Defining the Role of Contact Cooling in Non- Ablative Laser Therapy
By John Hoopman, CLMSO
One of the most significant advances in the safety and comfort of non-ablative laser
treatments has been the introduction of contact cooling. As the demand for aesthetic
laser procedures increases, so too does the responsibility of practitioners to ensure
effective results while minimizing adverse effects. Understanding the role of contact
cooling is key to mastering non-ablative laser therapies, particularly in the treatment of
vascular and pigmented lesions, skin rejuvenation, and hair reduction.
What Is Contact Cooling?
Contact cooling refers to a system where the skin is cooled directly via a chilled sapphire
or glass window built into the handpiece of the laser device. This method provides
continuous cooling to the epidermis before, during, and after the laser pulse is delivered.
The goal is twofold:
Protect the epidermis from thermal injury
Enhance patient comfort during treatment
Unlike cryogen spray or forced air cooling, contact cooling enables consistent and
predictable cooling across the treatment area. This method has become particularly
important in treating darker skin types where melanin density increases the risk of
epidermal damage.
Why Cooling Matters in Laser-Tissue Interaction
Every laser treatment generates heat within the tissue. The target chromophore (e.g.,
melanin, hemoglobin) absorbs the laser energy, converting it into heat that destroys the
target structure. However, surrounding tissues—especially the epidermis—are also
exposed to heat, increasing the risk of burns, blisters, or pigmentation changes.
By actively cooling the surface skin, practitioners can deliver higher energy fluence to the
target tissue without causing damage to the epidermis. This is particularly valuable in non-
ablative treatments where no intentional injury to the skin surface is desired.
Benefits of Contact Cooling
Minimized Epidermal Damage: Reduces the chance of burns and PIH (post-
inflammatory hyperpigmentation), especially in Fitzpatrick skin types IV–VI.
Enhanced Patient Comfort: Contact cooling significantly reduces the
discomfort patients feel during higher fluence treatments.
Allows for Aggressive Parameters: Because the skin surface is protected,
practitioners can use more powerful treatment settings safely.
Improved Recovery Times: Patients report fewer side effects and quicker
recovery when contact cooling is used.
Clinical Applications
Contact cooling has become the standard for a variety of non-ablative laser treatments:
1. Hair Reduction
Cooling protects the epidermis during high-energy treatments aimed at targeting melanin
in hair follicles. This is especially crucial when treating patients with darker skin tones.
2. Vascular Lesions
In procedures targeting hemoglobin, such as treatment of telangiectasia or rosacea,
cooling allows the use of effective fluence without causing purpura or blistering.
3. Pigmented Lesions
Melanin is highly absorptive and prone to overheating. Contact cooling ensures a margin
of safety when treating solar lentigines, freckles, or melasma.
4. Skin Rejuvenation
Non-ablative resurfacing relies on controlled dermal heating to stimulate collagen while
preserving the epidermis. Contact cooling ensures treatment comfort and protects
epidermal integrity throughout the session.
Comparing Cooling Methods
Cooling
Method Description Advantages Limitations
Contact
Cooling
Chilled sapphire window in
handpiece
Consistent, immediate, works during
treatment Requires device design integration
Cryogen Spray
Short spray of coolant before laser
pulse Effective for certain procedures
Can be uneven, doesn’t cool during
pulse
Air Cooling Cold air blown across skin surface Flexible and easy to use Less efficient, doesn’t protect deeply
Safety Considerations
Even with cooling, practitioners must remain vigilant:
Ensure full contact between the cooling window and skin
Avoid overlapping pulses
Adjust settings based on skin type and sensitivity
Cooling is not a license to overtreat—it is a tool that enhances the margin of safety but
should still be used with precise understanding of tissue response and patient variables.
Conclusion
Contact cooling is a vital component of safe and effective non-ablative laser therapy.
When used properly, it enhances patient comfort, protects the epidermis, and expands
your ability to treat a wider variety of skin types and conditions.
As with all tools in medical aesthetics, the benefit lies not just in having it—but in
understanding how to use it. Mastering laser physics and integrating safety features like
contact cooling will separate the technician from the true expert.
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