The epidermal melanin content affects most dermatologic treatments involving light, and can limit the therapeutic success significantly. Therefore, knowledge of the optical properties of skin is required. This study investigates how the concentration of melanin influences visible reflectance spectra of skin and the relationship to threshold radiant energy fluence for melanosomal or melanocyte destruction. Reflectance spectra were measured at 28 pigmented human skin sites in vivo. For Asian and Caucasian subjects, measured reflectance values varied over the same range, while significantly lower values were recorded for African individuals. Epidermal melanin absorption coefficients measured at 694 nm were about 2500 m-1 for African, and 300-1200 m-1 for Caucasian and Asian skin. Twenty-five skin sites were exposed to ruby laser pulses (694 nm), where the pulse duration was long enough to allow heat diffusion between melanosomes. Hypopigmentation occurred, on average, at 12 and 26 J cm-2 for sun-exposed and sun-protected white skin, respectively, while slightly lower threshold values resulted from the measured spectra. As visible reflectance spectra reveal information regarding skin pigmentation and individual threshold doses for melanosomal damage, a use as a diagnostic tool in various dermatological laser treatments is apparent.

Noncontact, frequency-domain measurements of diffusely reflected light are used to quantify optical properties of two-layer tissuelike turbid media. The irradiating source is a sinusoidal intensity-modulated plane wave, with modulation frequencies ranging from 10 to 1500 MHz. Frequency-dependent phase and amplitude of diffusely reflected photon density waves are simultaneously fitted to a diffusion-based two-layer model to quantify absorption (mu(a)) and reduced scattering (mu(s)') parameters of each layer as well as the upper-layer thickness (l). Study results indicate that the optical properties of two-layer media can be determined with a percent accuracy of the order of +/-9% and +/-5% for mu(a) and mu(s)', respectively. The accuracy of upper-layer thickness (l) estimation is as good as +/-6% when optical properties of upper and lower layers are known. Optical property and layer thickness prediction accuracy degrade significantly when more than three free parameters are extracted from data fits. Problems with convergence are encountered when all five free parameters (mu(a) and mu(s)' of upper and lower layers and thickness l) must be deduced.

Selective photothermolysis with pulsed lasers is presumably the most successful therapy for port-wine stain birthmarks (flammeus nevi). Selectivity is obtained by using an optical wavelength corresponding to high absorption in blood, together with small absorption in tissues. Further on, the pulse length is selected to be long enough to allow heat to diffuse into the vessel wall, but simultaneously short enough to prevent thermal damage to perivascular tissues. The optical wavelength and pulse length are therefore dependent on vessel diameter, vessel wall thickness and depth in dermis. The present work demonstrates that in the case of a 0.45 ms long pulse at 585 nm wavelength, vessels of 40-60 Μm require minimum optical fluence. Smaller vessels require higher fluence because the amount of heat needed to heat the wall becomes a substantial fraction of the absorbed optical energy. Larger vessels also require a higher dose because the attenuation of light in blood prevents the blood in the centre of the lumen from participating in the heating process. It is shown that the commonly used optical dose in the range of 6-7 J cm-2 is expected to inflict vessel rupture rather than thermolysis in superficially located vessels. The present analysis might serve to draw guidelines for a protocol where the optical energy, wavelength and pulse length are optimized with respect to vessel diameter and depth in dermis. © 1995 W.B. Saunders Company Ltd.

The ability to control the degree and spatial distribution of cooling in biological tissues during a thermally mediated therapeutic procedure would be useful for several biomedical applications of lasers. We present a theory based on the solution of the heat conduction equation that demonstrates the feasibility of selectively cooling biological tissues. Model predictions are compared with infrared thermal measurements of in vivo human skin in response to cooling by a cryogen spurt. The presence of a boundary layer, undergoing a liquid-vapour phase transition, is associated with a relatively large thermal convection coefficient (approximately 40 kW m-2 K-1), which gives rise to the observed surface temperature reductions (30-40 degrees C). The degree and the spatial-temporal distribution of cooling are shown to be directly related to the cryogen spurt duration.

The optical properties (absorption and transport scattering coefficients) of freshly excised, bulk human uterine tissues were measured at 630 nm using frequency-domain and steady-state photon migration techniques. Measurements were made on both normal (pre- and post-menopausal) and non-neoplastic fibrotic tissues. The absorption coefficient of normal post-menopausal tissue (approximately 0.06 mm(-1)) was found to be significantly greater than that of normal pre-menopausal tissue (0.02-0.03 mm(-1)) and pre-menopausal fibrotic tissue (0.008 mm(-1)). The transport scattering coefficient was similar in all three tissue types considered (0.6-0.9 mm(-1)). From the preliminary results presented here, we conclude that optical properties can be reliably calculated either from the frequency-dependent behaviour of diffusely propagating photon density waves or by combining the frequency-independent photon density wave phase velocity with steady-state light penetration depth measurements. Instrument bandwidth and tissue absorption relaxation time ultimately determine the useful frequency range necessary for frequency-domain photon migration (FDPM) measurements. Based on the optical properties measured in this study, we estimate that non-invasive FDPM measurements of normal uterine tissue require modulation frequencies in excess of 350 MHz.

The clinical objective in laser treatment of selected dermatoses such as port wine stain (PWS), hemangioma and telangiectasia is to maximize thermal damage to the blood vessels, while at the same time minimizing nonspecific injury to the normal overlying epidermis. 'Dynamic' cooling of skin, whereby a cryogen is sprayed onto the surface for an appropriately short period of time (on the order of tens of milliseconds), may offer an effective method for eliminating epidermal thermal injury during laser treatment. We present theoretical and experimental investigations of the thermal response of skin to dynamic cooling in conjunction with pulsed laser irradiation at 585 nm. Computed temperature distributions indicate that cooling the skin immediately prior to pulsed laser irradiation with a cryogen spurt of tetrafluoroethane is an effective method for eliminating epidermal thermal injury during laser treatment of PWS. Experimental results show rapid reduction of skin surface temperature is obtained when using tetrafluoroethane spurts of 20 - 100 ms duration. Successful blanching of PWS without thermal injury to the overlying epidermis is accomplished.