NDYAG - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about NDYAG or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
ND:Yag Laser
Overview:
Equipped with a wavelength that travels into the mid dermis, this laser safely treats fine but deep blood vessels (usually blue) and unwanted body hair in all skin types. To a small degree it can tighten skin.
Expected Results:
50-70% reduction of unwanted blood vessels with each treatment, permanent reduction of about 20-25% of unwanted body hair with each treatment, skin tightening.
Preparation:
None
Post treatment intructions:
Application of petrolatum if a scab forms. Picking is absolutely discouraged.
Time to desired results:
Variable, 2-5 treatments for blood vessels, 3-6 treatments for unwanted body hair, 3-6 treatments for skin tightening.
Contraindications:
None.
Lasting results:
Permanent for treatment of blood vessels and hair. Note: Our body will form new vessels after 5-7 years, especially in genetically determined spider veins. They may be located in the same area or away from treated areas. Even after 6 treatments for unwanted body hair, there may be residual hair in the treated area because the laser's efficacy is about 20-25% reduction of hair at each treatment. In other words, after the first treatment, 25% is destroyed, during the 2nd treatment 25 % of the residual hair and so on.
Some hair follicles are dormant for months or years and may not be affected by the laser treatment and may produce some hair in the future. Periodic maintenance treatment can be added when these hair follicles are producing hair again. During the course of the laser treatment, the residual hair typically becomes finer and lighter in color. Skin tightening is lesser compared to the gold standard of CO2 laser treatments and duration is variable.
Downtime:
Redness and swelling for 1-3 days, possible scabbing and bruising for up to 14 days (treatment of blood vessels), bruising for up to 3 months (leg veins)
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I am an Indian (Asia) woman with brown skin. I have capillaries or veins on my face that look like hyperpigmentation, an overall uneven skin tone issue. What laser would you use to treat my concerns?
An uneven skin tone can be brightened by a brief series of picosecond laser or fractionated radiofrequency treatments every 4 weeks regardless of skin color. If you are diligent about daily sun protection and reapply your sunscreen every 2 hours when outdoors you can maintain these results. Maintenance also includes daily topical agents such as vitamin C, kojic acid, azelaic acid in the morning and tretinoin at night.
Capillaries on the face can vary greatly in diameter. The finest capillaries might be treated by laser even when skin is brown but larger ones would need to be spared to avoid skin dimpling. Evaluation by a laser savvy dermatologist is needed to learn if your capillaries are amenable to laser treatment.
Hello,
I have two burns on either side of my face. The doctor I consulted has said he’d like to treat them with an nd:yag 1040 nw laser but every website I check seems to recommend the pulsed due laser. Do you think I should get a second opinion?
Young burn scars are best treated with pulsed dye laser unless you have dark brown or black skin (Fitzpatrick type 5 or 6). Older scars with persistent redness can be treated with pulsed dye laser or Nd:YAG laser followed by a non-ablative resurfacing laser in the same treatment session. A second opinion is never a bad idea, even if it is to confirm that you were advised correctly.
I have a pink flat mohs surgrey scar. It is 1 year and 11 months old. Doctor told me after lasing scar flat 11 month ago that pinkness would go away but the scar is still pink. I want to knew if there is a away to fix the pinkness and create a white scar. It is in the middle of my nose. just want the pinkness out and the skin to be white. Did not care if I loss pigment because my skin is very fair.
Please set up an appointment for scar consultation so that I can comment after in-person examination.
Dr. Ringpfeil,
I have been researching treatments to help with my Keratosis Pilaris Rubra Faceii. I believe this treatment would be very helpful but am fearful that it would cause permanent facial hair loss in the process. Is there any way to prevent this? Also my skin gets extremely tan during the summer, is there a cause for worry that this would cause uneven coloring in the future.
Thank you very much.
Treatment of keratosis pilaris rubra faceii is challenging. Nd:YAG laser treatment causes hair loss and should not be used in an area of terminal hair where hair loss is not desired. It is also not used in the brow area because of potential side effects unique to this anatomic location.
Hi…I have a small1/2 inch lipoma on my cheek. Does your practice employ any “scarless” approaches to removal such as YAG Laser assisted removal or other new approach such as removal form behind. Trying to accomplish removal with little or n scaring
Thanks
Lipomas are rare on the face. They should be able to be completely removed through a minute incision. The Nd:YAG laser also requires a small incision for the laser probe to be inserted. Removal of the lipoma is not precise, as the laser cannot spot the capsule of the lipoma. It is possible to leave some of the lipoma behind or to inadvertently destroy surrounding fat cells. Kybella treatment has the same limitations as the Nd:YAG laser. An internal approach through the mouth is not advised due to infection risk, as it is not possible to create a sterile field on oral mucosa.
I am a 27 year old African American male with light brown skin and I suffer from subtype 2 rosacae with patches of redness on my face. I’ve researched and found that IPL and the V Beam are not recommended for my skin type due to the risk of hyperpigmentation but saw the NDYAG laser is a safer option. Is this true and what are the risks with the NDYAG laser?
The Nd:YAG laser is indeed the only option for treatment of redness associated with rosacea for people with Fitzpatrick skin type IV to VI (black, brown, Mediterranean). Side effects consist of mild temporary swelling and pink color of treated areas, rarely lasting more than 2 days.
Dear Dr. Ringpfeil,
I am developing vertical lines at the front-center of my neck due to my skin loosing firmness. I am 52.
Is ND-Yag a effective but Safe option to firm the skin of this neck area without harming the vocal cords and the trachea? I have the auto-immune disease vitiligo; could I risk loosing skin pigment from this procedure? I understand that multiple treatments are necessary.
At what frequency, and do you perform this treatment for skin-tightening purpose? If not, what would you recommend for this area of the throat that Ultherapy can not be used? Thank you!!
Vertical neck lines, also called platysmal bands are not usually due to loss of tightness but occur with a genetic predisposition to fibrosis of the superficial sheet muscle on our lower face and neck, the platysma. This is a benign process that does not require intervention unless cosmetically desired. In some people, it might be possible to relax this fibrosis with Botox. If Botox fails to achieve this, surgical treatment is recommended.
Raised white scars, spider veins on knees & ankles and dark scars where bug bites healed in several places on my legs. Dry, itchy and aging quality to my skin after HRT was discontinued. Age spots on my hands and loose skin from aging on my upper arms. The HRT was discontinued on 1/01/10 and I have aged considerably in appearance since that time. I was prescribed HRT of Estertest hs, following a total hysterectomy on 8/01/89. Without the hormones I have aged not only in appearance but also I believe in my thinking. The reason I was given for stopping HRT was to avoid any chance of developing another blood clot. Since oral meds are processed thru the liver making another blood clot possible would I be a candidate for the compound HRT creams that are individualized to the patient and would be created to eliminate Estertest hs in its effect but are not processed by the liver possibly be a safe solution for me? I am a 66 year old female.
The absorption of hormones through the skin is certainly less than when ingested but they are also metabolized through the liver. I believe that you should consult an integrative medicine specialist or gynecologist versed in bioidentical hormone replacement therapy to discuss if these are a safer option.