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Nd:YAG laser at Dr. Nüchel Aesthetik in Mönchengladbach

Laser treatments

Nd:YAG laser

With its wavelength of 1,064 nanometres, the Nd:YAG laser penetrates particularly deep into the skin and is suitable for spider veins, permanent hair reduction and the removal of dark tattoo pigments.

Treatable areas

  • Leg thread veins
  • Facial hair
  • Body hair
  • Dark tattoos
  • Deep vessels

The Nd:YAG laser (neodymium-doped yttrium aluminium garnet laser) works with a wavelength of 1,064 nanometres and therefore penetrates particularly deep into the tissue. In long-pulse mode we treat spider veins, deeper-lying vascular changes and unwanted hair – thanks to its low melanin absorption also on darker skin types. For this we use the Nydon by Alma.

In Q-switch mode, the Nd:YAG laser removes dark tattoo pigments with extremely short, high-energy pulses; black and dark blue usually respond well – for this we use the Evo Q-Plus by Quanta System.

All information is provided for general guidance and does not replace personal medical advice. Treatment results can vary from one individual to another.

Indications

Who it is suitable for

Whether a treatment makes medical sense in your case is something we determine together in a personal consultation. Typical concerns include:

  • Spider veins on the legs (fine, superficially visible small veins)
  • Deeper-lying vascular changes that cannot be reached by superficially acting lasers
  • Unwanted body and facial hair with the wish for permanent hair reduction
  • Darker skin types for which other laser systems are unsuitable for hair removal
  • Ingrown hairs and recurrent inflammation of the hair follicles (e.g. after shaving)
  • Tattoo removal of dark pigments (black, dark blue) in Q-switch mode
  • Lightening or removal of unwanted permanent make-up remnants following individual assessment

Step by step

How the treatment works

This is how the treatment usually proceeds with us – from the first consultation through to aftercare.

  1. Consultation and information

    We assess the skin, vessels, hair or tattoo pigments, check for possible contraindications and discuss what result is realistic. Before the first treatment, detailed written information is provided.

  2. Test treatment on a trial area

    Particularly with tattoo removal and on darker skin types, we first treat a small test area where needed, in order to assess the skin's reaction and adjust the laser parameters individually.

  3. Preparation on the day of treatment

    The area is cleansed and, for hair removal, superficially shaved; on request, an anaesthetic cream numbs sensitive areas beforehand. You and the practice team wear protective goggles throughout the entire treatment.

  4. Laser treatment

    The physician guides the handpiece systematically over the area – depending on the indication in long-pulse mode (vessels, hair) or Q-switch mode (tattoos), accompanied by skin cooling.

  5. Follow-up and further sessions

    Several sessions are usually required: for hair reduction generally six to eight at intervals of four to eight weeks, for spider veins one to three, for tattoo removal often six to twelve or more. At follow-up appointments we assess the progress and adjust the parameters.

Transparency

Prices

Pro Laserimpuls (Spotgröße ca. 1,5 mm)
1 €

All prices are guide values for initial orientation. Medical services are billed according to the German scale of fees for physicians (GOÄ); the final amount depends on the individual effort involved and is discussed transparently with you before treatment. For treatments without a listed price, we are happy to give you a guide value during your consultation.

Enquire about this treatmentView the full price list →

Patient information

Safety & patient information

Responsible treatment includes open information about possible risks and side effects – even when they occur only rarely.

  • Redness and swelling

    Temporary redness and slight swelling are the most common reaction, as a rule harmless, and usually subside within hours to a few days.

  • Sensation of heat, tightness and pain

    During and shortly after the treatment, a feeling of warmth or tightness and a mild burning similar to sunburn may occur; cooling and, on request, an anaesthetic cream relieve these sensations.

  • Crusting and superficial wounds

    Particularly after tattoo removal, superficial crusts, small blisters or small wounds may form, which heal over one to two weeks. Peeling them off prematurely increases the risk of scars and pigment disorders.

  • Pigment shifts

    The skin in the treated area may temporarily – more rarely for longer – appear lighter (hypopigmentation) or darker (hyperpigmentation). Recent tanning and darker skin types increase this risk.

  • Blistering

    With higher energy or sensitive skin, blisters may form. They usually heal but should not be opened, in order to prevent infections and scars.

  • Infections

    Where the skin surface is briefly not intact – for example through crusts after a tattoo removal – there is a low risk of infection; careful hygiene and the aftercare instructions significantly lower it.

  • Scarring

    Rarely, permanent scars occur, above all after the premature peeling off of crusts, with infections or with a predisposition to excessive scarring (keloids).

  • Paradoxical hair thickening

    In very rare cases, hair removal may lead to increased hair growth (paradoxical hypertrichosis) at the margins of the area; this phenomenon is not fully predictable.

  • Colour change and incomplete removal with tattoos

    Individual pigments – in particular light or coloured inks – may change colour (colour change) or remain permanently visible. Not every tattoo can be completely removed; the result cannot be guaranteed in advance.

  • Eye damage without protection

    Laser light can seriously damage the eye; for this reason, you and the practice team wear suitable protective goggles throughout the entire treatment. Treatments in the immediate vicinity of the eye are subject to particular caution.

When we do not treat

In certain situations we do not carry out a treatment, or only at a later time – for your safety.

  • Pregnancy and breastfeeding – as a precaution, no treatment is carried out during this time.
  • Recent, intensive tanning of the skin through sun, tanning beds or self-tanner in the treatment area.
  • Acute infections or inflammatory skin conditions in the treatment area, for example an active lip or skin herpes infection.
  • The use or application of substances that make the skin more light-sensitive (photosensitising substances), as well as certain systemic acne medications from the retinoid drug class – medical consultation is required here.
  • Conditions with increased light sensitivity (e.g. certain autoimmune or metabolic disorders).
  • A known tendency to excessive scarring (keloids or hypertrophic scars).
  • Unclear or conspicuous pigmented marks, moles or skin changes in the treatment area – these must be clarified by a dermatologist before a treatment; we do not laser over moles.
  • Known or suspected skin cancer in the treatment area.
  • The use of anticoagulant medication – a treatment is only possible after medical consultation and individual consideration.
  • For hair removal: very light, grey or red hairs, as they contain too little pigment to respond to the treatment.

This information does not replace a personal medical consultation. Before every treatment we inform you individually about the procedure, risks and alternatives.

In depth

Medical details & background

How it works & the evidence

The basis of all applications is selective photothermolysis: laser light of a defined wavelength is specifically absorbed by a target structure in the skin – the chromophore, such as the red blood pigment haemoglobin, the skin pigment melanin or tattoo pigments. The light energy is converted into heat and destroys or alters the target structure, while the surrounding tissue is largely spared; wavelength, pulse duration and energy are tuned to the respective treatment goal for this.

The comparatively long wavelength of 1,064 nanometres penetrates deeper than shorter-wavelength systems and thus also reaches deeper-lying vessels and hair roots; at the same time, it is absorbed by the skin's melanin only to a small extent. With adjusted parameters, the Nd:YAG laser can therefore also be used on darker skin types (Fitzpatrick IV–VI), for which shorter-wavelength lasers carry a higher risk of burns and pigment disorders.

In long-pulse mode, the heat absorbed by the haemoglobin seals off dilated vessels, which the body breaks down over weeks; in hair reduction it damages the hair follicle – effective above all in the active growth phase (anagen phase), which is why a series of sessions is required and one correctly speaks of permanent hair reduction, not complete removal. In Q-switch mode, ultra-short pulses in the nanosecond range photoacoustically shatter tattoo pigments into tiny fragments, which are transported away via the lymphatic system; colours other than dark pigments can be treated only to a limited extent with this. Accompanying skin cooling protects the epidermis; the individual choice of parameters by the physician is essential for effectiveness and safety.

The Nd:YAG laser is among the long-established and comparatively well-studied laser systems in dermatology. Controlled studies and systematic reviews show, for hair reduction, a marked reduction in hair density that lasts for months – with particular significance for darker skin types. For spider veins and smaller vascular changes, an effective lightening or elimination is likewise demonstrated, although depending on vessel size and depth, other procedures such as sclerotherapy may be equivalent or superior. In tattoo removal, Q-switched systems are the professionally recognised standard procedure; the wavelength of 1,064 nanometres is suited above all to dark pigments.

The limits of the evidence must be stated honestly: the available studies differ considerably in devices, parameters, skin types and follow-up periods, long-term data are limited, and the individual response depends on many factors – such as hair colour and density, vessel characteristics, tattoo ink and skin type. A particular result or a complete removal cannot therefore be guaranteed.

Preparing for your treatment

A few simple measures before your appointment help you contribute to the best possible result with as few complications as possible.

  • Avoid intensive sun, tanning beds and self-tanner for about four to six weeks before the treatment.
  • Before hair removal, do not pluck, wax or epilate the hairs in the area – the hair root must be preserved. Shaving is permitted and is often recommended shortly before the appointment.
  • Inform us about all medications and conditions, in particular about anticoagulant or light-sensitising substances; pause or adjust anticoagulant medication only after medical consultation.
  • Come with clean skin in the treatment area, without make-up, creams, deodorant or perfume.
  • Cancel the appointment if there are acute skin irritations, infections, sunburn or a cold sore in the treatment area.
Aftercare

The right care after treatment supports healing and the result. You will receive individual recommendations from us – as a rule:

  • Cool the treated area in the first few hours where needed, in order to relieve redness, a feeling of warmth and swelling.
  • Protect the treated skin consistently from UV radiation and use a sun protection with sun protection factor 50+ for several weeks; avoid direct sun and tanning beds.
  • For a few days, refrain from sauna, steam bath, swimming pool, hot full baths and intensive exercise, in order to avoid heat and friction in the area.
  • Care for the skin gently with low-irritant products and refrain from peels, fruit acids, retinoids and irritating cosmetics until the skin has calmed down.
  • Do not peel off any crusts or small blisters that form – particularly after a tattoo removal – prematurely, in order to prevent scars and pigment disorders.
  • Avoid mechanical irritation through tight clothing or vigorous rubbing of the area.
  • Attend the agreed follow-up appointments and further sessions, so that we can assess the result and adjust the treatment.
  • Contact the practice in case of unusual complaints such as increasing pain, severe swelling, pus formation or fever as possible signs of an infection.

FAQ

Frequently asked questions

Answers to questions we are asked particularly often about “Nd:YAG laser”.

Most patients describe the pulses as a brief pinch or a feeling of warmth, similar to the snap of a rubber band. Tattoo removal in Q-switch mode is often experienced as somewhat more intense than hair removal; with cooling and, on request, an anaesthetic cream, the treatment can as a rule be tolerated well.

Exclusively licensed physicians with a dermatological background and experience in medical laser therapy – from the medical indication through the choice of laser parameters to the treatment itself. The careful medical assessment of skin type, pigmentation and medical history significantly reduces the risk of side effects.

As a rule, we treat adult patients. In minors, a treatment is considered only in justified exceptional cases, after careful medical consideration and with the consent of those holding parental responsibility, as hair growth and skin appearance can change hormonally into young adulthood.

In principle yes, but the cooler time of year is often more favourable: tanned skin contains more melanin, reacts more strongly to the laser light and carries a higher risk of pigment shifts. In summer, an untanned starting skin and consistent UV protection are therefore particularly important.

The Nd:YAG laser in Q-switch mode works with pulses in the nanosecond range and responds well to dark pigments such as black and dark blue. Pico lasers deliver even shorter pulses in the picosecond range and can offer advantages with multicoloured or particularly stubborn tattoos. The choice depends on the colours, pigment density and skin type.

Sources & guidelines

  • AWMF guideline register – guidelines of the specialist societies, including the German Dermatological Society (DDG), on dermatological and laser-medical topics.
  • Federal Office for Radiation Protection (BfS) – information and legal requirements on protection against the harmful effects of non-ionising radiation in application on humans (NiSV).
  • Specialist societies of aesthetic and laser-medical dermatology – general recommendations and statements on laser therapy.
  • Prescribing information and manufacturers' specifications of the laser systems used, as well as established dermatological specialist literature as the basis for the choice of parameters.

Personal consultation

Arrange a personal consultation

In a confidential conversation on our practice floor at the Albertus Zentrum in Mönchengladbach, we take time for your questions and assess whether the treatment may be suitable for you.

Book a consultation

More treatments

You might also be interested in

For tattoo removal, a pico laser with even shorter pulses may be a sensible alternative; for superficial vascular changes in the face, the dye laser; for larger leg veins, sclerotherapy. Where a renewal of the skin surface is the focus – for example with wrinkles or scars – the fractional CO₂ laser or the Erbium:YAG laser are the more appropriate procedures.

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