If you are considering laser treatment today, it may be surprising to learn that the first working laser appeared only in 1960. Since then, laser dermatology has developed from an experimental ruby laser into a wide range of treatments designed to target structures within your skin, including pigment, blood vessels, water and hair follicles.
For you, the important change is not simply that lasers have become more powerful. Modern treatment depends on choosing the right wavelength, pulse duration, energy and cooling for your skin and the condition being treated, helping your dermatologist target specific structures while limiting unnecessary damage to surrounding skin.
What Makes a Laser Different?
The word LASER comes from light amplification by stimulated emission of radiation. Laser systems typically produce an intense, highly directional beam within a relatively narrow wavelength range, giving specialists more control over how light energy interacts with your skin than is possible with ordinary light sources.
Different wavelengths are absorbed by different targets within your skin, such as melanin, haemoglobin and water. These light-absorbing targets are sometimes called chromophores. Your dermatologist can also adjust factors including pulse duration and delivered energy so that the laser effect is matched more closely to the structure being treated.
How Did the First Working Laser Change What Was Possible?
The modern laser era began in 1960, when Theodore Maiman demonstrated a functioning ruby laser that produced light at a wavelength of approximately 694.3 nanometres. This marked an important step in the development of laser technology and opened new possibilities for scientific and medical research.
Researchers soon began exploring whether this new technology could be used in medicine. If you have laser treatment today, the precision available to your dermatologist is the result of decades of research that began with these early experiments.
How Did Leon Goldman Bring Lasers Into Dermatology?
Dermatologist Leon Goldman became one of the most important pioneers of medical laser research soon after Maiman’s breakthrough. His laser research programme began in 1962, and in 1963 Goldman and colleagues published an early investigation of the effects of ruby laser radiation on skin.
His work showed that pigmented structures could respond differently to laser energy, including dark hair and other melanin-containing structures. This discovery helped establish an idea that still matters to you today: different targets within your skin can respond differently to particular wavelengths, allowing your dermatologist to select treatment more carefully.
Why Were Early Laser Treatments Harder to Control?
Early laser systems gave doctors much less control over energy, treatment time and heat than modern devices. If you had been treated with one of these early systems, surrounding skin could have been exposed to more heat as well as the intended target, increasing the risk of tissue damage and scarring.
These limitations encouraged researchers to develop more precise ways of controlling wavelength, pulse duration and energy. Better control gradually made it possible to target particular structures within your skin while reducing unnecessary injury to nearby tissue.
How Did Different Lasers Create New Treatment Options?
After Maiman’s ruby laser, the development of new laser systems introduced wavelengths that could interact differently with pigment, blood vessels, water and other tissue structures. A major milestone came in 1964 when C. Kumar N. Patel demonstrated continuous-wave carbon dioxide laser operation, while argon and neodymium-doped yttrium aluminium garnet (Nd:YAG) lasers later expanded the range of potential medical and dermatological applications. For you, these different wavelengths eventually meant that laser treatment could be matched more closely to the structure being treated rather than relying on one type of laser for every skin concern.
Development of Early Medical Lasers
| Laser Technology | Key Development | Interaction With Tissue | Dermatological Importance |
| Ruby laser | Maiman demonstrated the first working laser in 1960 | Produced a wavelength that interacted strongly with pigment | Helped establish the potential of lasers in medicine |
| COâ‚‚ laser | C. Kumar N. Patel reported continuous-wave laser action in 1964 | Infrared energy is strongly absorbed by water-containing tissue | Became important for surgical applications |
| Argon laser | Developed as another medical laser technology | Its wavelength could interact with selected tissue targets | Expanded investigation of vascular applications |
| Nd:YAG technologies | Introduced further wavelength options for medical use | Allowed researchers to explore different tissue interactions | Broadened potential dermatological applications |
| Different wavelengths | New laser media produced different wavelengths | Enabled more selective interactions with skin structures | Supported development of targeted treatments |
| Pigment and vascular targets | Researchers studied how laser energy affected specific structures | Helped identify suitable tissue targets | Created new possibilities for treating skin conditions |
How Did COâ‚‚ Lasers Change Skin Surgery?
The COâ‚‚ laser emits infrared light at approximately 10,600 nm, which is strongly absorbed by water within tissue. This allows rapid heating and vaporisation of water-containing skin, making the technology useful for controlled cutting, ablation and removal of selected lesions.
COâ‚‚ lasers became an important dermatological surgical tool and later played a major role in skin resurfacing. However, laser treatment is not automatically superior to conventional surgery, cryotherapy or other procedures for every lesion, so your diagnosis and treatment goal remain more important than the availability of a particular device.
Why Was Selective Photothermolysis a Turning Point?
One of the defining advances in laser dermatology came in 1983, when R. Rox Anderson and John Parrish described the principle of selective photothermolysis. They showed that selective injury could be achieved by matching the wavelength and duration of a laser pulse to the optical and thermal properties of a particular target.
For you, this principle helps explain why different lasers can be chosen for different concerns. By selecting a wavelength and pulse duration that match a particular target, your dermatologist can aim at pigment, blood vessels or other structures while trying to limit unnecessary heat damage to the surrounding skin. This principle became the scientific basis for many later vascular, pigment and hair-reduction laser treatments.
How Can Lasers Target Blood Vessels More Precisely?
If you have a vascular skin concern, the aim of laser treatment is to direct more of the light energy towards the affected blood vessels while limiting damage to the surrounding skin. This became possible by selecting wavelengths absorbed by haemoglobin and carefully controlling how long each laser pulse lasts.
Pulsed dye lasers became established during the 1980s for vascular lesions such as port-wine stains. Research with 577-nm pulsed dye technology showed how adjustment of wavelength, pulse duration and energy could increase selective vascular damage while reducing unnecessary injury to surrounding skin.
How Did Lasers Expand Treatment for Pigment and Tattoos?
Q-switched lasers deliver high-energy pulses over extremely short durations, allowing selected pigment particles to absorb substantial energy while reducing prolonged heating of surrounding tissue. This expanded laser treatment for tattoos and certain appropriately diagnosed benign pigmented lesions.
A 1990 study of Q-switched ruby laser treatment demonstrated selective effects on tattoo pigment and helped establish Q-switched technology as an important approach to tattoo removal. If you are considering laser treatment for a pigmented lesion, your dermatologist should first make sure that the lesion has been appropriately assessed. A changing, unusual or potentially malignant lesion should not simply be treated with a destructive laser without suitable clinical evaluation.
How Did Laser Resurfacing Change in the 1990s?
Skin resurfacing changed substantially during the 1990s with the development of high-energy, short-pulsed and scanned COâ‚‚ laser systems. These technologies allowed specialists to remove controlled layers of skin while limiting the prolonged thermal exposure associated with older continuous-wave techniques.
Pulsed COâ‚‚ lasers became widely used for photoageing, wrinkles and selected scars, while Er:YAG resurfacing provided another option that targets water in the skin. If resurfacing is being considered for you, these differences matter because your dermatologist needs to balance treatment depth and expected improvement against your recovery time, skin characteristics and risk of side effects.
How Did Laser Hair Reduction Develop?
Laser hair reduction developed rapidly during the mid-1990s as the principles of selective photothermolysis were applied to melanin within hair follicles. A landmark 1996 study demonstrated follicular injury and long-term hair reduction after treatment with a long-pulsed ruby laser.
If you are considering laser hair treatment today, the laser selected for you may depend on factors such as your skin pigmentation, hair colour and hair characteristics. Alexandrite, diode and long-pulsed Nd:YAG systems provide different wavelength options for different situations. You should also expect the treatment to be described as laser hair reduction rather than guaranteed permanent hair removal, because some regrowth can occur and repeated sessions are usually needed.
How Has Laser Treatment Improved Across Different Skin Tones?
If you have darker or more richly pigmented skin, laser treatment needs particularly careful planning because melanin in your skin can absorb some of the energy intended for another target. This can increase your risk of burns, post-inflammatory hyperpigmentation or unwanted loss of pigment if the wavelength or treatment settings are not suitable for your skin.
Longer wavelengths, cooling and carefully selected settings have expanded the laser treatments that may be suitable for you. For example, the long-pulsed 1064-nm Nd:YAG laser is commonly used for hair reduction in darker skin types because its longer wavelength is absorbed relatively less by epidermal melanin than shorter-wavelength hair-removal lasers. Careful assessment, appropriate settings and experience in treating different skin tones remain important.
How Did Fractional Lasers Change Resurfacing?
Another major milestone came in 2004 when Dieter Manstein, R. Rox Anderson and colleagues introduced fractional photothermolysis. Instead of treating the entire surface uniformly, the technique creates microscopic zones of thermal injury surrounded by areas of viable, untreated tissue.
The surrounding untreated skin can support repair, allowing remodelling while reducing the amount of tissue injured during one treatment session. This represented an important alternative to conventional full-field resurfacing.
How Can Fractional Technology Expand Your Treatment Options?
Fractional technology subsequently developed into both non-ablative and ablative systems. Non-ablative fractional lasers create controlled thermal injury without vaporising complete columns of tissue, while fractional ablative systems such as COâ‚‚ can remove microscopic columns of skin while leaving intervening areas untreated.
If fractional treatment is being considered for you, it may be used for concerns such as selected scars, acne scarring, photoageing or changes in skin texture. Your recovery may be shorter than with comparable full-field ablative resurfacing, but your downtime and risk still depend on the wavelength, treatment depth, density, energy settings and your individual skin.
Why Choosing the Right Laser Matters
There is no single laser that is best for every skin condition. Your dermatologist needs to consider the diagnosis, the target within your skin, your skin pigmentation, treatment depth, previous treatments and the balance between potential improvement, recovery time and risk.
This is particularly important with pigmented lesions because a lesion should be appropriately diagnosed before destructive treatment is considered. If you are seeking advice from an experienced dermatologist in London about laser treatment, your assessment can help determine whether a laser is appropriate at all and, if so, which wavelength and treatment approach best match your individual skin and concern.
How Could Newer Laser Technology Affect Your Treatment?
If you are considering laser treatment, you may hear terms such as vascular, pigment-specific, Q-switched, picosecond, hair-reduction, ablative and fractional lasers. Each works differently, and advances in pulse control, cooling and treatment planning allow your dermatologist to tailor treatment more closely to the target within your skin.
However, newer technology should not automatically be considered better for your skin. Appropriate diagnosis, operator experience, device selection, treatment settings and realistic expectations remain essential because laser complications can still include burns, pigmentary change, scarring and eye injury.
What Should You Know About Laser Safety in the UK?
If you are considering laser or IPL treatment, safety should be an important part of your decision. High-powered devices can cause serious injury to your eyes or skin if they are used incorrectly, so appropriate equipment controls, trained operators and suitable eye protection are important. UKHSA advises that laser products should comply with relevant safety standards, with additional risk assessment and controls needed for higher-risk Class 3B and Class 4 lasers.
In England, Care Quality Commission registration is not determined simply by whether a laser or IPL device is being used. Current CQC guidance states that laser and IPL services delivered by listed healthcare professionals require registration in particular circumstances, such as when their specific professional skills are being used as part of clinical care, when treatment is combined with another procedure requiring their professional qualification, or when the service is presented as being delivered by them in their registered healthcare-professional capacity. Other local licensing requirements may also apply, so you should consider clinical expertise, appropriate assessment and safety standards rather than choosing a provider solely because they advertise a particular laser or IPL device.
Myth vs Fact
| Myth | What You Should Know |
| The laser was invented specifically for medicine. | The first working laser was a physics breakthrough in 1960, and medical applications followed soon afterwards. |
| Leon Goldman invented the laser. | Theodore Maiman demonstrated the first working laser; Goldman pioneered its use in dermatology. |
| COâ‚‚ laser treatment has existed since 1960. | The ruby laser appeared in 1960, while Kumar Patel reported the COâ‚‚ laser in 1964. |
| A stronger laser always produces a better result. | Your outcome depends on wavelength, pulse duration, energy, target and appropriate clinical selection. |
| Any brown skin lesion can be removed with a pigment laser. | Your pigmented lesion should be appropriately diagnosed before destructive laser treatment. |
| Q-switched and picosecond lasers remove every tattoo completely. | Your result varies with ink colour, depth, tattoo composition, skin type and treatment response. |
| Laser hair treatment permanently removes every hair. | Your treatment is more accurately described as long-term hair reduction, and repeated sessions are commonly required. |
| Fractional laser treatment has no downtime. | Your recovery depends on whether treatment is ablative or non-ablative and on treatment depth and density. |
| Modern lasers are equally safe for every skin tone. | Your skin pigmentation affects wavelength choice, settings and pigmentary risk. |
| IPL is simply another type of laser. | IPL is a light-based technology that uses a broader spectrum and is not technically a laser. |
| The newest laser is automatically the best option. | Your diagnosis, skin and treatment target should determine the most appropriate technology. |
Key Takeaways
- Laser dermatology has developed considerably since Theodore Maiman demonstrated the first working ruby laser in 1960.
- Leon Goldman helped introduce laser research into dermatology during the early 1960s.
- Selective photothermolysis changed laser treatment by showing how specific structures could be targeted while limiting unnecessary injury to surrounding skin.
- Different laser wavelengths can target different structures within your skin, including pigment, blood vessels, water and hair follicles.
- If you are considering laser treatment, your skin tone, diagnosis and treatment goal all influence which technology and settings may be suitable for you.
- Fractional, Q-switched, picosecond, vascular and hair-reduction technologies have expanded the range of concerns that lasers can address.
- Newer technology is not automatically better for you, so appropriate assessment, experienced treatment and realistic expectations remain important.
Frequently Asked Questions
1. When was the first laser developed?
The first working laser was demonstrated by Theodore Maiman in 1960. His ruby laser produced light at approximately 694 nanometres and marked the beginning of the modern laser era.
2. When did lasers first become used in dermatology?
Dermatologists began investigating laser applications soon after the first laser was developed. Leon Goldman was an important pioneer whose research in the 1960s helped establish how laser energy could interact with pigmented and vascular structures in the skin.
3. How did lasers improve skin treatment?
If you have laser treatment today, one of the main advantages is that your dermatologist can choose light settings that target particular structures within your skin. Improvements in wavelength, pulse duration and energy control have made treatment more precise while helping limit unwanted effects on surrounding tissue.
4. What is selective photothermolysis?
Selective photothermolysis is the principle that helps explain how your dermatologist can target one structure within your skin while trying to protect the surrounding tissue. Introduced by Rox Anderson and John Parrish in 1983, it involves matching the wavelength, pulse duration and energy to the intended target.
5. Which lasers can treat blood vessels?
If you have a vascular skin concern, your dermatologist may consider a vascular laser such as a pulsed dye laser. These systems target haemoglobin within selected blood vessels and may be used for concerns such as port-wine stains and other vascular lesions.
6. Can lasers treat pigmentation and tattoos?
Yes. If you are considering treatment for a tattoo or selected pigmentation, Q-switched and other short-pulsed lasers may be used to target pigment. Your dermatologist should assess pigmented lesions appropriately before treatment, particularly if a lesion is new, changing or unusual.
7. How did CO2 lasers change dermatology?
COâ‚‚ lasers became valuable because their energy is strongly absorbed by water in your skin. If COâ‚‚ treatment is considered for you, it may be used for controlled cutting, ablation or resurfacing depending on your diagnosis and treatment goal. Your dermatologist should also consider the expected recovery and risk before deciding whether it is appropriate for your skin.
8. What are fractional lasers?
If fractional laser treatment is suitable for you, the laser treats microscopic areas of your skin while leaving surrounding areas untreated. This can support skin remodelling while reducing the amount of tissue treated during each session, although your recovery depends on the type and intensity of treatment used.
9. Are modern lasers suitable for all skin tones?
Yes, but the safest and most appropriate laser can differ according to your skin tone. If you have darker skin, your dermatologist may use different wavelengths, cooling or treatment settings to reduce the risk of burns and unwanted pigment changes.
10. How do dermatologists choose the right laser?
The choice depends on the condition being treated, the target within the skin, your skin tone, the desired treatment depth and other individual factors. A specialist can assess your skin and treatment goals before selecting the most appropriate laser technology and settings.
Final Thoughts: How Laser Dermatology Has Evolved
Laser dermatology has developed from the experimental ruby laser of the 1960s into a highly specialised field with technologies designed to target blood vessels, pigmentation, hair, scars and changes in skin texture. Each advance has improved the ability to deliver controlled energy to specific structures while reducing unnecessary effects on the surrounding skin. If you would like to book a consultation with one of our dermatologists in London, you can contact us at the London Dermatology Centre.
References:
- Anderson, R.R. and Parrish, J.A. (1983) ‘Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation’, Science, 220(4596), pp. 524–527. Available at: https://pubmed.ncbi.nlm.nih.gov/6836297/
- Gianfaldoni, S., Tchernev, G., Wollina, U., Fioranelli, M., Roccia, M.G., Gianfaldoni, R. and Lotti, T. (2017) ‘An overview of laser in dermatology: the past, the present and … the future (?)’, Open Access Macedonian Journal of Medical Sciences, 5(4), pp. 526–530. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5535675/
- Goldman, L., Blaney, D.J., Kindel, D.J. Jr and Franke, E.K. (1963) ‘Effect of the laser beam on the skin: preliminary report’, Journal of Investigative Dermatology, 40, pp. 121–122. Available at: https://pubmed.ncbi.nlm.nih.gov/13948765/
- Preissig, J., Hamilton, K. and Markus, R. (2012) ‘Current laser resurfacing technologies: a review that delves beneath the surface’, Seminars in Plastic Surgery, 26(3), pp. 109–116. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC3580982/
- Shah, S. and Alster, T.S. (2010) ‘Laser treatment of dark skin: an updated review’, American Journal of Clinical Dermatology, 11(6), pp. 389–397. Available at: https://pubmed.ncbi.nlm.nih.gov/20866114/