Laser/tissue interaction.

When laser light impinges on tissue, it can reflect, scatter, be absorbed, or transmit to the surrounding tissue. Absorption controls to a great degree the extent to which reflection, scattering and transmission occur, and wavelength is the primary determinant of absorption. The CO2 laser is consistently absorbed by most materials and tissues and the Nd-YAG laser wavelength is preferentially absorbed in pigmented tissues. The factors which determine the initial tissue effect include the laser wavelength, laser power, laser waveform, tissue optical properties, and tissue thermal properties. There are almost an infinite number of combinations of these factors possible, many of which would result in unacceptable damage to the tissues. This underscores the need to thoroughly test any particular combination of these factors on the conceptual, in-vitro, and in-vivo level before a treatment is offered.