http://www.lasercertification.org/Libra ... July05.pdf
§ Dermal/Subcutaneous Fat Interface
– below Dermis
§ separates the reticular dermis from underlying subcutaneous tissues. Ablating past this level in
ablative resurfacing, or lethally heating it in laser hair removal or other procedures, causes a third
degree burn and possible keloid scars since the dermis cannot regenerate.
§ Everything below the dermis. Includes subcutaneous fat and is the source of blood
vessels & nerves entering the dermis. Destroying skin to this level will create a third
Fitzpatrick Skin Types I-VI
§ The higher the number, generally the darker the skin, but is primarily an indication of
how one burns in the sun. The darker the skin, the harder it is to treat by laser without
§ This scale is the primary determinant of choice of laser type and settings for laser hair
§ Darker skin types generally require longer wavelengths (and pulse widths) to prevent
skin burning (i.e. diode or Nd:Yag lasers)
§ Higher Fluences from laser pulses result in less thermal spread (better
thermal precision) from the intended target when used in thermal applications
such as skin resurfacing, hair removal, removal of surface vascular marks,
fine incisions, etc.
§ Excessive Heating of Skin
§ Developing strategies to prevent or control excessive skin heating is critical to all
dermatological laser procedures.
§ Blistering can potentially lead to infections.
§ Scarring, including Keloids, or hypo or hyperpigmentation can also result.