What Is Laser Energy?

Laser energy is measured in millijoules (mJ).

One millijoule is one-thousandth of a joule.

On the Thulium Laser Pro Dual™, the energy values in the treatment parameter tables are expressed in mJ for both the 1927nm and 1550nm wavelengths.

The energy setting contributes to the amount of thermal interaction created at each treatment point.

However, higher energy does not automatically mean a better result. The selected wavelength, pulse duration, spot distribution and overall treatment protocol all matter.

What Is Pulse Width?

Pulse width is measured in milliseconds (ms) and describes the duration of a laser pulse.

Delivering energy over a shorter or longer period can change the way heat is deposited and dissipated within tissue.

Pulse width should therefore be considered alongside pulse energy, not simply viewed as a separate comfort setting.

What Is Laser Power?

Power is measured in watts (W) and describes the rate of energy delivery.

The machine's operating manual states that the displayed energy is calculated from power and pulse width.

In basic physical terms, energy is the product of power and time.

Fractional laser treatments deliver energy to multiple small treatment zones rather than uniformly treating the entire skin surface.

The spot spacing setting influences how far apart those treatment points are positioned.

When treatment points are closer together, more points may be placed within a given area.

When they are further apart, fewer points may be delivered to the same area.

This has implications for overall treatment coverage and the proportion of tissue exposed to laser energy.

It is important, however, not to assume that a particular spacing number has the same meaning on every laser system.

Manufacturers may use different units, scan geometries or density calculations.

For this reason, settings taken from another laser platform should not be directly transferred to Thulium Laser Pro Dual™.

The term overlap can mean different things in laser treatment literature.

On some systems, it refers to the degree to which adjacent laser spots physically overlap.

On the Thulium Laser Pro Dual™ interface described in the manual, the Overlap control refers to the number of scan repetitions.

That distinction is important. It should not be interpreted as a percentage of overlapping spot diameter.

Repeating a scan can increase the total energy exposure delivered to the selected area.

The effect depends on the number of repetitions, their spatial distribution, the interval between pulses and the selected energy settings.

Practitioners must also consider any additional manual passes over the same skin.

Thulium Laser Pro Dual™ provides selectable scan shapes and treatment area dimensions.

These allow the practitioner to configure how fractional treatment points are distributed within a selected area.

The manual describes geometric patterns including rectangular, triangular, circular and hexagonal shapes.

It also describes different emission sequences, including sequential, centre-outward and random delivery.

These controls are relevant to treatment coverage and the spatial and temporal distribution of energy.

They do not replace the need for correct handpiece positioning, appropriate eye protection or careful selection of the treatment area.

Thulium Laser Pro Dual™ combines two established fractional laser wavelengths:

• 1927nm Thulium
• 1550nm Erbium Glass

Both wavelengths interact with water in the skin, but they have different absorption characteristics and typical treatment depths.

As a result, their settings cannot simply be treated as equivalent.

For a more detailed explanation of the technology, read our guide to 1927nm Thulium and 1550nm Erbium Glass .

The Importance of Visible Skin Response

1927nm Thulium is usually described as a non-ablative fractional technology.

However, on Thulium Laser Pro Dual™, very high settings can produce visible surface ablation.

That means there is a meaningful difference between a gentle treatment intended to produce limited surface disruption and a more intensive protocol associated with a stronger epidermal response.

The observed tissue response must therefore form part of treatment assessment.

A practitioner should not assume that all 1927nm treatments have the same recovery profile merely because they use the same wavelength.

The possibility of visible ablation is also relevant when considering whether additional 1550nm treatment during the same appointment would be appropriate.

Before selecting energy, pulse width, spacing or scan repetitions, the practitioner should establish the patient's main treatment objective.

Pigmentation, superficial texture, atrophic acne scars and fine lines do not necessarily require the same wavelength or treatment approach.

Skin phototype, pigmentation history, medical history, previous laser treatments, skin sensitivity and expected recovery also need to be considered.

The aim is not to select the highest energy the patient can tolerate.

It is to select an appropriate combination of parameters for the intended treatment response.

Thulium treatments are commonly delivered as a course, but there is no single interval that is optimal for every patient or indication.

At Pure Tone, our usual starting point is to schedule treatments approximately four weeks apart.

This is consistent with many published fractional laser treatment protocols, but it should not be interpreted as a scientifically established optimum for every application.

More intensive treatments, patients at greater risk of pigmentary changes or those requiring additional recovery may benefit from longer intervals.

Intervals of six to eight weeks may therefore be appropriate in selected circumstances.

A further session should only proceed when the skin has recovered sufficiently and the practitioner considers it appropriate.

Post-treatment care should be planned around the actual response of the skin, not simply the name of the laser treatment.

Gentler fractional treatments may produce limited redness and warmth, while stronger treatments can result in more noticeable dryness, flaking, bronzing or surface disruption.

Donna Cummings, Aesthetic Nurse and Pure Tone trainer, typically uses a chilled, single-use facial mask soaked in sterile saline to help cool and calm the skin immediately following treatment, where appropriate.

The skin can be gently cleaned with cool or tepid water as directed by the practitioner.

Patients are generally advised to avoid hot showers, hot baths, saunas, swimming, ordinary facial cleansers and other potentially irritating products during the initial 24–36 hours.

More intensive treatments may require different or longer precautions.

These are general aftercare principles. The treating practitioner should determine the appropriate routine according to the wavelength, settings, skin response and individual patient circumstances.

Thulium Laser Pro Dual™ brings together the relatively superficial treatment applications of 1927nm Thulium and the deeper dermal remodelling potential of 1550nm Erbium Glass.

The system provides control over pulse energy, pulse duration, fractional spacing, scan coverage and repeated delivery, allowing a trained practitioner to develop an appropriate treatment plan.

For clinics considering dual-wavelength technology, understanding those controls is essential when evaluating how the machine would fit within an existing treatment menu.

Published clinical research involving comparable dual-wavelength systems has investigated the use of 1927nm and 1550nm during the same appointment.

However, same-session treatment should not be interpreted as performing two full-intensity treatments consecutively.

The cumulative thermal effect depends on the parameters selected for each wavelength, the treatment area and the response of the skin.

This is especially important when the initial 1927nm treatment has produced marked epidermal disruption or visible ablation.

For some patients, separate appointments may be more appropriate.

Pure Tone is continuing to evaluate combination and stacked laser treatments with an experienced laser specialist, including protocols involving Thulium, Erbium Glass and fractional CO₂ technology.

Further practical guidance will be shared following clinical review of those treatment approaches.