17.1 Safety Considerations

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  Wavelength-specific safety equipment (i.e., eye protection) is required. When performed in the operating room, a laser-safe endotracheal tube must be used, and the lowest possible FiO2 should be given. Wet towels are applied around the treatment area to absorb heat energy and reduce risk of fire. ^{4 , 7}

  
  
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  A test area can be used to identify the optimal fluence for the patient’s skin.

  
  
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  There are usually no visual endpoints for nonablative lasers used for the treatment of rhytids. ^{8 , 9 , 10}

  
  
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  For hypervascular lesions, the treatment endpoint is mild purpura, persistent bluing of the vessels, or stenosis of the vessels. ^{1 , 7}

  
  
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  For tattoo removal, the treatment endpoint is skin whitening. ¹¹

  
  
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  Hypopigmentation (10–20%) is thought to be caused by melanocyte destruction secondary to heat injury. This is often transient and self-limited. Rarely delayed hypopigmentation can present 6–12 months after treatment. ¹

  
  
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  Scarring is rare with nonablative lasers. Blistering may occur and is typically treated with antibiotic ointment until healed. ^{3 , 4 , 7 , 10}