Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
What is the Sinon Ruby laser?
The ruby laser, as the name suggests, emits a ruby coloured wavelength of light (694 nanometres).
One of the features of this laser is that it has the option of having;
- extremely short pulses of high power that can be shorter than 20 nanoseconds (one nanosecond equals one-billionth of a second). This allows this laser to have a photo-mechanical effect on skin pigmentation and tattoo inks or pigments, literally shattering these small particles. The remnants are then removed by the body immune system.
- Longer pulses of laser energy in the millisecond range (one millisecond equals one -thousandth of a second), that allow it to selectively heat hair follicles to induce permanent hair reduction.
Also important, is the depth of penetration of the laser. The longer the wavelength, the deeper the penetration. Therefore the 694nm wavelength penetrates much deeper than the 532nm wavelength. This is important for deeper problems such as deep pigmentation removal for problems such as birthmarks, Naevus of Ota, Hori macules, naevus spilus, freckles, cafe au lait spots, and other pigmentation problems
What can be treated with the Ruby laser?
The wavelength of light that is emitted by the ruby laser is selectively attracted to certain colours in the skin;
- Skin pigmentation the 694nm wavelength from the ruby laser is attracted to the melanin in skin. Although it is not as attracted to melanin as highly as the 532nm wavelength of the Medlite laser, it penetrates deeper than the Medlite laser and is able to reach deeper unwanted pigmentation. Skin pigmentation is usually performed in the q-switch (short pulse) mode to help to shatter the pigment. Click here for more information on skin pigmentation. Types of skin pigmentation treatable with the ruby laser include;
- Birthmarks – a variety of brown birthmarks can be treated with the Ruby laser. Any raised lesions cannot be treated however. Treatable pigmentation include Naevus of Ota, Hori macules, naevus spilus, congenital melanocytic naevi, and cafe au lait spots.
- Post-sclerotherapy pigmentation This is a particular kind of pigmentation that arises from sclerotherapy, or injections for leg veins. Haemosiderin, a constituent of blood, remains in the skin and causes a bruised like appearance on the skin. The pigmentation has an absorption peak of 410-415nm that tapers down through the remainder of the visible spectrum and can be improved significantly with the q-switched lasers.
- Melasma – this is pigmentation due to hormonal factors, and can be treated with the ruby laser
- Freckles – the ruby laser is highly effective in getting rid of freckles on the body or face
- Sun spots/sun damage – the ruby laser is effective at removing sun spots, although the medlite laser is usually used for this.
- Green, blue, and black tattoo removal the 694nm wavelength is highly attracted to the darker tattoo pigments. Although the 1064nm wavelength of the Medlite laser is capable of removing black and dark blue pigments, it is not attracted to green pigment. Therefore, the ruby laser is required to properly treat those who want green tattoo pigments removed. Again laser tattoo removal is performed with the ruby laser in q-switch or short pulse mode and this allows the shattering of the tattoo pigment. Click here for more information on laser tattoo removal.
- Hair follicles in long pulse mode, the ruby laser can also induce permanent hair reduction by heating of the hair follicle and the stem cell present there. The ruby laser is only suitable for those with fair skin, however, it works more effectively than the Gemini laser on thinner hairs (the reason for this is that it is more highly attracted to the melanin in skin than the Gemini laser and hence it is not safe with darker skins). The laser imparts heat energy preferentially to the hair follicles over the skin. Furthermore, the hair follicle tends to lose heat quicker than the skin. This causes selective heating of the hair follicle and hair reduction. Click here for more information on laser hair removal.
What will my skin look like after treatment?
This will depend on the strength of the treatment. The skin may appear mildly sunburnt for 24 to 48 hours. For pigmentation removal, the skin may crust and appear darkened for approximately one week. After tattoo removal, the skin may have some small pinpoint bleeding and appear white in colour. The recovery can take some time depending on the aggressiveness of the treatment. Dressings and antibiotic ointment may be required for a few days.
Will it hurt?
Topical anaesthesia can be used to numb the area prior to laser treatments. Especially when higher energies are used, such as with tattoo removal, topical anaesthesia is necessary. Without this anaesthesia, laser tattoo removal is said by some to be more painful than the initial tattoo application itself. If appropriate, an injection can be given to numb the area for treatment.
For lower energy treatments, anaesthesia may not be required.
Ruby laser case study - freckle removal
This patient presented for a single treatment of ruby laser to remove the freckles on her face. Recovery time was approximately 7 days, and a significant improvement in the freckles can be seen.
What are the possible adverse outcomes of treatment?
Adverse outcome with laser treatments are undesired outcomes that occur in a small percentage of patients treated. These include;
- post-inflammatory hyperpigmentation – a brown mark left on the skin after treatment that usually takes some months to fade with the assistance of lightening agents.
- Hypopigmentation – loss of pigmentation in the treated area that can be permanent (rare). Prolonged redness. Sometimes the redness of the skin can take a longer time to fade than expected.
Bacterial or viral infection laser treatments can sometimes trigger herpes simplex outbreaks. Any viral or bacterial infection in a wound created by a laser has the potential for scarring. Scarring a very rare possibility, usually associated with darker skin types, over-zealous energy settings, and bacterial or viral infection.
How much does q-switched laser treatment cost?
Laser treatments for pigmentation start at $250 and tattoo removal starts at $350 per session. The cost will depend on the time taken and the surface area treated.
Why should I choose Victorian Cosmetic Institute as my provide of laser treatments?
At Victorian Cosmetic Institute, we use the latest laser technology to perform your treatment. The Ruby laser is an extremely safe and effective laser for the removal of pigmentation, hair and tattoos.
Our doctors are also highly experienced in laser treatments, and will be able to give you the best advice for your treatment.
The first step is simply contacting us for your initial laser skin rejuvenation consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your laser treatment.