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Fractional Q switch ND:Yag laser


Fractional Q Switch ND YAG Laser


Laser stands for ‘light amplification by stimulated emission of radiation’. 

Dermatologists use lasers for various procedures. They work by emitting high-intensity radio-frequency waves. These penetrate the uppermost layer of the skin. These light waves are absorbed into the skin. 

The energy in the waves destroys the tissue by heating it. As a result, it encourages new cells to replace the damaged cells. It stimulates new collagen formation; thereby producing new skin that is clear and smooth. 

Q switch ND-YAG laser is one of the most commonly used lasers. 

Lasers can treat:

  • Melasma
  • Freckles
  • Post-inflammatory hyperpigmentation 
  • Acne
  • Erythema
  • Post-traumatic inflammation 
  • Enlarged pores
  • Seborrheic keratosis
  • Cafe-au-lait spots
  • Nevus 
  • Tattoo removal 

However, laser treatment is contraindicated in conditions such as:

  • Pregnancy 
  • Active skin infections – bacterial, fungal, or viral such as herpes simplex 
  • Active skin conditions such as psoriasis, eczema, skin cancer
  • History of keloid scarring
  • Allergic response to topical anaesthesia, antibiotics, or other medications
  • Seizure disorder caused by bright light
  • History of drug abuse
  • Patients who have unrealistic expectations regarding the outcome of the treatment 
  • Patients who are unable or unwilling to follow post-treatment guidelines 


  • During the consultation, your doctor will first provide you with detailed information of the nature of your problem and your treatment options.
  • Secondly, he will explain the risks, benefits, possible complications and expected outcomes of those treatments. 
  • Thirdly, he will take your detailed medical history and rule out any contraindications. 
  • Lastly and most importantly, he will discuss your treatment requests, the anaesthetic requirements and the likely treatment costs.

How does the procedure work? 


  • Your doctor will explain the procedure to you step-by-step. 
  • He will address all your concerns. 
  • Subsequently, he will take your written consent for the procedure. 
  • Before the procedure, make sure to wash your face and clean away all makeup. 
  • You will be made to wear an eye shield to protect your eyes from the laser beams. 
  • Before starting the actual procedure, your doctor will first evaluate your response to “test spots”. He will wait for an appropriate period of time, during which he will observe the reaction of your skin. 
  • This helps to determine the treatment parameters, which take into account the patient’s skin type, tolerance of discomfort, potential allergic reactions and the efficiency of the treatment. 
  • Above all, they ensure that they provide the desired results but minimise negative effects. 
  • Your doctor will check that all equipment being used is sterilised. Likewise, he will be dressed in sterilised gloves and mask. 
  • Thereafter, your doctor will properly clean the treatment area and apply local anaesthesia to it. 
  • Depending on the results of the test spots, your doctor will adjust the treatment parameters accordingly. 
  • You may experience minor pain and burning sensation and that is normal. 
  • You doctor will use a cooling pad or chilled air before, during, and after the procedure to reduce discomfort and post-treatment redness and swelling. 
  • In case you experience excessive pain, he will discontinue the procedure and reevaluate. 

Post-procedure care:

  • Your doctor will put a dressing on the treatment area to avoid infection until crust formation. Leave it on for at least 24 hours.
  • Similarly, avoid contact with water on the day of treatment. Keep it clean and dry. 
  • After that, you can wash it with water and a mild cleanser. 
  • Avoid friction of any kind over the treated area, so don’t rub over it, touch it frequently, or wear tight clothing. 
  • A crust will form over the treatment area, as it is a part of the healing process. As a result, you must avoid picking or peeling off the crust yourself. 
  • Apply antibacterial cream twice a day until the crust falls off. 
  • It will naturally fall off within 5-7 days.
  • Your doctor may prescribe anti-inflammatory medications and antibiotics to reduce pain, swelling, and the chances of infection. 
  • Avoid cosmetic products containing retinoids for 3 days, and those containing alcohol for a week. 
  • Don’t use any exfoliating or peeling treatments for at least a week after treatment. 
  • Apply moisturiser twice a day to hydrate and moisturise your skin.  Similarly, hydrate your body by drinking plenty of water. It helps facilitate healing. 
  • Avoid direct sun exposure and apply a broad-spectrum sunscreen with an SPF of 30. 
  • Meanwhile, avoid hot baths, steam baths, saunas, and swimming in strongly chlorinated water. 
  • Likewise, avoid vigorous activities, smoking, and alcohol consumption. 
  • Above all, leave any skin responses alone. They are typically temporary and will subside. 

To sum up, each treatment session will last for about 30-45 minutes. 

Moreover, it’s important to know that the effectiveness of the treatment is related to different factors. Such as:

  • Your skin colour
  • Skin type

In fact, you will require multiple treatment sessions at an interval of 3-8 weeks, depending on your indication for treatment.

Accordingly, the number of treatment sessions also varies. However, most patients require 4-5 sessions on an average. 

Consequently, some patients will receive excellent results. 

On the other hand, a few patients may receive minimal benefit from laser treatment. 

However, most patients will fall between these extremes. 

In short, it is important to understand that a range of results is possible. In fact, it is difficult to predict the clinical outcome of the procedure until treatment starts. 

Possible Complications

You should be aware of the risk of possible complications of laser treatment:

  • Pigmentary Changes

Transient Hypopigmentation: In most patients, the treated area loses pigmentation and becomes lighter in colour. This is temporary and may last up to 4 weeks.

Hyperpigmentation: There is some risk of increased pigmentation as a healing reaction. This is a very rare reaction with Nd: YAG lasers. However, if it occurs, it may last up to 3 to 6 months. 

Doctors advise you to use sunscreen and medicated creams before and after the procedure. This can help prevent and reduce it. 

  • Allergic Reaction

Allergic reactions to tattoo pigments after Q-switched laser treatment are also possible. In such cases, the procedure is contraindicated. 

  • Textural Changes

Your doctor will note and monitor for transient textural changes. However, they usually resolve within 1 to 2 months. Therefore, they are rarely permanent. 

Consequently, longer treatment intervals are recommended if you are prone to textural or pigmentary changes. 

  • Persistent tattoos or pigmentation

In most cases, laser treatment provides positive results. However, at times some tattoo particles are located deep in the skin. Hence they may not be totally removed, even with repeated treatments. 

As a result, these tattoos cannot normally be treated with a laser, or many repeated treatments may be needed to remove them. 

Similarly, some pigmentary lesions, such as melasma, may also return after treatment. 

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