they pose a higher risk of complications such as dyschromia (hypopigmentation or hyperpigmentation) and scarring. By properly selecting the wavelength which is maximally absorbed by the target – also called the chromophore (haemoglobin in the red blood cells within the vessels) – and a corresponding pulse duration which is shorter than the thermal relaxation time of that target, the target can be preferentially injured without transferring significant amounts of energy to surrounding tissues (epidermis and surrounding dermal tissue). Larger structures require more time for sufficient heat absorption. Therefore, a longer laser‐pulse duration has to be used. In addition, more deeply situated vessels require the use of longer laser wavelengths (in the infrared range) which can penetrate deeper into the skin. Although laser and light sources are very popular due to their non‐invading nature, caution should be considered by practitioners and patients to avoid permanent side effects. These guidelines focus on patient selection and treatment protocol in order to provide safe and effective treatment. Physicians should always make the indication for the treatment and are responsible for setting the machine for each individual patient and each individual treatment. The type of laser or IPLS and their specific parameters must be adapted to the indication (such as the vessel's characteristics, e.g. diameter, colour and depth, the Fitzpatrick skin type). Treatments should start on a test patch and a treatment grid can improve accuracy. Cooling as well as a reduction of the fluence will prevent adverse effects such as pigment alteration and scar formation. A different number of repeated treatments should be done to achieve complete results of different vascular conditions. Sunscreen use before and after treatment will produce and maintain untanned skin. Individuals with dark skin, and especially tanned patients, are at higher risk for pigmentary changes and scars after the laser or IPLS treatment.