Thulium Laser Treatment Protocols & Recommended Settings - 1927nm and 1550nm
Pure Tone Journal · Professional Treatment Guidance
Thulium Laser Treatment Protocols & Recommended Settings
1927nm Thulium and 1550nm Erbium Glass: recommended reference parameters for qualified laser practitioners.
Our Thulium Laser Pro Dual™ combines two complementary fractional laser wavelengths within one professional treatment platform.
Understanding how to select and adjust treatment parameters is central to using this technology effectively. Energy, pulse width, spot spacing and scan repetitions all influence the way laser energy interacts with the skin.
In this guide, we share our recommended treatment parameter ranges for selected applications, together with the clinical considerations that inform treatment planning.
The information is intended to support qualified practitioners already trained on our equipment and to help prospective professional customers understand the treatment capabilities of Thulium Laser Pro Dual™.
Professional clinical guidance
About These Treatment Protocols
The treatment parameters and protocols presented in this article are intended exclusively for appropriately qualified laser practitioners who have completed Pure Tone Aesthetics' equipment-specific training.
These recommendations relate specifically to our Thulium Laser Pro Dual™ and must not be applied to other laser systems.
All settings are provided as recommended reference parameters, not fixed treatment prescriptions.
The treating practitioner must assess each patient's skin type, skin condition, medical history, treatment objectives and individual response before determining the appropriate settings.
Energy, pulse width, spacing, overlap, number of passes and treatment intervals may all require adjustment according to the individual patient.
Our practical machine training does not replace the independent laser qualifications or Core of Knowledge education required for professional practice.
All treatments must be performed in accordance with the practitioner's qualifications, our current equipment instructions, applicable safety requirements and appropriate clinical judgement.
Understanding treatment protocols
Why Treatment Parameters Must Be Considered Together
A fractional laser treatment protocol involves several parameters working together.
Energy influences the amount delivered at each treatment point, while pulse width describes the duration of that delivery.
Spot spacing controls the distribution of fractional treatment points, and overlap determines the number of scan repetitions.
The selected wavelength also changes how the energy interacts with the skin.
For this reason, two treatments using the same pulse energy can produce different responses if their spacing, number of scans or wavelength differs.
Understanding these relationships is essential when choosing appropriate treatment settings and assessing the overall thermal effect.
We explain the individual controls in greater detail in our Thulium Laser Settings Explained article.
Reading the treatment tables
Understanding the Recommended Parameters
Our treatment tables use the same terminology as the Thulium Laser Pro Dual™ controls.
Energy (mJ)
The laser energy delivered during an individual pulse, expressed in millijoules.
Energy contributes to the thermal interaction produced at each fractional treatment point.
Pulse Width (ms)
The duration of an individual laser pulse, expressed in milliseconds.
Pulse width influences how energy is delivered over time and must be considered alongside energy.
Space & Overlap
Space adjusts the spacing between fractional treatment points.
Overlap controls the number of scan repetitions within the selected area.
1927nm Thulium
1927nm Thulium Recommended Treatment Parameters
Our reference settings for selected skin-rejuvenation, pigmentation and textural treatments.
Our 1927nm Thulium wavelength has a strong affinity for water and is particularly relevant to selected superficial pigmentation, uneven skin tone, photoageing and skin texture.
The fractional delivery system creates controlled microscopic treatment zones, with the intended effect varying according to the selected parameters.
The following ranges are taken from our Thulium Laser Pro Dual™ operation manual and form part of our professional technical guidance.
| Application | Energy (mJ) | Pulse Width (ms) | Space | Overlap |
|---|---|---|---|---|
| Pigmentation spots | 1.2–3.6 | 0.3–0.6 | 1.1–1.3 | 1–2 |
| Wrinkles | 0.9–2.5 | 0.3–0.5 | 1.0–1.3 | 1–2 |
| Stretch marks | 2.5–4.9 | 0.5–0.7 | 0.9–1.1 | 2–3 |
| Acne scars | 1.6–3.6 | 0.4–0.6 | 0.9–1.1 | 1–2 |
| Other scars | 1.5–3.5 | 0.5–0.7 | 0.7–1.1 | 2–3 |
| Skin renewal | 1.6–3.6 | 0.4–0.6 | 1.1–1.3 | 1–2 |
← Swipe sideways to view the full table →
Source: Pure Tone Aesthetics — Thulium Laser Pro Dual™ Operation Manual. Recommended 1927nm treatment parameters.
The settings are guidance for qualified practitioners trained on our equipment. Each treatment requires individual assessment and appropriate adjustment.
Understanding the 1927nm Ranges
The recommended parameters vary by application because the intended treatment response is different.
For example, a protocol for superficial pigmentary concerns should not automatically be applied to scars or stretch marks.
The practitioner must consider the complete combination of energy, pulse width, space and overlap rather than selecting values from each column independently.
The final settings should reflect the treatment objective, patient's skin characteristics, treatment area and expected recovery.
1550nm Erbium Glass
1550nm Erbium Glass Recommended Treatment Parameters
Reference settings for selected deeper fractional treatment applications.
Our 1550nm Erbium Glass wavelength provides a deeper non-ablative fractional treatment approach.
It may be selected for clinical applications involving skin texture, selected acne scars, fine lines and dermal remodelling.
Because 1550nm and 1927nm have different tissue absorption characteristics, their treatment parameters are not interchangeable.
The following ranges are our recommended 1550nm reference settings for Thulium Laser Pro Dual™.
| Application | Energy (mJ) | Pulse Width (ms) | Space | Overlap |
|---|---|---|---|---|
| Wrinkles | 18–45 | 3–5 | 0.9–1.1 | 1–2 |
| Skin rejuvenation | 15–40 | 3–5 | 0.9–1.1 | 1–2 |
| Other scars | 35–88 | 5–8 | 0.7–0.9 | 1–2 |
| Acne scars | 24–70 | 4–7 | 0.7–1.0 | 2–3 |
| Pigmentation spots | 24–70 | 4–7 | 0.9–1.1 | 1–2 |
← Swipe sideways to view the full table →
Source: Pure Tone Aesthetics — Thulium Laser Pro Dual™ Operation Manual. Recommended 1550nm treatment parameters.
These ranges are intended as professional clinical guidance. The practitioner must assess treatment suitability and select settings appropriate to the individual patient.
Choosing 1550nm for the Appropriate Clinical Objective
1550nm Erbium Glass is particularly relevant where the aim is deeper fractional dermal remodelling.
It may be considered for selected scarring, fine lines and textural irregularities.
Although pigmentation appears among the available treatment applications, the presence and type of pigmentation should be assessed before selecting a wavelength.
Conditions such as melasma can behave unpredictably following laser exposure and require careful patient selection and treatment planning.
The presence of an application in the reference table does not remove the need for clinical diagnosis, appropriate training or individual assessment.
Choosing the appropriate treatment
Two Wavelengths. Different Treatment Objectives.
Thulium Laser Pro Dual™ allows practitioners to select the wavelength most relevant to the patient's skin concerns.
1927nm Thulium
Particularly relevant for selected superficial pigmentation, uneven tone, photoageing and skin renewal.
1550nm Erbium Glass
May be selected for deeper fractional remodelling, selected scars, fine lines and texture.
Individual Assessment
Skin type, medical history, treatment area, clinical indication and expected recovery inform the treatment decision.
Understanding cumulative exposure
Why Spacing, Overlap and Treatment Coverage Matter
It is easy to focus on the energy setting and overlook the importance of how that energy is distributed.
The Space setting affects the distance between fractional treatment points within the selected scan pattern.
Closer treatment points may increase fractional coverage within a defined area.
The Overlap setting on Thulium Laser Pro Dual™ controls the number of repeated scans.
Increasing scan repetitions or making additional passes over the same area can increase cumulative thermal exposure.
This means that relatively low individual pulse energy does not necessarily produce a low-intensity treatment if the combination of other settings increases overall exposure.
Energy, pulse width, space, overlap, scan area and the number of passes must therefore be considered together.
Why Settings Cannot Be Copied Between Different Laser Systems
Different laser systems may use different pulse characteristics, fractional spot geometry, scanning systems and energy delivery methods.
Even where two machines operate at the same wavelength, their settings cannot automatically be considered equivalent.
The treatment parameters published here relate specifically to our Thulium Laser Pro Dual™ .
Clinical consultation
Adapting Treatment to the Individual Patient
The first clinical decision is whether the proposed treatment is appropriate. The parameter selection follows that assessment.
Skin tone, pigmentation history, previous laser responses, the condition being treated and relevant medical history can all influence treatment suitability.
Particular care may be required for patients susceptible to post-inflammatory hyperpigmentation, including those with darker skin types or a previous history of unwanted pigmentary changes.
The practitioner must also consider the treatment area, skin sensitivity, existing skin conditions and the level of recovery the patient can reasonably accommodate.
Every treatment plan should reflect these individual factors.
Pre-Treatment Assessment Checklist
- Confirm the skin concern, clinical indication and intended treatment outcome.
- Assess the patient's Fitzpatrick skin type and pigmentation history.
- Review recent tanning, sun exposure and any history of photosensitivity.
- Check relevant medical conditions, medications and previous laser treatments.
- Identify active infection, inflammation or other skin conditions affecting the treatment area.
- Review any history of abnormal scarring or delayed wound healing.
- Discuss the expected treatment response, limitations, recovery and possible complications.
- Obtain appropriate informed consent and clinical photographs.
- Confirm treatment-room safety arrangements and appropriate laser eye protection.
- Record the selected parameters, treatment area and observed skin response.
Contraindications and Precautions
Appropriate screening is an essential part of treatment planning.
As part of our precautionary clinical guidance, we recommend that treatments are not performed during pregnancy, where there is an active relevant infection or inflammatory skin condition affecting the treatment area, within two weeks of botulinum toxin injections in the treatment area, or during or within six months of oral isotretinoin treatment.
Isotretinoin (Roaccutane) is a prescription oral medication commonly used to treat severe acne. Patients may recognise the name Roaccutane rather than isotretinoin, so practitioners should ask about both during consultation.
Our two-week interval following botulinum toxin injections and six-month isotretinoin exclusion are precautionary Pure Tone policies rather than universal requirements for every non-ablative fractional laser procedure.
Patients with diabetes, hypertension or cardiovascular disease should be assessed individually rather than automatically excluded solely on the basis of their diagnosis.
Where a condition is poorly controlled, healing may be impaired, or there is uncertainty about suitability, the practitioner should defer treatment pending appropriate medical advice.
These examples are not an exhaustive contraindication list. Practitioners must follow our current clinical guidance and carry out a full patient assessment before treatment.
Treatment course planning
How Many Treatments and How Far Apart?
The appropriate number of treatment sessions depends on the condition being treated, the wavelength, treatment intensity and the patient's response.
In our practical training, we generally use approximately four weeks between treatments as a starting point.
This interval is consistent with many published fractional laser protocols, but four weeks should not be considered a universally established optimum for every application.
Some patients may benefit from longer intervals, particularly following more intensive treatments or where additional skin recovery is required.
Intervals of six to eight weeks may therefore be appropriate in selected circumstances.
The treating practitioner should evaluate the response to the previous session before deciding when further treatment should take place.
We do not recommend performing another session simply because a predetermined number of weeks has passed.
The skin should have recovered sufficiently, and the practitioner should be satisfied that further treatment is appropriate.
Understanding treatment intensity
Recognising Different Levels of Skin Response
1927nm Thulium is generally described as a non-ablative fractional laser technology.
However, our Thulium Laser Pro Dual™ can produce visible surface ablation at very high settings.
This must be considered when assessing treatment intensity and planning recovery.
The cumulative thermal effect depends on the selected wavelength, pulse energy, pulse width, fractional spacing, scan repetitions, number of passes and the patient's skin characteristics.
A treatment should not be regarded as gentle solely because the individual pulse energy is relatively low.
The overall parameter combination and the observed skin response are both important.
This is particularly relevant when considering whether a second wavelength might be used during the same appointment.
1927nm and 1550nm treatment planning
Can Both Wavelengths Be Used During the Same Appointment?
The combination of 1927nm Thulium and 1550nm Erbium Glass provides practitioners with two different fractional treatment approaches.
Published clinical research involving comparable dual-wavelength laser systems has investigated the use of both wavelengths during the same appointment.
This supports the clinical principle of combining superficial and deeper fractional treatment approaches.
However, an appropriately planned combined treatment is not the same as performing two separate full-intensity procedures back to back.
The practitioner must consider the total thermal effect of both wavelengths.
This is especially important where a more intensive 1927nm treatment has already produced marked epidermal disruption or visible ablation.
In those circumstances, additional energy during the same appointment may not be appropriate.
Where necessary, the wavelengths can instead be used in separate appointments, allowing recovery and reassessment before further treatment.
Our Ongoing Work on Combination and Stacked Treatments
We are continuing to evaluate ways of combining 1927nm Thulium and 1550nm Erbium Glass to develop further practical treatment guidance.
This includes working with an experienced laser specialist who has developed approaches involving Thulium, Erbium Glass and fractional CO₂ laser technology.
Our work will consider treatment sequencing, parameter selection, clinical applications and appropriate patient selection.
As this progresses, we intend to publish further clinically reviewed treatment guidance for our professional customers.
Until those additional protocols have been reviewed and approved, we are not recommending a single fixed same-session sequence or combined parameter set for every patient.
Post-treatment care
Recovery and Aftercare Following Thulium Laser Treatment
The recovery period following fractional laser treatment depends on the wavelength used, selected parameters, treatment intensity and individual skin response.
Temporary warmth, redness, dryness, bronzing or flaking may occur following some treatments.
More intensive treatments may produce a stronger surface response and require additional recovery precautions.
Immediate Cooling
Following treatment, our aesthetic nurse and trainer Donna Cummings typically uses a chilled, single-use facial mask soaked in sterile 0.9% saline solution to help cool and calm the skin.
The mask is prepared hygienically and applied according to the patient's comfort and skin response.
Where appropriate, the treated skin may also be gently cleaned with cool or tepid water immediately after the procedure.
The First 24–36 Hours
We generally recommend avoiding hot showers, hot baths, saunas, swimming, conventional facial cleansers and other products or activities that could irritate or overheat the treated skin during the first 24–36 hours .
More intensive treatments may require longer restrictions depending on the condition of the skin.
Patients should avoid scrubbing, exfoliation and picking at flaking or crusting skin.
R7 Recovery Cream and S7 SPF50+ Protection
Our R7 Regenerating and Moisturising Cream has been developed specifically for post-laser skincare, including following fractional CO₂ treatments.
As part of our usual recovery guidance, we recommend applying R7 twice daily for seven days , with additional applications where required, according to the skin's condition and the practitioner's instructions.
We also advise patients to avoid direct sunlight as much as possible during recovery.
Where going outdoors cannot be avoided, our S7 Recovery and Regeneration Sun Cream SPF50+ can provide additional UV protection, provided the practitioner considers the treated skin suitable for sunscreen application.
S7 should be reapplied as necessary in accordance with the product instructions and level of exposure.
Sun protection is a last line of defence, not permission to expose recently treated skin to strong sunlight.
Avoiding unnecessary sun exposure remains the preferred approach during recovery.
These are general aftercare recommendations. The treating practitioner should determine the appropriate routine for each individual patient.
Any unexpected, persistent or worsening skin reaction should be assessed by an appropriately qualified clinician.
Technology · Training · Support
Professional Training Is Essential to Treatment Planning
Understanding the reference parameters is one part of professional laser practice. Using them appropriately requires the right qualifications, practical training and clinical judgement.
Independent Laser Qualifications
Practitioners must hold the relevant qualifications and competence for the laser treatments they intend to perform.
Practical Machine Training
We provide one-to-one, nurse-led, equipment-specific training at the purchasing customer's clinic.
Ongoing Clinical Support
Our support continues after delivery and installation, including technical and clinical guidance on our equipment.
Pure Tone Aesthetics is a CPD Approved Provider and supplies practical, nurse-led training for our professional equipment.
Our training focuses on the operation and appropriate clinical use of the machine purchased.
It does not replace the independent laser qualifications, relevant Core of Knowledge training or other competence requirements necessary for professional practice.
Where practitioners require additional laser education, we can recommend an independent specialist training provider that offers relevant laser qualifications and training on Pure Tone equipment.
This allows practitioners to develop their underlying laser knowledge alongside the equipment-specific training we provide.
Clinical evidence and treatment planning
Understanding the Published Clinical Research
Our recommended treatment parameters provide equipment-specific guidance for Thulium Laser Pro Dual™.
Published clinical research provides additional context, demonstrating how 1927nm Thulium and 1550nm Erbium Glass have been used in different patient groups and treatment applications.
This research can help practitioners understand treatment selection, appropriate intervals, expected skin responses and clinical outcomes.
For example, a 2022 expert consensus publication in Dermatologic Surgery examined treatment settings and best practices for combined 1550nm and 1927nm fractional laser technology.
The publication considered patient selection, clinical applications, treatment parameters and practical approaches to the two wavelengths.
These findings provide useful clinical context. However, the numerical settings used in studies involving other laser platforms should not be transferred directly to our equipment.
For Thulium Laser Pro Dual™, practitioners should use our recommended parameters and equipment-specific clinical training as their reference.
Further Clinical Reading
Best Practices and Treatment Setting Recommendations
1,550 nm Erbium-Doped and 1,927 nm Thulium Nonablative Fractional Laser System: Best Practices and Treatment Setting Recommendations.
Read the research publication →
Optimising Dual-Wavelength Treatment Outcomes
Optimizing Outcomes With the 1550/1927 nm Dual Wavelength Non-Ablative Fractional Laser.
These publications provide clinical research context for the two wavelengths. The settings published in those studies are not substitutes for our equipment-specific treatment guidance.
Technical questions
Thulium Laser Protocol FAQs
Are these recommended settings suitable for every patient?
No. The settings provide reference ranges for qualified practitioners trained on Thulium Laser Pro Dual™.
Treatment parameters must be selected according to the patient's skin type, skin condition, medical history, treatment objectives and clinical response.
Can these settings be used on other Thulium lasers?
No. Our recommended settings apply specifically to Thulium Laser Pro Dual™.
Other laser systems may use different pulse characteristics, scanning technology or energy delivery methods.
Are all energy values expressed in mJ?
Yes. Energy values for both 1927nm Thulium and 1550nm Erbium Glass are expressed in millijoules (mJ).
What does Overlap mean on Thulium Laser Pro Dual?
Overlap refers to the number of scan repetitions within the selected treatment area.
The number of scans must be considered alongside energy, pulse width, spacing and total treatment coverage.
Is four weeks the recommended treatment interval?
Approximately four weeks is our usual starting point between treatments.
However, the interval should be adjusted according to treatment intensity, clinical indication, skin response and recovery.
Longer intervals may be appropriate for some patients.
Can 1927nm Thulium produce visible ablation?
Yes. Although 1927nm Thulium is generally described as non-ablative, very high settings on Thulium Laser Pro Dual™ can produce visible surface ablation.
Treatment intensity and the skin's actual response must be considered when planning further treatment and aftercare.
Can 1927nm and 1550nm be combined in one appointment?
Same-session dual-wavelength treatments have been investigated in published clinical research.
However, the suitability of a combined protocol depends on the patient, selected settings and total thermal exposure.
We are continuing to evaluate specific stacked-treatment protocols and will publish further guidance following clinical review.
What is Pure Tone's usual recovery cream?
We normally recommend R7 Regenerating and Moisturising Cream as part of post-laser skin care.
Our usual guidance is twice-daily application for seven days, with additional applications where appropriate.
The treating practitioner should adapt aftercare to the patient's skin response.
Can patients go into the sun after laser treatment?
We recommend avoiding direct sunlight as much as possible during recovery.
Where outdoor exposure cannot be avoided, S7 SPF50+ may provide additional protection if the skin is suitable for sunscreen application.
Sunscreen does not replace the need to minimise sun exposure.
What laser qualifications are required?
Practitioners must have the relevant laser qualifications and competence for their professional practice.
Pure Tone's training is equipment-specific and does not replace independent Core of Knowledge or other required laser education.
Does Pure Tone provide practical machine training?
Yes. We provide practical, nurse-led, one-to-one training on the equipment purchased.
Our trainers travel to the customer's clinic, where training takes place on the installed machine.
Ongoing clinical and technical support is also available.
Final thoughts
Recommended Parameters. Individual Treatment Planning.
Our recommended treatment settings provide a structured reference for qualified practitioners using Thulium Laser Pro Dual™.
They reflect the different applications of 1927nm Thulium and 1550nm Erbium Glass, and the importance of selecting appropriate energy, pulse width, spacing and overlap.
However, no single parameter combination is suitable for every patient.
The treatment objective, patient's skin characteristics, clinical assessment and observed response must always determine the final treatment plan.
Technology · Training · Support
Explore Thulium Laser Pro Dual™ for Your Clinic
Discover the versatility of 1927nm Thulium and 1550nm Erbium Glass in one professional fractional laser system.
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