Hair Removal Guidelines (755nm)

DCD Spray/Delay/Post Spray

Spot Size (mm) Pulse Duration (ms) Fluence (J/cm2) Retreat Comments
Fitzpatrick Skin Type (ms)
8 30-40
10 26-35
I-II 12 26-36
(Caucasian red hair, 15 20-30
3
freckles, fair skin, blue 18 14-20
eyes) 20 11-16
22 9-13 Skin Type I-III
40/40/0
24 8-11
50/30/0
8 26-40 Test small area and wait several minutes to evaluate response prior to
50/40/0
10 16-30 treating entire area
12 18-30
III
15 16-26
(Darker Caucasian, light 3
18 10-16
Asian)
20 8-13
22 7-11
24 6-9
8 22-30
10 16-26
12 16-20
IV Facial: 4-6 weeks
15 10-20
(Mediterranean, Asian, 3 Trunk 6- 8 weeks
18 8-16
Hispanic) Leg: 10-12 weeks
20 7-13
22 5-11 40/30/0 Skin Type IV-VI and tanned skin
24 4-9 40/40/0
8 22-26 50/30/0 Pre-test with prescription strength hydroquinone for at least 2 weeks
10 16-20 50/40/0 prior to treatment. Test small area and wait 12 weeks prior to treating
V
entire area to evaluate tissue response. DCD may need to be adjusted
(Middle Eastern, 12 14-20
when altering fluence.
Hispanic, Asian, light 15 10-20
3
skinned African 18 6-16
Do not treat recently tanned skin
American, Indian, Native 20 5-13
American) 22 4-11 Allow tan to fade prior to treatment
24 3-9
8 22-26 Consider the 1064nm for hair removal treatment on Type V-VI skin
10 16-20 type.
12 10-20
VI 15 7-20 40/40/0
3
(Dark African American) 18 6-16 50/30/0
20 5-13
22 4-11
24 3-9

Vascular Lesions Guidelines (755nm)

DCD Spray/Delay/Post Spray
Spot Size (mm) Pulse Duration (ms) Fluence (J/cm2) Retreat Comments
Lesion/Skin Type (ms)

50/30/0 Pulse each area once. Endpoint is perivascular erythema, subtle edema
8 3 40-50
60/40/0 of vessel, or no vessel re-fill

Telangiectasia Face
4-6 weeks
Skin Types I-III
60-80 for diffuse Skin type I-II
redness Consider longer pulse duration within the recommended range for
6 20-60 50/20/0 larger vessels (0.4 to 1.6 mm). Adjust pulse duration and fluence for
80-90 for discrete desired endpoint: Vasoconstriction, Vasospasm and/or Darkening
vessels vessel contents

8 3 50-80

Consider longer pulse duration within recommended range for larger

Telangiectasia Legs vessels ( > 0.6 mm). Adjust pulse duration and fluence for desired
10-12 weeks
Skin Types I-III endpoint: Vasoconstriction, Vasospasm and/or Darkening vessel
contents

6 20-60 85-90 50/20/0

Hemangioma 8 3 60-70 90/80/0 3-4 weeks

40/40/0
Face: 8 weeks Transient greying of skin followed by purpura
Port Wine Stain 8 3 35-85 50/40/0
Extremities: 12 weeks
60/40/0
*DCD is an option. If DCD is not used another form of epidermal cooling should be used. Skin cooling reduces the rise in temperature in the epidermis, allows for higher tolerated fluences, and provides partial anaesthesia.
Cool compress or cold gel pack may be applied immediately before treatment to cool skin and after treatment to remove heat

Wrinkles Treatment Guidelines (755 nm)

DCD Spray/Delay/Post Spray
Skin Type Spot Size (mm) Pulse Duration (ms) Fluence (J/cm2) Retreat Comments
(ms)
40/40/0 May apply cold compress or cold gel packs immediately after
I-IV 12 3 26-40 2-4 weeks
50/30/0 treatment to cool skin and remove heat

*DCD is an option. If DCD is not used another form of epidermal cooling should be used. Skin cooling reduces the rise in temperature in the epidermis, allows for higher tolerated fluences, and provides partial anaesthesia.
Cool compress or cold gel pack may be applied immediately before treatment to cool skin and after treatment to remove heat

Benign Pigmented Lesions (755 nm)

DCD Spray/Delay/Post Spray
Lesion/Skin Type Spot Size (mm) Pulse Duration (ms) Fluence (J/cm2) Retreat Comments
(ms)

Seborrheic Keratoses Treatment of skin types V or VI is NOT recommended.

8 3 60-80
(Skin Type I-IV) Start at lowest fluence for treatment one and observe tissue response.
Start by treating darkest lesions, which require lower fluences. Lighter
spots may require higher fluence.
Solar Lentigines, Clinical endpoint: Darkening of the lesion and/or perilesional
Lentigines, 10 3 30-60 4 Weeks
erythema.
dyspigmentation, The DCD is generally not used for the treatment of benign pigmented
ephelides, solar lesions. For some patients, some cryogen may be beneficial. A cooling
melanocytic, benign method such as cool gel pack or cold compress for brief pre and post
melanocytic nevi 12 3 30-40 Off laser epidermal cooling may be used.
(Skin Type I-IV)

Solar Lentigines, Endpoint: Typically, slight popping of the skin and slight white-to-grey
Lentigines, 12,15 3 12-30 discoloration immediately post laser pulse, followed by slight
dyspigmentation, erythema.
ephelides, solar For use of the 18mm Refer to Candela Clinical Bulletin No. 19 or
melanocytic, benign Candela Clinical Educator. The distance of the handpiece to the skin
melanocytic nevi 18 3 12-20 should be varied dependent upon the laser-tissue interaction
(Skin Type I-III) observed, start at 1-2 cm off the skin.

Hair Removal Guidelines (1064nm)

DCD Spray/Delay/Post Spray
Spot Size (mm) Pulse Duration (ms) Fluence (J/cm2) Retreat Comments
Fitzpatrick Skin Type (ms)
8 90-100
I 10 70-80
Scandinavian 12 60-70
15 40-44
3, 10, 20
II 18 26-30
Northern European 20 21-24
(Caucasian) 22 17-20
24 15-16
8 80-90
10 50-70
12 40-60
III
15 30-40 Consider the 755nm laser for hair removal treatment on Type I skin
(Darker Caucasian, Light 3, 10, 20
18 24-30 type.
Asian) 30/20/0
20 19-24
40/20/0
22 16-20 Test small area and wait several minutes to evaluate response prior to
24 14-16 treatment.
DCD spray duration and
8 60-70 delay may be adjusted to
10 40-50 Facial: 4-6 weeks 1. Establish skin type
accommodate patient
12 20-46 Trunk 6- 8 weeks 2. Select pulse duration;
comfort
IV Leg: 8-12 weeks short = finer hair
15 20-30
(Mediterranean, Asian, 3, 10, 20 long = thicker hair
18 14-20 Do NOT use post laser pulse
Hispanic) 3. Select fluence based upon skin type.
20 11-16 DCD cooling for hair removal
Cold compress or cold gel packs may be applied after
22 9-13
treatment to cool skin and remove heat Look for perifollicular edema
24 8-11 DCD settings set too high or
8 50-60 too low may cause
Increase fluence in a 2 J/cm2 increment until this response is seen.
10 30-50 pigmentary problems. Lower
V
12 18-30 DCD setting on darker skin
(Middle Eastern, Balance between laser heating and DCD cooling is critical.
types.
Hispanic, Asian, light 15 10-30
3, 10, 20
skinned African 18 6-20
American, Indian, Native 20 5-16
American) 22 4-13
24 3-11
8 40-50
10 30-40
12 18-30
VI 15 7-30
3, 10, 20
(Dark African American) 18 6-18
20 5-14
22 4-12
24 3-10

Vascular Lesions Guidelines (1064 nm)

STARTING Fluence
(J/cm2)
DCD Spray/Delay/Post Spray
Lesion Spot Size (mm) Pulse Duration (ms) Single pulse only Clinical Endpoint & Retreatment If Clinical Endpoint NOT Achieved
(ms)
(No stacking or
multiple passes)

Telangiectasia 10 ms spray/20 ms delay/10

1.5 20-40 Start with 360 ms post spray Vasoconstriction, vasospasm and/or darkening of
Leg Vessels < 0.5mm vessel contents 1. Decrease pulse duration
2. Increase fluence incrementally until desired result is achieved up to
Evaluate/Retreat 8-10 weeks apart a maximum of 320Jcm2 with 3mm spot size and up to 500J/cm2 with
1.5mm spot size
Post treatment
Telangiectasia 15-20 ms spray/20 ms cold compress or cold gel packs may be applied after No post spray should be used on skin types IV - VI
3 40-60 Start with 220 delay/10 ms post spray treatment to cool skin and remove heat
Leg Vessels < 1.0mm

Increase fluence incrementally until desired result is achieved up to a

Telangiectasia 15 ms spray/20 ms delay/
maximum of 280J/cm2
3 40-60 Start with 200 10 ms post spray Vasoconstriction, vasospasm and/or darkening of
Leg Vessels < 1.5mm vessel contents No post spray should be used on skin types IV-VI

Evaluate/Retreat 8-12 weeks apart

Cold compress or cold gel packs may be applied after Increase fluence incrementally until desired result is achieved up to a
Telangiectasia 15 ms spray/20 ms delay/
treatment to cool skin and remove heat maximum of 260J/cm2
3 60 Start with 180 10 ms post spray
Leg Vessels 1.5-3.0 mm
No post spray should be used on skin types IV-VI

Telangiectasia
20-30 180
Leg Vessels < 0.5mm

Vasoconstriction, vasospasm and/or darkening of

vessel contents
Telangiectasia
40 ms spray/20 ms delay/0
3 x 10 30-50 160 ms post spray Evaluate/Retreat 8-12 weeks apart Increase fluence incrementally until desired result is achieved
Leg Vessels 0.5mm - 1.5
mm
Cold compress or cold gel packs may be applied after
treatment to cool skin and remove heat

Telangiectasia
60 140
Leg Vessels 1.5mm - 3.0
mm

Vasoconstriction, vasospasm and/or darkening of

vessel contents Increase fluence incrementally until desired result is achieved up to a
Telangiectasia 10 ms spray/20 ms delay/10
Evaluate/Retreat 6-8 weeks apart maximum of 400J/cm2
1.5 20 Start with 340 ms post spray
Cold compress or cold gel packs may be applied after
Facial Vessels < 0.5mm
treatment to cool skin and remove heat No post spray should be used on skin types IV-VI

Vasoconstriction, vasospasm and/or darkening of

Telangiectasia vessel contents
40 ms spray/30 ms delay
3 30 130 Evaluate/Retreat 8-12 weeks apart No post spray should be used on skin types IV-VI
Facial Vessels < 1.5mm Cold compress or cold gel packs may be applied after
treatment to cool skin and remove heat

Wrinkles Treatment Guidelines (1064 nm)

DCD Spray/Delay/Post Spray
Area Spot Size (mm) Pulse Duration (ms) Fluence (J/cm2) Retreat Comments
(ms)
Face & Neck 10 50 50 40/20/0
4-5 treatments performed monthly
Forehead 10 50 40-50 40/20/0