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The following skin disorders can be treated with Nd:YAG laser beams.

Vascular lesions

• ND:YAG can be used to remove spider and thread veins in the face (cheek, temporal region, nasal dorsum, forehead) and legs.
• Some vascular birthmarks (capillary vascular malformations)
• Varicose veins in the leg
• Facial veins (telangiectasis)
• Haemangiomas (vascular tumours) in the face and around the mouth

The laser light pulses target red pigment (haemoglobin). Typical settings employed for the treatment of facial veins include a 50 milliseconds pulse duration, and fluence (ie output energy) of 150¬250 J/cm² (measured in Joules per centimetre squared).

Pigmented lesions

• Nd:YAG laser can be used to remove brown age spots (solar lentigines), freckles, naevus of Ota, naevus of Ito, mongolian spots, Hori naevus and café-au-lait-macules.

Light pulses target melanin at variable depth on or in the skin.

Hair removal

• Nd:YAG laser may be used for hair removal in any location including underarms, bikini line, face, neck, back, chest and legs.
• Nd:YAG laser is generally ineffective for light-coloured (grey) hair, but effective for treating dark (brown/black) hair in patients of types I to IV, and perhaps light-coloured type V skin.
• Extreme caution is recommended in tanned or darker-skinned patients, as the laser can also destroy melanin, resulting in white patches of skin .

The longer-pulse (millisecond) 1064-nm Nd:YAG laser system has been shown to be more effective in safely removing hair than has the Q-switched (nanosecond) Nd:YAG system.

Light pulses target the hair follicle, which causes the hair to fall out and minimises further growth. Typical settings employed include pulse durations of 2 to 20 milliseconds and fluences of 10¬40 J/cm².

Tatoo removal

• Blue, grey and black tattoos can be removed with a Q-switched Nd:YAG laser (1064 nm wavelength).
• The colour of the tattoo and the depth of the pigment influence the duration and the outcome of the laser treatment.
• Laser treatment involves the selective destruction of ink molecules that are then absorbed by macrophages and eliminated.

Typical settings are pulse duration: 10 nanoseconds, output energy: 300¬500Mj.

Onychomycosis

• Onychomycosis is a common nail disorder caused by fungal pathogens.
• There are significant barriers to treatment with oral and topical antifungals.
• Successful treatment of onychomycosis requires antifungal drugs to penetrate the nail plate and nail bed, but this is oftn incomplete with oral and topical agents.
• Several laser devices have been granted FDA marketing approval for the treatment of onychomycosis.
• The first two lasers that were sanctioned by the FDA for the treatment of onychomycosis (PinPointe™ FootLaser™ [Cynosure, Massachusetts, USA ] and Cutera GenesisPlus™ [Cutera, California, USA]) are both flashlamp pumped short-pulse Nd:YAG 1064 nm lasers.
• These lasers emit 100–3000 microsecond pulses with an energy fluence of 25.5 J/cm² for a 1 mm spot size.