The field of laser medicine and surgery has evolved a great deal over the past few years and in my opinion, one of the lasers first discovered and researched extensively upon was the Q switched ND YAG and now we have the nano second Q-switched available in most clinics and many of these are USFDA approved. The one which I work with is the helios 3 and in this article I shall showcase and discuss the various indications both off label and US FDA approved which i have been using this laser for namely:

  • White Hair Reduction
  • Congenital Naevis Removal
  • Atrophic Scar Treatment
  • Scar Texture Improvement
  • Pigmented Scar Revision/Reduction
  • Melasma
  • Atypical Lhr

Now, before I start with the actual details I would like to also emphasize on the US FDA and some finer points which all laser surgeons should follow :-

  • We should always work on demonstrable and reproducible results with definite protocols.
  • The idea is todemonstrate the superiority of lasers over conventional excision measures of scar revision and naevus surgeries.
  • Why US FDA emphasis?? The simple answer is safety and litigation preparedness, It might be surprising to many that whenever in consumer courts the laser in question has been the gold standard US FDA approved, the view of the courts has been most lenient towards the laser surgeons.

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ATYPICAL LHR REMOVED WITH THE QUASI LONG PULSE (NEO GENISIS MODE) HELIOS 3

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POST CHICKEN POX SCARS TRETED WITH THE HELIOS 3

Rationale of Neogenesis, Quasi Long Pulse Mode

  • This mode utilizes the microsecond pulse instead of the nanosecond pulse, hence dermal collagen synthesis is triggered and dermal remodeling takes place.
  • Since the spot size can be varied linear and odd shaped scars can be treated successfully.
  • Texture and tone can also be dealt with Helios 3 so the nanosecond mode with the zoom and fractional handpiece is absolutely safe with a pulse width of 8 it is ideal to treat hyper-pigmented and pigmented scars.
GREY/WHITE HAIR LHR

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Treatment of Congenital Naevus (Ablative Indications)

GREY/WHITE HAIR LHR

Melasma Treatment Single Sitting Helios 3

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Rationale In Melasma Treatment

  • Once synthesized melanin is packed in melanosomes, melanosomes are then transferred to keratinocytes from dendritic processes ,here is where Helios 3 comes in thus preventing the incorporation to the keratinocyte ,by photoacoustic effect ,as melanosome is heated steam is formed =whitening clinically = endpoint in most cases.
  • The Helios 3 or the fractional Q switched ND YAG works on melanosomes and their suppression and via this we perform the laser dendrectomy, earlier and till today fractional photothermolysis with diode 1550 nm is the US FDA approved protocol however nanosecond and picosecond lasers are showing promising results.
  • Since we all know the nature of melasma is notorious for recurrence despite after all available treatments so the Helios 3 offers a safe and effective way to keep melasma in check in a clinically safe environment
Resistant Onychomycosis /Toe Nail Fungus Treated with the Helios 3

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  • For the Q switched ND YAG,  I use zoom hand piece one to two passes, spot size 3 to 5 depending on size of scar and hyper pigmented area energies 450 to 800 frequency 1 to 3.
  • For linear scars weekly sittings of FR mode zoom handpiece spot size 3, 4 and 5 energies between 1400-1500, energy density up to 7 j/cm2.
  • Duration of treatment in combination will range from 4 to 8 sittings again dependent on the scar characteristics. Usual time gap between 2 sittings is 21 to 28 days. PIH cases during treatment do require fortnightly follow ups.
Conclusions and Summary
  • In scar revision with the Helios 3, we can counter the PIH plus the texture can be improved with Helios 3.
  • In today’s practice, patient expects perfection from his laser surgeon so finer aspects and fine tuning are the norm which can be achieved with the certified prowess of the Helios 3
  • In pigmentory disorders there is near zero down time, freedom to give packages, economical sittings, hope against hope as melasma is considered untreatable conventionally, we can always try and get another chance as Helios 3 is quite versatile.
  • In LHR, we can dare to treat difficult areas inaccessible to the diode tip, ear lobes, grafted areas and white/grey hair can be treated.

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