| Category Name | Content |
| Name | Non-Ablative Laser |
| Uses | Fractional or full-field laser treatment designed to improve skin tone, texture, fine lines, pigmentation, and mild scarring without damaging the outer skin layer. |
| Route Of Administration | External laser application delivering controlled heat to the dermis while preserving the epidermis. |
| Frequency Of Use | Typically performed every 4-6 weeks for an initial series of 3-5 treatments; maintenance every 6-12 months as needed. |
| Concentration(s) | Common non-ablative laser wavelengths: - **Fractional 1550 nm (Erbium Glass)**: Collagen stimulation, fine lines, acne scars - **1927 nm (Thulium Laser)**: Pigment reduction, sun damage, melasma - **1064 nm Nd:YAG**: Skin tightening, vascular lesions, deeper penetration |
| Maximum Dosage (Day, Wk) | One treatment per session, using manufacturer-recommended fluence, pulse duration, and density settings to ensure patient safety. |
| Contraindications | Pregnancy, active acne or rosacea flares, history of keloid scarring, use of isotretinoin within the last 6 months, active infections (herpes simplex, bacterial, or fungal), history of poor wound healing, uncontrolled diabetes, recent sunburn, or skin cancer in the treatment area. |
| Possible Side Effects | Mild redness, swelling, transient heat sensation, dryness, mild peeling, rare risk of post-inflammatory hyperpigmentation (PIH) in darker skin tones, or temporary increased skin sensitivity. |
| Compatibility With Other Treatments/Drugs | Avoid combining with deep chemical peels or microneedling within 4 weeks. Safe to combine with LED therapy, PRP, and post-procedure hydrating treatments. |
| Allergies | Assess for hypersensitivity to topical numbing agents, post-procedure serums, or laser cooling gels. |
| Administration Time | 30-60 minutes per session, depending on treatment area and laser settings. |
| Dosing/Settings | Customized based on patient skin type and concerns: - **Fluence (Energy Density)**: 10-40 mJ/cm² - **Pulse Duration**: 0.5-10 ms - **Spot Size**: 3-15 mm - **Density**: 5-30% (fractional lasers) |
| Test Spot Requirement | Required for Fitzpatrick III-VI and patients with a history of post-inflammatory hyperpigmentation. Perform a test spot 48 hours before full treatment. |
| Pre-Treatment Guidelines | - Avoid sun exposure, self-tanners, and tanning beds for 4 weeks before treatment. - Discontinue retinoids, AHAs, BHAs, and other exfoliating agents 5-7 days before treatment. - Patients with a history of herpes simplex (cold sores) should start antiviral prophylaxis (e.g., valacyclovir 500 mg BID x 5 days). - Ensure skin is clean and free of makeup, lotions, or sunscreen before treatment. |
| Provider Clearance Guidelines | - Ensure the patient meets all clearance criteria before treatment. - Consult a physician for any borderline cases (e.g., history of scarring, active inflammation, or uncontrolled medical conditions). - Document physician approval when required. |
| Pre-Treatment Screening Workflow | - Has the patient used isotretinoin in the last 6 months? (If YES, contraindicated) - Does the patient have a history of keloids? (If YES, proceed with caution & document risk counseling) - Is the patient currently on photosensitizing medication? (If YES, delay treatment until discontinued) - Has the patient recently had a deep resurfacing treatment? (If YES, delay until fully healed) |
| What To Do If Adverse Reaction Occurs | - **Blistering/Burns**: Stop treatment immediately, apply a cool compress, and document the area. Use topical antibiotics and consider short-term corticosteroids. - **Hyperpigmentation**: Initiate hydroquinone 4% BID and enforce strict sun avoidance. - **Infection**: If suspected, swab for culture and initiate empirical antibiotic therapy (e.g., mupirocin topical, oral cephalexin if needed). - **Severe Pain or Prolonged Redness (>4 weeks)**: Consider short-term topical steroid use (hydrocortisone 1% cream BID x 5 days). |
| Clinic Implementation Guidelines | - Confirm all consents are signed before treatment. - Ensure protective eyewear for provider and patient is in place. - Set up cooling gel and post-procedure skincare products before treatment begins. - Conduct post-treatment follow-up within 24-48 hours. |
| Photographic Documentation Protocol | - Take pre-treatment photos from 3 standardized angles (front, left, right). - Take post-treatment photos immediately after the procedure and at the 2-week follow-up. - Store images securely in the patient’s medical record. |
| Post-Treatment Care | - Apply a soothing gel or cooling mask immediately post-treatment. - Avoid direct sun exposure for at least 4 weeks post-treatment; use SPF 50+ daily. - Avoid retinoids and exfoliating products for at least 7 days post-treatment. - Redness and mild swelling may persist for up to 48 hours. |
| Additional Documentation Requirements | - Signed informed consent explaining risks and expected outcomes. - Fitzpatrick skin type assessment. - Treatment log including settings used, areas treated, and patient response. - Post-treatment care instructions provided to the patient and documented. |