Aesthetic treatments have been vastly transformed since the introduction of medical lasers. Dermatologists are now able to treat skin conditions that were once considered incurable. On top of that, the introduction of laser and other energy-based devices (EBDs) has opened new financial opportunities for physicians. This set of circumstances has created an influx in competing technologies, manufacturers and various brands that can make it hard, especially for a novice clinic owner, to decide which aesthetic laser to acquire.

Dr. Reyes of @cdipanama with her Harmony XL Pro laser platform

Dr. Reyes of @cdipanama with her Harmony XL Pro laser platform

Things to consider when purchasing an aesthetic laser device

There are many considerations that come into the process of deciding which aesthetic laser device. These include the following:

  • The technical specifications of the device – laser wavelengths, energy output
  • levels, laser pulse duration, laser spot sizes, lasing medium.
  • The user interface – display screen, applicators, measurements of the device.
  • Financial aspects – the price of the laser, does it use any expensive consumables?
  • Warranty – a crucial subject. What kind of policy does the seller offer?
  • Maintenance & service.
  • Credibility of the device’s manufacturer.
  • Technology that is clinically proven and FDA approved.

All of the above are highly important. All of the above are highly important. However, aside from these objective questions comes the matter of what type of laser should the physician be looking for in the first place. Though this question might feel difficult to answer, the past few decades have shown that there are several types that are well established and are considered somewhat of a gold standard in aesthetic dermatology practice. These include the following aesthetic laser types:

  • The 755nm Alexandrite laser for hair removal.
  • The 308nm Excimer laser/light used mainly for treatment of Psoriasis and Vitiligo.
  • The 2940nm ER: Yag fractional laser and CO2 (10,600nm) ablative lasers for skin resurfacing and benign lesion removal.
  • The Q-switched ND: Yag 1064nm laser for pigmented lesions removal, skin rejuvenation and tattoo removal.

You can find some of the above lasers, like the CO2 laser, mostly as standalone device. In this instance, a device designed to treat a different range of skin conditions. However, some are available both in standalone laser form and on multi-technology platforms as well. This poses a dilemma for some users which can be solved if you have the right information and through a simple thought process.

The Arion Alexandrite 755nm standalone laser hair removal device, photo by @Feliciamed_Athens

The Arion Alexandrite 755nm standalone laser hair removal device, photo by @Feliciamed_Athens

Standalone machines vs. platform lasers

In many cases, standalone lasers tend to have a single wavelength and a small variety of applicators. These devices usually treat a narrow range of indications. That is one of the reasons why they are more favorable among experienced physicians who have an established practice. They simply have the privilege of focusing on certain areas of expertise. A younger clinic owner, one who is still building his or her reputation and clientele would prefer to acquire a more flexible device, that can answer the needs of all sorts of patients. These platforms offer several applicators, various laser types and sometimes even both laser and IPL or other light-based technology.

Generally speaking, standalone lasers tend to be more robust, and have the reputation of being “work horses”. Platform lasers on the other hand, are cheaper to own, require less office space and are a bit cheaper to maintain.

The Q-switched Nd: YAG laser is a very popular laser and a good example for a laser that can be found either as standalone or as part of a platform. Let’s use Two of Alma’s bestselling aesthetic laser devices for this comparison. The ALMA-Q laser and the Harmony XL Pro platform. We’ve asked Mr. Ohad Toledano, one of Alma’s clinical instructors for more insights on this comparison.

Q- The Harmony XL Pro laser platform boasts various technologies – the Q-switched ND: Yag laser, the 2940nm ER: Yag laser, 1540nm ER: Glass laser and various IPL hand-pieces. It has 65 cleared FDA indications for treatment – is there a case of quantity over quality with such a device?

“Absolutely not. The laser itself is almost as good as the standalone laser and differences are mostly not related to its clinical potential. For example, in Q-switched Nd:YAG laser, tattoo removal will be as effective in both. However, in a standalone laser, treatment time will be shorter and handling it will be more convenient. Yet, end results differ in lasers specifications such as pulse width rather than is it a standalone or platform. Secondly, if you use a platform laser, and don’t achieve the results you initially wanted, you can differ to a different technology (or wavelength). This means a seasoned user will be able to get better results by utilizing his experience.

An example for that can be choosing an ablative over a none ablative one, or IPL vs Laser. I admit there are rare specific cases (certain lesions) that might be best treated with only a specific laser type. However, with the platform the value you get by the wide variety and flexibility exceeds the value a standalone laser will give you by being great at treating something specific. To go back to the point made earlier in this article – for a beginner that hasn’t carved his or her niche yet – the platform is great because it enables them to gain more experience treating many skin conditions.”

A display of few of the hand-pieces available with Harmony XL Pro, photo courtesy of @pulse_laser, UK

A display of few of the hand-pieces available with Harmony XL Pro, photo courtesy of @pulse_laser, UK

Q – What are the benefits that standout to you in favor of a standalone laser device?

“Within standalone lasers what you get is the robustness of the standalone and the higher peak power levels. In addition, standalone laser tends to last longer. A platform laser uses a hand-piece with a small laser rod positioned inside. You will have to be replace this laser rod periodically. The ALMA-Q also represents a more modern approach to standalone aesthetic lasers, as it features up to 7 different hand-pieces that gives it much more flexibility than traditional single devices. So even though it can still work at 1064nm or 532nm via the Q-switch, the specially designed hand-pieces broaden the range of its capabilities. In Addition, the ALMA-Q is unique in the sense that it has 3 different pulse duration settings (Nanosecond, Microsecond & Millisecond) which is highly unique for a Q-switched laser.”

Q – Have you had experience treating the same indication with both of these laser devices? What were your impressions?

“Yes. We have been conducting in depth researches of laser tattoo removal and superficial pigment removal. ALMA-Q is faster than the Harmony XL Pro and has a larger spot size. Hence, the treatment time is shorter. That is especially great when removing large tattoos. Yet over all, the number of sessions needed to remove a tattoo or a pigment is the same.”

Q – Any advice for those who find it hard to decide?

“I think firstly you as a practitioner must ask what are your goals? If a physician is focused on treating a specific field of interest, let’s say, vascular pigmentation, then I would suggest a standalone laser. One that focuses on that field of interest. Yet if he/she is seeking to cover as much indications as possible, attracting more clients, then a multi-technology will be the better choice.

Generally, we always advise physicians not to lose too much sleep over this matter. This is a growing industry, and many of them will have long and prosperous careers. That means they will get the chance to work with both kinds of devices and sometimes even simultaneously at their practice. Also, I always tell them to closely examine what kind of training does the company that sells the device offer. That is because even the best technology available is not worth much without the expertise of the practitioner.”

For more tips on buying your first medical aesthetic laser, contact our team.