Ruby Lasers

Ruby Laser Treatment

In 1960, the first operational laser was constructed. It was a ruby laser. Once quite common in medical and industrial, Ruby Lasers have declined in popularity with the development of modern laser systems. Ruby Lasers have been used extensively in medical applications (eg. tattoo and hair removal) and industrial applications (eg. diamond cutting and holography). Ruby Lasers are rarely used in the treatment of acne or acne scars, but there have been a handful of studies investigating the use of Ruby Lasers in the context of acne treatment.

How do Ruby Lasers Work?

Ruby Crystal
Ruby Crystal

Ruby Lasers produce a laser beam that has a deep red color and a wavelength of ~694 nm. Ruby Laser are solid-state lasers that have a synthetic ruby as the lasing medium. Ruby Lasers are one of the few solid state lasers that produce light in the middle of the visible spectrum. Light in this wavelength is readily absorbed by the pigment melanin and many of the dyes used in tattoos.

Ruby Laser Treatment of Hyperpigmentation on Cheek
Ruby Laser Treatment of Hyperpigmentation on Cheek

The energy in the laser beam from a Ruby Laser is absorbed tattoo dye or melanin pigment, which causes thermal damage to the surrounding cells. This causes the dye and pigment to be released, dispersed and eventually removed by body. This process can also be used to permanently damage the hair roots in their follicle. Ruby lasers are quite effective for laser hair removal, but they have been phased out of this application because they can cause more collateral damage then newer versions laser hair removal systems.

Ruby Lasers, Active Acne and Acne Scars.

Hypopigmentation after Ruby Laser Treatment (Nanni)
Hypopigmentation after Ruby Laser Treatment (Nanni)

Ruby Lasers are not commonly used for the treatment of either active acne or acne scars. Ruby Lasers are occasionally used to some types of skin discoloration associated with acne scars. However, other types of laser treatments are more frequently used for this purpose (eg. IPL, PDL). Ruby Lasers are not considered to be an effective treatment for the damaged skin tissue associated with moderate to severe acne scarring. For the repair of significant acne scars, ablative laser resurfacing technologies (eg. CO2, Er:YAG, Nd:YAG) are generally much more effective.

Many patients who have undergone laser hair removal with Ruby Lasers have reported a reduction in the severity of their acne following treatment. The exact cause of these reported improvements has not been thoroughly studied and it is not clear whether these reports are reliable. Ruby Lasers are not generally used as a treatment for active acne. Other Light and Laser systems (eg. Blue Light Phototherapy, PDT, Diode Lasers) are considered better treatments for active acne.

Effect of Ruby Laser on Sebaceous Glands (Manuskiatti)
Effect of Ruby Laser on Sebaceous Glands (Manuskiatti)

Unlike Diode Lasers, which can effectively target and damage the sebaceous glands, the deep red light produced by a Ruby Laser is poorly absorbed by the sebaceous gland, which lacks pigments like melanin. There has been limited clinical research investigating the efficacy of Ruby Lasers for acne treatment. However, the available research does provide some insight into the relationship between Ruby Laser treatment and acne. Researchers found that treatment with Ruby Lasers did tend to improve acne symptoms, but also increased the amount of sebum being secreted to the surface of the skin. Upon closer examination, they found that the size of the sebaceous gland was reduced, but it appeared to be producing more sebum. They hypothesized that this extra space created by removal of the hair shaft might allow the sebum to be secreted more freely, preventing the kinds of clogged pores and impacted follicles that can lead to inflammatory acne. This decreased resistance to secretion could lead to a smaller sebaceous gland. Despite this initial research, Ruby Lasers are not widely available as an laser acne treatment and their decreasing popularity in dermatology and cosmetic surgery make it unlikely that this will change.

How and where is Ruby Laser treatment administered?

Table of Side Effect Frequencies for NdYAG Ruby and Alexandrite Laser Treatment (Nanni)
Table of Side Effect Frequencies for NdYAG Ruby and Alexandrite Laser Treatment (Nanni)

Ruby Laser treatment is administered in laser hair and tattoo removal clinics, dermatologists offices and cosmetic surgery practices. Ruby Laser hair removal starts at approximately $100 dollars per session for a small treatment area and increases depending on the size and region of the treated area. Fractional laser platforms are available with Ruby Lasers.

Popular Ruby Laser Systems

EpiLaser, EpiPulse Ruby, Palomar E2000, RubyStar.

Ruby Laser Images

References

Laser hair removal affects sebaceous glands and sebum excretion: A pilot study. Manuskiatti, et al. 1999. 
Laser-assisted hair removal: Side effects of Qswitched Nd:YAG, long-pulsed ruby, and alexandrite lasers. Nanni, et al. 1999.
The Removal of Cutaneous Pigmented Lesions with the Q-switched Ruby Laser and the Q-switched Neodymium: Yttrium-Aluminum-Garnet Laser. Tse, et al. 1994.
Scar Sarcoidosis—Treatment With the Q-Switched Ruby Laser. Grema, et al. 2002.
Recalcitrant Scarring Follicular Disorders Treated by Laser‐Assisted Hair Removal: A Preliminary Report. Chui, et al. 1999.
Ruby Lasers @ Wikipedia
Ruby Laser Hair Removal @ Medic8