TREATMENT GUIDELINES

MNP0102-EN.R2

* Not intended for U.S. Market *

Treatment Guidelines – MNP0102-EN.R2 1/15

 Disclaimer agreement
• The treatment guidelines here below are already pre-set in the laser system. The intention of this guide is to give a
suggestion which is never in replacement of the physician’s experience, knowledge and patient’s skin evaluation to be done
before the performing of the treatment.
• The pre-sets of the software and the treatment guidelines are subject to changes without notice.
• Treatment Guidelines are not intended to be used in replacement of User Manual information, which must be
always read prior to start using the laser system. Failure to use the laser in accordance with the User Manual
could result in serious injury to the operator, the patient and others, and damage the laser system. Please follow
OSHA, ANSI and IEC standards for laser safety.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before performing the treatment.
o to use an adequate skin cooling system.
• The Manufacturer is not liable for any damage to patients or third parties arising from the use of these treatment
guidelines.

Parameters definitions
Fluence.
The Fluence is a measure of the Energy density, and is calculated as Energy over Area with the
following formula:
F=E/A
The Energy is measured in Joule (J), while the area in square centimeters (cm2), so the Fluence’ unit of
measure will be (J/ cm2).

Clinical information:
1. Decreasing the spot-size, you’re decreasing the Area, which means increasing the Fluence
with the risk to overpass the suggested parameter and burn the skin.

2. The laser system’s software shows you the Fluence, and doesn’t show the Energy, to
immediately provide the clinical relevant parameter in the laser-skin interaction and avoid
confusions.

3. The Fluence is the most important parameter involved in the laser-skin interaction and the
amount of energy prescribed for each patient is the trade-off between the minimum
Fluence needed to perform an effective hair removal and the threshold of burn.
a. When you overlap the spots, or pass multiple time on the same portion of skin,
you’re delivering the sum of the Fluence delivered with each shot.

Pulse Duration.
The Pulse Duration is the duration of a laser pulse, measured in milliseconds (ms).

The value of the laser pulse duration in the field “Pause” indicates the delay time, or pause time,
between the first laser pulse and the second laser pulse.

When the setting of the Pause is zero, the 2 laser sources Alexandrite and Nd:YAG will emit
simultaneously in the same time, the wavelengths will be blended, and the Fluence delivered on the
skin is the sum of the Fluences emitted by each source. This emission mode is so-called “blend mode”.

Clinical information:
The Pulse Duration is involved in the Power emitted on the skin. Fixing the Fluence, the shorter is the pulse
duration and the higher is the emitted Power. The shorter is the Pulse Duration, the less painful is the
treatment.

Treatment Guidelines – MNP0102-EN.R2 2/15

Frequency.
The emission Frequency, or Pulse Repetition Rate, is the number of shots, or pulses, delivered in a
second by the laser system and is measured in Hertz (Hz).

Clinical information:
1. The Frequency is just involved in the emission speed.

Spot-size.
The Spot-size is a measure of the Diameter (D or ∅) of the round laser-print on the skin, in case you
have purchased a round spot laser, or the Side of the square laser-print on the skin, in case you have
purchased a square spot laser. The spot-size is typically measured in millimeters (mm).

The Area of the laser-print could be calculated with the formula:

A = 3.14 * (∅)/2)2

Typical areas to mind are:

Round spot Square spot
(mm) Area (cm2) Area (cm2)
18 2.54 3.24
20 3.14 4.00
24 4.52 5.76
26 5.30 6.76
27 n.a. 7.29
30 7.06 n.a.

Clinical information:
1. Fixing the other parameters, the Spot-size is involved in the emission speed and penetration
depth per the below scheme. The penetration depends by many factors, like skin type,
hydration, etc.

2. According to point 1, the larger is the spot-size and the deeper is the penetration of the laser
beam with a much better success of results.

Treatment Guidelines – MNP0102-EN.R2 3/15

 HAIR REMOVAL

The following information are in common for all the laser sources, Alexandrite, Nd:YAG and blend
Alexandrite+Nd:YAG.

1. The Fluence should be adjusted according to the Hair Thickness.

a. The thinner is the hair, the higher should be the Fluence.

b. In the 1st and 2nd session the hair are thick and gradually become thinner going with
further sessions. We suggest to start with 15J/cm2.

c. 3rd and 4th session we suggest to use 20J/cm2.

d. further sessions and thinnest hair we suggest to exceed very carefully and step by
step with patch tests in different body area the value 20J/cm2.

e. The “gold standard” parameter for an effective hair removal is 20J/cm2. Exceeding
this value might cause burns or ipo-pigmentations or iper-pigmentations. Below
15J/cm2 the treatment might be non-effective.

2. The Pulse Duration should be adjusted according to the Hair Thickness as well and the
patient’s pain feeling.

a. if the Total Fluence is set below 20J/cm2: we suggest to always set the Pulse
Duration as lowest as possible.

b. if the Total Fluence is set over 20J/cm2: we suggest to increase the Pulse Duration
longer than 20ms per laser source to give enough time to the skin to dissipate the
heat.

3. The Spot-size and the Frequency should be adjusted according to the treatment speed,
minding that the larger is the spot-size and the more effective is the treatment. Typically
most of the operators prefer to use 2Hz Frequency to have a better control of the emitted
area avoiding overlaps or missed parts.

Treatment Guidelines – MNP0102-EN.R2 4/15

 Laser Source: ALEXANDRITE 755nm + Nd:YAG 1064nm

Pulse Duration:
We strongly recommend to work in the blend mode, mixing the 2 wavelengths 1064nm and 755nm,
setting the “pause” value of the Pulse Duration to 0.

The Alexandrite Nd:YAG blend mode is the safest, most versatile and most effective mission mode,
allowing to work on all skin types and all seasons including the summer time.

For Alex Pulse duration and Nd:YAG pulse duration, please set the lowest available once you have
already set the Fluence, Frequency and Spot-size.

Fluence mix:
Selecting the Alexandrite+Nd:YAG laser source, the Fluence delivered on the skin is shown in the
software as “Total Fluence”, and is the sum of the “Alex Fluence” plus the “YAG Fluence”.

The Fluence mix is only involved in the patient’s skin type and hair color.

As per above mentioned the gold standard for hair removal is 20J/cm 2. This should be the maximum
value of Total Fluence delivered on the skin. During the 1st and 2nd session we will start from 15J/cm2.

Session #1 and #2
Fluence = 15J/cm2
Alexandrite Fluence Nd:YAG Fluence
2
S.T. (% on the total) (J/cm ) (% on the total) (J/cm2)
I-II 75% 10 25% 5
III 50% 8 50% 7
IV 50% 7 50% 8
V 25% 5 75% 10
VI Use Nd:YAG only laser source

Session #3 and #4
Fluence = 20J/cm2
Alexandrite Fluence Nd:YAG Fluence
2
S.T. (% on the total) (J/cm ) (% on the total) (J/cm2)
I-II 75% 15 25% 5
III 50% 11 50% 9
IV 50% 9 50% 11
V 25% 5 75% 15
VI Use Nd:YAG only laser source

Treatment Guidelines – MNP0102-EN.R2 5/15

 HAIR REMOVAL
ALEXANDRITE 755nm + Nd:YAG 1064nm (blend mode)
The suggested spotsize is 24mm round or 20x20 mm square.
“Pulse Duration = min” means the lowest parameter selectable

Fluence Fluence Pulse Duration

2 2 Freq. Program
Skin Type Tanning Hair Color Hair Thickness (J/cm ) (J/cm ) (ms) (ms) (ms)
(Hz) #
Alex YAG TOTAL Alex pause YAG
absent 8 9 17 min 0 min 2 47
thin
present 4 13 17 20 0 20 2 48
brown
absent 7 7 14 min 0 min 2 49
thick
present 3 11 14 20 0 20 2 50
I-II
absent 10 7 17 min 0 min 2 51
thin
present 6 11 17 20 0 20 2 52
black
absent 9 5 14 min 0 min 2 53
thick
present 5 9 14 20 0 20 2 54
absent 5 11 16 min 0 min 2 55
thin
present 2 13 17 20 0 20 2 56
brown
absent 5 9 14 min 0 min 2 57
thick
present 3 11 14 20 0 20 2 58
III
absent 7 9 16 min 0 min 2 59
thin
present 3 13 16 20 0 20 2 60
black
absent 7 7 14 min 0 min 2 61
thick
present 3 11 14 20 0 20 2 62
absent 5 10 15 min 0 min 1,5 63
thin
present 2 14 16 20 0 20 1 64
IV black
absent 5 7 12 min 0 min 1,5 65
thick
present 2 11 13 20 0 20 1 66
thin 2 13 15 20 0 20 1 67
V absent black
thick 2 10 12 20 0 20 1 68

Disclaimer agreement
• The treatment guidelines here below are already pre-set in the laser system. The intention of this guide is to give a suggestion which is never in
replacement of the physician’s experience, knowledge and patient’s skin evaluation to be done before the performing of the treatment.
• Treatment Guidelines are not intended to be used in replacement of User Manual information, which must be always read prior to start using
the laser system. Failure to use the laser in accordance with the User Manual could result in serious injury to the operator, the patient and
others, and damage the laser system. Please follow OSHA, ANSI and IEC standards for laser safety.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before performing the treatment.
o to use an adequate skin cooling system.
• The Manufacturer. is not liable for any damage to patients or third parties arising from the use of these treatment guidelines.

Treatment Guidelines – MNP0102-EN.R2 6/15

 HAIR REMOVAL
ALEXANDRITE 755nm only

The suggested spotsize is 24mm round or 20x20mm square for the model Splendor X | Alex2
The suggested spotsize is 20mm round or 18x18mm square for the models:
Splendor X | Alex
Splendor X | Alex+Nd:YAG

“Pulse Duration = min” means the lowest parameter selectable

Fluence Pulse Duration

Freq. Program
Skin Type Tanning Hair Color Hair Thickness (J/cm2) (ms)
(Hz) #
Alex Alex
absent 14 min 2 1
thin
present 10 20 2 2
brown
absent 13 min 2 3
thick
present 9 20 2 4
I-II
absent 12 min 2 5
thin
present 8 20 2 6
black
absent 11 min 2 7
thick
present 7 20 2 8
absent 11 min 2 9
thin
present 7 20 2 10
brown
absent 10 min 2 11
thick
present 6 20 2 12
III
absent 9 min 2 13
thin
present 5 20 2 14
black
absent 8 min 2 15
thick
present 4 20 2 16
absent 7 min 1,5 17
thin
present 3 20 1 18
IV black
absent 6 min 1,5 19
thick
present 2 20 1 20

Disclaimer agreement
• The treatment guidelines here below are already pre-set in the laser system. The intention of this guide is to give a suggestion which is never in
replacement of the physician’s experience, knowledge and patient’s skin evaluation to be done before the performing of the treatment.
• Treatment Guidelines are not intended to be used in replacement of User Manual information, which must be always read prior to start using
the laser system. Failure to use the laser in accordance with the User Manual could result in serious injury to the operator, the patient and
others, and damage the laser system. Please follow OSHA, ANSI and IEC standards for laser safety.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before performing the treatment.
o to use an adequate skin cooling system.
• The Manufacturer is not liable for any damage to patients or third parties arising from the use of these treatment guidelines.

Treatment Guidelines – MNP0102-EN.R2 7/15

 HAIR REMOVAL
Nd:YAG LP 1064nm only

The suggested spotsize is 20mm round or 18x18mm square

“Pulse Duration = min” means the lowest parameter selectable

Fluence Pulse Duration

Freq. Program
Skin Type Tanning Hair Color Hair Thickness (J/cm2) (ms)
(Hz) #
YAG YAG
absent 17 min 2 23
thin
present 15 20 2 24
brown
absent 15 min 2 25
thick
present 13 20 2 26
I-II
absent 15 min 2 27
thin
present 13 20 2 28
black
absent 13 min 2 29
thick
present 11 20 2 30
absent 16 min 2 31
thin
present 14 20 2 32
brown
absent 14 min 2 33
thick
present 12 20 2 34
III
absent 14 min 2 35
thin
present 12 20 2 36
black
absent 12 min 2 37
thick
present 10 20 2 38
absent 13 min 1,5 39
thin
present 11 20 1 40
IV black
absent 11 min 1,5 41
thick
present 9 20 1 42
thin 13 20 1 43
V absent black
thick 11 20 1 44
thin 13 20 1 45
VI absent black
thick 11 20 1 46

Disclaimer agreement
• The treatment guideliness here below are already pre-set in the laser system. The intention of this guide is to give a suggestion which is never in
replacement of the physician’s experience, knowledge and patient’s skin evaluation to be done before the performing of the treatment.
• Treatment Guidelines are not intended to be used in replacement of User Manual information, which must be always read prior to start using
the laser system. Failure to use the laser in accordance with the User Manual could result in serious injury to the operator, the patient and
others, and damage the laser system. Please follow OSHA, ANSI and IEC standards for laser safety.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before to perform the treatment.
o to use an adequate skin cooling system.
• The Manufacturer is not liable for any damage to patients or third parties arising from the use of these treatment guidelines.

Treatment Guidelines – MNP0102-EN.R2 8/15

 VASCULAR LESIONS

For all the vascular lesions, please follow the next suggestions.

Always use skin cooling.

For vascular lesions, selected patients included all skin types and did not have any contraindications
as listed above. Spot sizes of 1.5, 3 and 5 mm were used depending on the size and the color of the
vascular lesion being treated. The maximum size of telangiectasia was limited to 3 mm. Initial
fluence and pulse durations were based on manufacturer’s recommendations but these parameters
were adjusted by the clinician in order to achieve complete removing of the vascular lesion. Pain
reported by the patient was also used to direct the fluence and pulse duration selection. The end
point for the treatment of vascular lesions was either slowing of blood flow in the targeted vessel,
bleaching of the vessels or perivascular purpura and urticaria.

- Nd: YAG laser for:

o facial veins
▪ Treatments without redness
▪ Modality of choice for veins to 0.6mm
▪ Treatment with spot 3mm @ 100-125 J/cm², 2-3 sessions
▪ Best results on smaller vessels @ 3 mm & 120 J/cm²
o veins of the lower limbs
▪ Treatments for vessels up 1-1.5mm
▪ Treatment of choice for spider veins, blue veins in general
▪ Treatment with 3 or 5mm spot @ 150-175 J/cm²
▪ Typically 2-3 sessions
▪ Cryo air cooling needed
▪ Observe the marking of veins up coagulation or spasm
- Leg red superficial veins:
o 1st treatment:
▪ old lesions, 16 shots, 3 mm, 0.5 ms, 83 J/cm²
• light redness, healed in 3 days.
▪ recent lesions, 2 shots, 3 mm, 1 ms, 83 J/cm²
• light crust, healed in 4 days
▪ 2nd treatment after 2 weeks
• 31 shots, 3 mm, 1 ms, 160 J/cm²
- Benign pigmented lesions:
o Skin cooling needed @ 8°C during treatment.
Nd: YAG laser treatment for Facial Rejuvenation Non-invasive quintessential:
- Treatment Protocol:
o 4 to 6 treatments and from 3 weeks to 1 month break
o Low Fluence: 13-14 J/cm²
o 5 Hz
o Handpiece 5mm
o Pulse time: 0.4 ms
o Cooling unnecessary this time
▪ Reduction of redness and sun damage
▪ Result improves skin texture and sensitive reduction of fine lines
- The Pulse duration should be adjusted according to the blood vessel diameter.
.

Treatment Guidelines – MNP0102-EN.R2 9/15

 VASCULAR LESIONS PROGRAMS
PROG. 81-85 – FACE TELEANGIETASIA @ Nd:YAG LP

NOTE:
• Skin Cooler Temp (°C): use proper cold air.
• Use 10 ms pulses for smallest vessels.
• Reduce starting fluence by 40 j/cm2 for Nose and Forehead
• For vascular lesions, selected patients included all skin types and did not have any contraindications as
listed above. Spot sizes of 1.5, 3 and 5 mm were used depending on the size and the color of the
vascular lesion being treated. The maximum size of telangiectasias was limited to 3 mm. Initial fluence
and pulse durations were based on manufacturer’s recommendations, but these parameters were
adjusted by the clinician in order to achieve complete blanching of the vascular lesion. Pain reported by
the patient was also used to guide the fluence and pulse duration selection. The end point for the
treatment of vascular lesions was either slowing of blood flow in the targeted vessel, blanching of the
vessels or perivascular purpura and urticaria. Pulse stacking was avoided.

Disclaimer agreement
• The protocols here below are already pre-set in the laser system. The intention of this guide
is to give a suggestion which is never in replacement of the physician’s experience, knowledge and
patient’s skin evaluation to be done before the performing of the treatment.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before to perform the treatment.
o to use an adequate skin cooling system.
• The Manufacturer is not liable for any damage to patients or third parties arising from the use of
these protocols.

PROG TREATMENT Wave Spot Pulse Freq. Fluence FOTO

lenght Size Width (Hz) (J/cm2)
nm mm ms recommented
81 FACE 2 10 1 250
TELEANGIECTASIE
≤ 0,3 mm

82 FACE 3 15 1 150
TELEANGIECTASIE
0,3÷0,5 mm

83 FACE 5 15 1 140
TELEANGIECTASIE 1064
0,5 ÷ 0,8 mm

Treatment Guidelines – MNP0102-EN.R2 10/15

PROG. TREATMENT Wave Spot Pulse Freq. Fluence PHOTO
Length Size Width (Hz) (J/cm2)
nm mm Ms recommended
84 FACE 5 20 1 130
TELEANGIECTASIE
0,8 ÷ 1mm

85 FACE 5 25 1 110
TELEANGIECTASIE
1 – 1,3 mm

86 BLUE LEG 3 20 1 130

TELANGIECTASIA

0,5 ÷ 0,8 mm

1064

87 BLUE LEG 5 20 1 120

TELANGIECTASIA

0,8 ÷ 1,2 mm

88 BLUE LEG 5 25 1 110

TELANGIECTASIA

1,2 ÷ 1,5 mm

Treatment Guidelines – MNP0102-EN.R2 11/15

PROG. TREATMENT Wave Spot Pulse Freq Fluence PHOTO
Length Size Width (Hz) (J/cm2)
nm mm ms recommended
89 Leg red 3 15 1,5 140
superficial veins

≤ 0,3 mm

90 Leg red 3 20 1 130

superficial veins

0,3 ÷ 0,5 mm 1064

91 Spider Neavi 3 15 1 150

Φ 0,5 mm

92 Hemangioma 5 20 1 50
Φ 3-4 mm

BLUE LEG TELANGIECTASIA @ Alex+Yag 755>1064 (sequence of 755 then 1064 nm

PROG. TREATMENT Wave Spot Pulse Width Freq. Fluence PHOTO

Length Size ms (Hz) (J/cm2)
nm mm recommended
755 Pause 1064 755 1064
nm nm nm nm
93 BLUE LEG 755> 5 10 8 15 1 26 60
TELANGIECTASIA 1064

0,5 ÷ 1 mm

Treatment Guidelines – MNP0102-EN.R2 12/15

 PIGMENTED LESIONS WITH ALEX LASER
Disclaimer agreement
• The protocols here below are already pre-set in the laser system. The intention of this guide
is to give a suggestion which is never in replacement of the physician’s experience, knowledge and
patient’s skin evaluation to be done before the performing of the treatment.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before to perform the treatment.
o to use an adequate skin cooling system.
• The Manufacturer is not liable for any damage to patients or third parties arising from the use of
these protocols.

NOTE:
• Only lesions benign
• Skin Cooler Temp (°C): 8 during the treatment

PROG. TREATMNET Wave Spot Pulse Freq Fluence PHOTO

Lengt Size Width (Hz) (J/cm2)
hnm mm ms recommended
PIGMENTED
LESIONS
(BENIGN) Light
94 755 5 5 1 26

98 PIGMENTED 755 5 5 1 26
LESIONS
(BENIGN) Dark

o It is necessary to cool the skin during the treatment

Treatment Guidelines – MNP0102-EN.R2 13/15

 SKIN TREATMENT ND YAG SP

Disclaimer agreement
• The protocols here below are already pre-set in the laser system. The intention of this guide is to give a suggestion which is never in replacement of
the physician’s experience, knowledge and patient’s skin evaluation to be done before the performing of the treatment.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before to perform the treatment.
o to use an adequate skin cooling system.
• The Manufacturer is not liable for any damage to patients or third parties arising from the use of these protocols.

PROG. TREATMNET Wave Spot Size Pulse Freq. Fluence PHOTO

Length mm Width (Hz) (mJ/cm2)
nm ms recommended
95 WRINKLES (non ablative) 1064
Short 5 0,5 5 1500
pulse

96 ACNE 1064 5 0,6 5 5000

Short
pulse

Treatment Guidelines – MNP0102-EN.R2 14/15

 97 SKIN REJUVINATION 1064 10 0,5 10 600
Short
pulse

99 ONYCHOMYCOSIS 1064 5 0,3 10 1000

Short
pulse

100 BODY TIGHTENING 1064 10 0,6 10 1300

Short
pulse

Disclaimer agreement
• The treatment guidelines here below are already pre-set in the laser system. The intention of this guide is to give a suggestion which is never in replacement of the physician’s experience, knowledge and patient’s skin evaluation to
be done before the performing of the treatment.
• Treatment Guidelines are not intended to be used in replacement of User Manual information, which must be always read prior to start using the laser system. Failure to use the laser in accordance with the User Manual
could result in serious injury to the operator, the patient and others, and damage the laser system. Please follow OSHA, ANSI and IEC standards for laser safety.
• We kindly also recommend:
o to perform a patch-test on the patient’s skin before performing the treatment.
o to use an adequate skin cooling system.
• The Manufacturer S.r.l. is not liable for any damage to patients or third parties arising from the use of these treatment guidelines.

Treatment Guidelines – MNP0102-EN.R2 15/15