Nd:Yag laser; What’s the hype about it?

Nov 08, 12 Nd:Yag laser; What’s the hype about it?

Nd:Yag laser is one of the most commonly talked about laser, especially in our part of the world where pigmentary disorders are rampant. We read about it on the news, magazines, facebook and probably hear about this from friends and relatives. Many equate lasers with red swollen face, probably watery as well. This may repulse people from even considering lasers for their woes. Lets examine what Nd:Yag laser is about in this issue…

What is Q-switched Nd:Yag laser?

Laser is basically a type of light that carries only a specific wavelength, as opposed to visible light that carries a range of wavelength. Laser waves are parallel to each other and all waves move temporally in the same phase. Visible lights are not parallel and does not move temporally in the same phase. There are many lasers in the market. Nd:Yag laser is named after the laser medium,  Neodymium:yytrium-alumunium-garnet.

It comes in 2 wavelengths, 1064 nm and 532 nm. It is a non-ablative laser. This means that there is no break in skin tissue continuity during the treatment. It is designed to target pigment cells. This specific wavelength are absorbed preferentially by pigments (melanin) and the resultant heat will cause generation and propagation of waves that cause damage to the cells containing pigment. These damaged cells will then be cleared from the site resulting in lightening of the pigmented site.

When do we use Q-switched Nd:Yag laser?

Q-switched Nd:Yag laser are used mainly for pigmentary disorders resulting in darker patch/lesions. It can target both superficial and deeper skin pigmentation. However, not all lesions have good results with Q-switched Nd:Yag laser. Some pigmentary disorders work very well with Nd:Yag laser, e.g. solar lentigo,freckles, lentigines and etc while some produce variable results, i.e. Hori’s nevus and melasma. It is important to get the correct diagnosis at the start to ensure careful selection of treatment modalities. Of course, the machine as well as the operator (the doctor performing the laser) are also key to the results of the treatment.

Another major indication of Q-switched Nd:Yag laser is for tattoo removal. Amateur tattoo, those purely black tattoos seems to work better than multicoloured tattoos (professional tattoos). Black pigments work better compared to  other colours.

Apart from these, Q-switched Nd:Yag also produces rejuvenation effect and provides lightening of the skin, which is very much favoured by Asians.

How is the laser procedure?

Most of the patients are tolerable to the discomfort cause by the laser. Hence, there is usually no need for anaesthetic creams for this procedure.

Firstly, the skin is cleansed, eyes covered by protective googles followed by the laser therapy. You will expect mild discomfort/pain which is usually tolerable. The whole procedure will take about 15-30 minutes.

After the procedure, you may experience redness over the treated site which may last few hours. Most of the time, there is no swelling and most patients can return to work almost immediately.

Immediately post laser, you may or may not see lightening of the pigmentation. In fact, the pigmented spot may even darken for 1-2 weeks before getting lighter. However, the skin lightening and rejuvenation may be seen immediately post-laser. Do not expect dramatic result.

Is it an one-off treatment?

Most of the time, one treatment does not yield adequate results. Depending on the diagnosis, the number of treatment needed is variable. Repeat treatment is often scheduled 4-6 weeks later.

What are the potential complications of Q-switched Nd:Yag laser?

Every treatment comes with its own list of potential complications. The rate of complications may be lessen with good laser operator and good laser machines.

There may be temporary pigmentary changes i.e. darker or lighter than normal. Occasionally the lighter than normal spot may be permanent. Risk of scarring is low with pigmentary disorders and tends to be higher with tattoo treatment. Other potential complications include partial removal of the tattoo, infection, change of colour (especially with tattoos) and textural changes. Tattoo removal may sometimes even cause allergic reaction.


Always consult your physician, preferably a dermatologist for your pigmentary problems. A right diagnosis with the right machine and doctor makes a huge difference to the treatment outcome.

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