Knowledge of laser tissue reactions and tissue properties allows the practitioner to tailor a treatment to an individual patient's need and goals. A laser's power, spot size and pulse duration may be manipulated to yield different tissue reactions. Five tissue reactions, each the result of varying laser pulse durations and energy densities, may be achieved. They are photochemical, photothermal, photoablation, plasma-induced ablation and photomechanical. Of these, photothermal reactions are most utilized in dermatology. When higher powered pulses are applied, tissue often undergoes multiple reactions simultaneously. An understanding of these reactions allows their effects to be predicted. In this chapter, the various reactions are reviewed, and the reactions caused by many of the most commonly used lasers in dermatology are discussed.
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