Neodymium or Nd is a chemical element, which characterizes the ionic charge attributed to crystals. Different crystals provide different optical properties.

Lauren Smith, Vice President of Sales and Marketing, Aerolase said, "The Neo has 1064 nanometers (nm) wavelength that targets the chromophore (a region in the molecule) of melanin or hemoglobin. It has an affinity for deep and colored chromophores; so, the application works on spider veins, dark colored tattoos, and hair removal."


The Era is an erbium Nd:YAG laser with 2940 nm wavelength. It has an affinity for water and transfers light to heat on contact with dermis. Smith says, "It performs a chemical peel without the chemicals, reducing scars, wrinkles and cutaneous lesions."

The Neo and Era sell individually for approximately $45,000.

Candela offers a consolidated multi-wavelength product. The GentleMAX workstation incorporates the GentleYAG an Nd:YAG 1064 nm laser that is suggested for all skin types with the Gentle LASE, a 755 nm laser. With both lasers, a clinician can effectively treat for hair reduction, leg and facial veins, wrinkles, skin tightening, pigmented and vascular lesions. A touch screen interface guides the clinician in determining settings for each patient.

Service and training go hand-in-hand

Physicians and clinicians must be able to count on equipment functioning properly.

Signs of malfunction show as error messages or alarms, reduced efficacy, lower power output, noise, or in some cases, pain for the patient.

Kirk's organization is a foremost a service company. He said, "Poor customer service, long lead times or hidden costs may mean paying more in the long run for that laser you thought you were getting at a deal."

He adds, "As with most electro-mechanical devices, performance of the device is the largest factor in determining need for service. A drop in effectiveness is the first indication. New noises such as an increase in the sound of electronic activity (a louder bang on the product when the capacitor discharges, for example) or the sound of the water pumps working harder could be an early indication. It is always recommended that a laser should be serviced twice a year by a reputable laser service company."

Physicians who use lasers in surgery know what equipment they need and buy accordingly, but there are some advances in the industry. Kirk tells DOTmed that in Ophthalmology the diode lasers are taking over the Argon and Krypton gas tube technology. The advantage of small size and portability has changed how an Ophthalmology office operates. The holmium laser is still the workhorse. Urology and hospitals still use the CO2.

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