From the mouths of experts:
No one form of treatment exists that effectively treats all vascular lesions. And not everyone even agrees on the best treatment modality for specific lesion type. The following are some helpful tips to keep in mind when treating patients for vascular lesions. Have respect for 1064 nm and take the minimalist approach. It really can cook the tissue, so to look for these endpoints as we do with the PDL is dangerous because once you’ve reached that endpoint many times it’s already too late for the patient. It’s a wonderful tool, but it’s also dangerous.
Commonalities between PDL and Nd:YAG. You can use the Nd:YAG clinically like a PDL. Your endpoint is purpura. Without adequate cooking, you have epidermal damage because when you have graying it’s too much. Many practitioners have not experienced
ulceration with the Nd:YAG and are therefore comfortable using it on infants. And you use it just as you would a PDL (with the same endpoints), only for a different indication.