Q-Switched lasers remain one of the most widely used technologies for pigment removal, tattoo removal, and overall skin rejuvenation. Because of their strong selective action on pigment and their ultra-short pulse width, they are considered a safe and effective choice for both medical and aesthetic clinics.
This guide explains the physics, wavelength functions, treatment indications, skin analysis, התוויות נגד, treatment steps, after-care, ו common issues—all in one place.
1. How Q-Switched Pico Laser Works (Mechanism Explained)
1.1 Selective Photothermal & Photoacoustic Effects
The main working mechanisms of Q-switched lasers are אפקט פוטותרמי סלקטיבי ו selective photoacoustic effect.
- Selective photothermal effect. Selective effect means that different target chromophores in the skin (such as melanin, hemoglobin, or tattoo pigment) absorb specific laser wavelengths more strongly than the surrounding tissue. Convert it to heat, and fragment the pigment.
- Selective photoacoustic effect
ה photothermal or photoacoustic effect depends on the relationship between the thermal relaxation time of the target וה- laser pulse duration, leading to the conversion of light energy into heat and mechanical (shockwave) energy.
A Q-switched laser uses Q-switch technology to compress laser energy into an extremely short time and release it as a high-energy pulse.
You can imagine changing a continuous stream of water into a series of powerful “water bullets” – this gives stronger impact on the target pigment that absorbs that wavelength.
Pulses longer than 1 μs = thermal effect dominant
Pulses shorter than 1 μs = photoacoustic effect dominant (Q-Switch mode)
This ensures pigment is shattered while surrounding tissues remain protected.
2. Q-Switched Pico Laser Wavelengths & Their Targets
The Q-switched laser treatment system is designed based on the principle of “selective photothermal absorption.”
The device emits giant pulses at 1064 nm and 532 nm, which can be selectively absorbed by melanin ו hemoglobin.
Under high-energy laser impact:
- Pigment rapidly expands
- Is “blasted” into tiny fragments
- These fragments are then cleared from the body
Other skin tissues absorb very little of these wavelengths, so surrounding structures are largely spared.
🔵 1064 nm — Deep Penetration
- Reaches the עוֹר
- יעדים black, blue pigment
- משמש ל:
- Deep dermal pigmentation (Ota nevus, ABNOM)
- Dark tattoos
- Carbon laser (black doll treatment)
- Melanin regulation & חידוש העור
🟢 532 nm — Superficial Layer
- Stays in the epidermis
- יעדים red, yellow, brown pigments
- משמש ל:
- Freckles
- Sun spots
- Seborrheic keratosis (early)
- Red tattoos
- Café-au-lait spots (partial response)
Q-Switch technology compresses energy into ultra-short pulses, like “micro-explosions” that shatter pigment while minimizing heat diffusion. This increases precision and reduces side effects.
3. Pigment Removal Principle
Laser energy:
- Hits pigment particles
- Causes rapid expansion & fragmentation
- Breaks them into micro-particles
- Some are expelled through the epidermis
- Others are consumed by macrophages and removed via the lymphatic system
This creates a gradual and safe pigment-clearing effect.
4. Skin Rejuvenation Mechanism (Black Doll & White Doll)
4.1 Black Doll (Carbon Laser Facial)
1064 ננומטר can blast and remove blackheads and oxidized debris on the skin surface.
Its thermal effect improves sebaceous gland function and promotes collagen contraction, resulting in firmer, younger-looking skin. By applying carbon powder (with small particles and hard texture) and using the principle of selective light absorption
- Carbon powder absorbs 1064 nm energy
- Laser explosion removes:
- Oxidized sebum
- Blackheads
- Surface keratin
- Heat penetrates the dermis, stimulating:
- Collagen remodeling
- Sebaceous gland regulation
- Skin brightness & pore tightening
4.2 White Doll (Porcelain Laser Rejuvenation)
- 1064 nm stimulates the dermis directly
- Promotes:
- Collagen regeneration
- Elastic fiber activation
- Skin brightening
- Even skin tone
- Tightened pores
No downtime, minimal discomfort.
5. Skin Analysis: Understanding Melanin
Melanin is the fundamental pigment of the skin. It determines the depth of skin color and is the main factor involved in various pigmentary disorders.
Melanocytes are located in the basal layer of the epidermis. These dendritic cells produce melanin granules, which can absorb ultraviolet radiation and prevent UV from penetrating deeper into the skin.
Melanin is formed through a chemical reaction involving tyrosinase. When melanin production exceeds the skin’s natural metabolic clearance, pigmentation and visible spots will appear.
Factors increasing melanin:
- UV exposure
- Hormones
- Inflammation
- Genetics
- Aging
Understanding melanin behavior helps clinics choose the correct wavelength and treatment settings.
6. Clinical Indications (What Q-Switched Laser Treats)
6.1 Freckles
Appearance:
Freckles present as light-yellow to brown macules. They may be round, oval, or irregular in shape. Lesions appear on sun-exposed areas such as the nose, cheeks, shoulders, neck, and the backs of the hands. They are usually small—ranging from pinhead size to larger—and may be scattered or clustered, but do not merge.
Onset & seasonality:
Freckles commonly appear between ages 6–7 and gradually increase with age. They become more prominent during puberty.
They darken in summer due to UV exposure and fade in winter, but rarely disappear completely.
Cause:
Freckles follow autosomal dominant inheritance. Many individuals across generations may develop freckles in similar facial areas.
6.2 Age Spots
Seborrheic keratosis (SK), also known as age spots or basal cell papilloma, is one of the most common benign skin tumors.
Characteristics:
- Typically occurs after age 40
- Common on the scalp, face, trunk, arms, and the backs of the hands
- Does not occur on palms or soles
- Starts as flat, light-brown lesions that gradually thicken
- Surface may become waxy or warty
- Lesions range from 1–10 mm; some may reach several centimeters
- Color varies widely from skin-colored to deep brown or black
- Greasy crust may form and can be scraped off easily
- Usually multiple, slow-growing, and asymptomatic (sometimes mildly itchy)
- Extremely low risk of malignant transformation
6.3 Sun Spots
Also known as actinic lentigines or senile lentigines, sun spots are early forms of seborrheic keratosis.
Cause:
- Chronic UV exposure
- Skin aging
Appearance:
Multiple light-brown patches, ranging from millimeters to centimeters. Color may vary from light to dark brown.
Sun spots occur on all sun-exposed areas:
- פָּנִים
- עוֹרֶף
- נֶשֶׁק
- Back of hands
- רגליים
- בְּחֲזָרָה
Individuals with UV-sensitive skin are particularly prone to developing them.
6.4 Café-au-Lait Spots
Also called milk-coffee spots, they appear as light to dark brown patches with well-defined borders. Edges can be smooth or irregular.
Characteristics:
- Vary greatly in size and shape
- Uniform pigmentation
- Can occur anywhere on the body
- May be associated with systemic conditions such as neurofibromatosis or tuberous sclerosis
- Genetic testing may be recommended when multiple or large lesions are present
Treatment Outlook:
Some lesions show good improvement after 1–4 laser sessions, but recurrence is common—up to 50% may reappear within 1 year.
Long-term, repeated treatment over months or years is usually required.
6.5 מלזמה
Also known as the “butterfly mask” or “pregnancy mask,” melasma primarily affects women after puberty.
Appearance:
Symmetrical patches of brown pigmentation on sun-exposed areas:
- לחיים
- אַף
- שפה עליונה
- מֵצַח
Causes:
- UV exposure
- Hormonal fluctuations (pregnancy, oral contraceptives)
- Genetic predisposition
Characteristics:
- Darker in summer, lighter in winter
- Easily worsened by sun exposure
- One of the most challenging pigmentation conditions to treat
הערה חשובה:
Light-based devices and lasers are not recommended as first-line treatments because they may trigger post-inflammatory hyperpigmentation (PIH) or worsen melasma, especially during the active phase.
Melasma: Active vs. Stable Phases
Active Phase (within 3 months)
- Area expanding
- Color deepening
- Redness present
- Scratching induces redness
- Glass-slide pressure test shows fading (vascular involvement)
Stable Phase
- No significant changes in 3 months
- No redness or expansion
- Glass-slide test shows minimal or no fading
Melasma Types
- Pigment type (M-type)
- No fading with pressure test
- High contrast under Wood’s lamp
- Pigment + vascular type (M+V type)
- Partial fading with pressure
- Contrast not obvious under Wood’s lamp
Recent studies suggest that impaired skin barrier and reduced lipid synthesis allow melanocytes to migrate upward, leading to persistent surface pigmentation.
Key takeaway:
Melasma patients must avoid laser treatments during the active phase to prevent worsening.
6.6 Hori’s Nevus (Acquired Bilateral Nevus of Ota-like Macules)
Characteristics:
- Appears in adulthood (commonly after age 20)
- Mostly affects women
- Typically located on:
- Cheekbones
- Lower eyelid area
- מֵצַח
- Outer eye corners
- Nasal wings
- Usually bilateral and symmetrical
- Gray-brown, gray-blue, or dark brown dots
- 10–20 lesions on average
- No mucosal involvement
- No symptoms
Histology:
Increased spindle-shaped melanocytes in the upper dermis, aligned along collagen fibers.
Also called oculodermal melanocytosis. First described in 1938.
Characteristics:
- Gray-blue or gray-brown discoloration
- Located along the ophthalmic and maxillary branches of the trigeminal nerve
- Unilateral in most cases
- More common in Asian and dark-skinned individuals
- Female predominance
- Onset peaks: infancy and puberty
- May involve scleral pigmentation
Important Medical Note:
אוֹדוֹת 10% of patients have elevated intraocular pressure and may be associated with glaucoma.
Eye examination is strongly recommended.
6.8 Post-Inflammatory Hyperpigmentation (PIH)
PIH occurs after acute or chronic skin inflammation.
Inflammation enhances tyrosinase activity, increasing melanin production.
Why PIH happens after laser treatments:
Although lasers aim to lighten pigmentation, the heat or shockwave may stimulate melanocytes, leading to temporary darkening.
This is commonly referred to as “laser rebound pigmentation.”
6.9 Tattoo, Eyebrow, and Eyeliner Pigments
Tattoo pigments vary widely:
שָׁחוֹר & Grey
- Carbon-based pigments
- Iron oxides
- Easiest to remove with 1064 nm
אָדוֹם
- Often contains iron oxide or copper pigments
- May darken temporarily after treatment
Blue & Green
- Usually copper phthalocyanine
- Hardest to remove
- Requires multiple sessions
Yellow & Orange
Orange may include various organic dyes
Yellow pigments often contain chromium compounds
6.10 Carbon Laser Facial (Black Doll) & White Doll Laser Facial
Black Doll (Carbon Laser Facial)
- Nano-carbon powder applied to the skin absorbs 1064 nm energy
- Laser explosion removes surface keratin, oil, blackheads
- Heat penetrates the dermis to:
- Stimulate collagen
- Improve pores
- Brighten skin
- Regulate oil production
- Minimal discomfort, no downtime
White Doll (Porcelain Laser Rejuvenation)
- Laser penetrates the epidermis to reach the dermis
- Breaks melanin into fine particles
- Stimulates cell renewal and collagen production
- Results in:
- הלבנת עור & brightening
- הידוק נקבוביות
- יציבה & הֲרָמָה
- Improved texture
7. התוויות נגד
Q-Switched laser treatment should NOT be performed on the following individuals:
7.1. Photosensitive individuals or those taking photosensitizing medications
Including but not limited to:
- Tetracyclines
- Sulfonamides
- Antidepressants
- Diuretics
- Hypoglycemic medications
- Anti-inflammatory pain medications
- Hormonal medications (estrogen, etc.)
7.2. Recent use of peeling or resurfacing products
- Use of isotretinoin (Accutane) within the past 6 חודשים
- Use of AHA/BHA chemical peels or other exfoliating agents within recent months
- Use of strong whitening or peeling products within the past 3 months
7.3. Active skin infections or open wounds
- Active herpes simplex outbreak
- Large areas of broken skin at the treatment site
7.4. Implanted electronic medical devices
- Pacemaker
- Implanted defibrillator
7.5. Patients taking anticoagulants
Treatment is contraindicated unless anticoagulants are discontinued for at least 2 weeks, under physician guidance.
Common anticoagulants include:
- EDTA
- Oxalates
- Heparin
- Citrates
7.6. Specific health conditions
Laser treatment should not be performed on individuals who are:
- Pregnant or breastfeeding
- Suffering from severe diabetes
- Uncontrolled hypertension
- Epilepsy
- Active keloid or hypertrophic scar disorder
- Infectious skin diseases in the treatment area
7.7. Recent or upcoming heavy sun exposure
Those who have recently been sunburned or who plan to undergo intense sun exposure should postpone treatment.
8. Q-Switched Laser Treatment Procedure (Professional Workflow)
Select the Correct Treatment Mode
Choosing the proper wavelength is essential for safe and effective Q-Switched laser treatment.
Different pigments absorb different wavelengths, so the operator must match the wavelength to the target chromophore.
Use the 1064 nm Handpiece for:
- Pigment management (deep or dermal lesions)
- Eyebrow color correction (dark/blue/gray)
- Eyebrow shape modification
- Eyeliner removal
- Tattoo removal (gray, black, blue, cyan/greenish-blue pigments)
Reason:
1064 nm penetrates deeper into the dermis and is strongly absorbed by black and blue pigment.
Use the 532 nm Handpiece for:
- Eyebrow color correction (red/brown tones)
- Eyebrow shape modification
- Eyeliner removal (red or warm-toned pigments)
- Tattoo removal of red, brown, or multicolored pigments
- Age spots (solar lentigines)
- Café-au-lait macules (partial response)
Reason:
532 nm targets red, yellow, and brown colors and acts mainly on the superficial epidermal layer.
9. Laser Treatment Parameter Guide for Q-Switched Pico Laser
The following pico laser parameters serve as standard clinical reference values for Q-Switched laser treatments. Because every patient’s skin response is different, settings must always be customized based on skin type, pigment depth, device output, and the practitioner’s experience to ensure optimal safety and efficacy.
| מַצָב | אֹרֶך גַל (nm) | אֵנֶרְגִיָה (J/cm²) | תֶדֶר (Hz) | גודל נקודה (mm) | Sessions per Treatment | Reaction | Recovery Period / Notes |
| Freckles / Melasma / Yellow-brown Pigmentation | 1064 / 785 | 0.6–1.8 | 3–6 | 7–10 | Full face: 2–4 times | Mild redness | 14–28 days Redness is normal. Cooling or repair masks recommended. Avoid sun exposure. |
| Café-au-lait Spots | 1064 / 785 / 532 | 0.4–1.0 | 1–4 | 2–5 | Local: 1–2 times | Scab formation, mild bleeding | Around 28 days Avoid water for 6–8 hours. Prevent infection. Use repair products. |
| Sun Spots | 1064 / 785 | 0.4–1.0 | 1–4 | 2–5 | Local: 1 time | Scab formation | Around 28 days Avoid water 6–8 hours. Prevent infection. Apply repair products. |
| Age Spots (Senile Lentigo) | 532 | 0.35–0.6 | 1 | 1 | Local: 1 time | Scab formation | Around 28 days Avoid water 6–8 hours. Apply repair products accordingly. |
| Chloasma (Melasma) | 1064 / 785 | 0.6–0.8 | 1–2 | 7–10 | Full face: 1–2 times | Delayed response (invisible redness) | 30–45 days Mild redness may appear later. Cooling, gentle skincare. Adjust hormones if needed. |
| Nevus of Ota | 1064 / 785 | 0.5–1.5 | 1–4 | 2–5 | Local: 1 time | Scab formation, mild bleeding | 45–90 days Avoid water 6–8 hours. Prevent infection. Use repair products. |
| הסרת קעקועים | 1064 / 785 / 532 | 0.2–0.8 | 1–6 | 3–10 | Local: 1–3 times | Scab formation, mild bleeding | 28–90 days Use certified device. Avoid water 6–8 hours. Prevent infection. Apply repair products. |
9.1. Pre-Treatment
- Clean the skin
- Take standardized photos
- Both operator and client wear protective goggles
- Select the correct wavelength (1064 or 532 nm)
9.2. Parameter Selection
- אֹרֶך גַל
- גודל ספוט
- תֶדֶר
- Energy (start low, adjust gradually)
9.3. Treatment Technique
- Keep the handpiece 90° perpendicular to skin
- Overlap light spots slightly
- Observe skin endpoint:
- Whitening (“frosting”)
- Mild erythema
- Ask client feedback constantly
- Adjust settings accordingly
9.4. Immediate Post-Care
- Ice compress
- Apply EGF or calming repair product
- Avoid sun exposure
10. Emergency Management
Overheating / Thermal Accumulation
- Ice packs immediately
- Apply burn ointment
- Avoid rupturing blisters
Bleeding
- Use compression to stop bleeding
Tattoo Hyperthermia
- Ice during treatment
- Extend interval between passes
11. Post-Treatment Home Care
- Ice compress immediately for 30–60 minutes
- Keep area clean and dry
- Avoid water for 7 days
- Do NOT pick scabs
- Use high-SPF sunscreen every day
- Oral Vitamin C (optional)
- Repair products:
- Tranexamic acid
- Vitamin C serum
- Medical repair masks
- Avoid:
- Alcohol
- Spicy food
- Sauna / hot yoga
- Strenuous exercise
- Treatment intervals:
- 2–3 sessions, spaced 3–6 months
- Cosmetic tattoo discoloration may require more sessions
12. Frequently Asked Questions (FAQ)
1. Does the treatment hurt?
Mild stinging sensation, tolerable, usually no anesthesia needed.
2. Will it leave scars?
Q-Switched lasers target only pigment; scar risk is extremely low when operated correctly.
3. Can I work after treatment?
Yes. Mild redness or scabbing may appear but daily activities are unaffected.
4. Why does skin sometimes darken after treatment?
This is post-inflammatory hyperpigmentation (PIH) אוֹ rebound pigmentation.
It occurs when:
- Pigment is deeply embedded and moves upward
- Past use of steroid/lead-mercury whitening creams
- Skin barrier is damaged
- Excess sun exposure
Solution: Continue correct treatments; allow pigment to gradually metabolize.
5. Can freckles be permanently removed?
Yes. Freckles are genetically based epidermal pigment, and once removed, they usually do not return unless heavily sun-exposed again.
13. Summary
Q-Switched laser is a versatile, powerful, and precise tool for pigmentation removal, tattoo removal, and skin rejuvenation. When operated correctly, it offers:
- High selectivity
- זמן השבתה מינימלי
- Low risk of scarring
- Wide treatment range
Combined with proper patient selection, after-care, and sun protection, Q-Switched lasers deliver long-lasting results.
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