Author: Anoma Ranaweera B.V.Sc; PhD (Clinical Biochemistry, University of Liverpool, UK); Copy Editor Clare Morrison, June 2014. Updated by Dr Todd Gunson, Dermatologist, Auckland, New Zealand. July 2014.
LASERs (light amplification by stimulated emission of radiation) are sources of high-intensity monochromatic (single wave length) coherent light that can be used for the treatment of various dermatologic conditions. How they are used depends on the wavelength, pulse characteristics, and fluence (energy output) of the laser being used, and the nature of the condition being treated.
Various kinds of lasers are available; they are differentiated by the medium that produces the laser beam. Each of the different types of lasers has a specific range of utility, depending on its wavelength and penetration.
A ruby laser is a solid-state laser that uses a synthetic ruby crystal as its laser medium. The active laser medium (laser gain/amplification medium) is a synthetic ruby rod that is energised through optical pumping (typically by a xenon flashtube).
The wavelength of a laser is measured in namometres (nm). Ruby lasers produce pulses of visible light of a deep red colour, at a wavelength of 694.3 nm. Typical ruby laser pulse lengths are of the order of a millisecond.
The following skin disorders may be treated with ruby laser beams.
Melasma is an acquired pigmentary disorder characterised by brownish hyperpigmented macules that usually appear on the face. The role of ruby laser in melasma treatment is controversial, as studies showing conflicting results. However, at least one study has shown that 6 sessions of low-dose fractional QSRL (694 nm) treatment at 2-week intervals with fluence of 2-3 J/cm2 and pulse duration of 40 nanoseconds is effective in the treatment of patients with melasma.
It is important that the correct diagnosis has been made by the clinician prior to treatment, particularly when pigmented lesions are targeted to avoid mistreatment of skin cancer such as melanoma. The patient should wear eye protection consisting of an opaque covering or goggles throughout the treatment session.
Side effects from ruby laser treatment are usually minor and may include:
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