Laser-based therapies are widely used in aesthetic dermatology for the treatment of vascular lesions, pigmentation disorders and skin rejuvenation. Treatment outcomes and safety depend on appropriate selection of technical parameters, including fluence, pulse duration and spot size; however, standardized guidelines remain limited. This study systematically reviews the impact of key laser parameters on clinical efficacy and adverse events, with emphasis on vascular treatments using Nd:YAG, IPL and modern platforms, including Cutera systems. A literature search in PubMed (2010–2025) identified clinical studies reporting specific laser settings. Fluence was the primary determinant of efficacy, with higher energy improving vascular clearance but increasing the risk of burns and post-inflammatory hyperpigmentation. Pulse duration influenced tissue selectivity, while spot size affected penetration depth and treatment outcomes. Advanced systems demonstrated improved safety due to enhanced pulse modulation and cooling; however, complications remained linked to improper parameter selection. Optimization of laser parameters is essential for balancing efficacy and safety, and individualized treatment based on lesion characteristics and skin type remains crucial. Further research is needed to establish standardized protocols.
Lewandowska et al. (Fri,) studied this question.