I.

Laser Toning Tx Guidelines

VRM Laser Toning™?

VRM Laser Toning is a skin rejuvenation treatment with 1064nm wavelength in Q-Switched Mode(5ns) without
using Spectra Lotion. This treatment effectively destroys melanin which is abnormally dispersed in the dermis
causing dermal Melasma. This treatment may be combined with Soft Peel for treating Epidermal Melasma as well.

Tx Parameters
Wavelength Spot size Fluence Tx
Indic ations Tx Interval Pass
(nm) [h/piece] (J/cm2) Sessions
8 mm
Melasma / PIH 1064 1.0 ~ 1 - 2 week 5~6 10 sessions
[Collimated]
Keloids / 7 mm
1064 1.3 – 1.7 1 - 2 week 2~3 10 sessions
Hypertrophic scars [Collimated]
7-8
2.0 ~ 2 week 2~3 10 sessions
Nevus of Ota / [Zoom]
ABNOM /Hori’s 1064 Endpoint is dark erythema (Absolutely avoid Pinpoint bleeding)
Macules (Start with 1.7~ J/cm2 and then adjust fluence by following reaction in the case
of patients before adolescent )
We recommend a parameter with low Hz (2-5Hz) in laser toning because it protect side affect from stacking

Tx Procedure

1 2 3
1st pass
4100130401 / Rev 0.1

2nd pass
put goggles on face After Adjust a fluence based on a color of The ending point is when mild erythema
cleansing the face. Melasma(The darker melasma, the is appeared after emitting repetitive
Soft peel is recommended before lower fluence) after choose 1064nm shots with 2~3 pass following the
Laser toning because it makes with collimated handpiece, direction on the picture
better result of laser toning
End Point
[Caution!]
• Treat with 50% spot overlap and 2-3 passes until
mild erythema appeared
(exception: Nevus of Ota / ABNOM /Hori’s Macules)
- over 80-90% overlapping might cause post
treatment side effects such as PIH).
• When treatment is around eyes and cheekbone,
please decrease the number of pass after watching
the skin reaction. Because these area have very
After Tx
thin skin with sensitive and easy to make visible
Before Tx redness
(Appropriate reaction of the skin)
• Keep the distance between the end of the
handpeice and skin within 5 cm during the Tx
Melasma Tx (examples)

Soft Peel + Soft Peel + Laser toning

Laser toning
Laser toning Laser toning
1week 1week 1week Interval

4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved
 II. SpectraPeel Tx Guidelines

SpectraPeel™
Spectra PeelTM is a skin rejuvenation treatment with 1064nm wavelength, using both Spectra
Mode (300μs) and Q-switched Mode(5ns) with Spectra Lotion™. Spectra Mode provides
photobiostimulation to the epidermis by gentle heat.

Tx Parameters
Spectra Wavelength Spot Size Fluence Tx
Indication Pass
Lotion (nm) (mm) (J/cm2) Interval
O Spectra 1.0 ~ 1
• Inflammatory Acne
O 1064 8 mm 1.0 ~ 3
• Erythema/Post Collimated Multi
Inflammatory Acne X Spectra 2.0 ~ passes
O Spectra 8 mm 1.0 ~ 1
O 1064 Collimated 1.0 ~ 3 1 – 2 week
• Enlarged Pores
6 mm Zoom
X 1064 (n T-zone) 2.5~4.2 3-5
O Spectra 8 mm 1.0 ~ 1
• Skin Rejuvenation Collimated
O 1064 1.0 ~ 3
7mm
For wrinkles -> X 1064 Collimated 2.0~ 3-5
After finish Spectra Peel process(without Spectra Lotion), multiple pass approach
with 1064 nm, 2.0 ~ 2.5 J/cm2 (6, 7 mm spot size) to localized large pores and wrinkles.

Tx Procedure

1 2 3

Apply a thin layer of Spectra

Lotion on entire surface of the Select a Spectra mode on Wavelength 1pass Tx with Spectra mode
face for Spectra Peel peel Tx [Caution!]
☞ Use smooth concurrent passes to explode
4 5 the Spectra Lotion particles. Treat with 50%
spot overlap and 2-3 passes until all residual
1 pass
st Spectra Lotion has been removed.
- over 80-90% overlapping might cause post
treatment side effects such as PIH).
☞ In case of sensitive and thin skin, when
2 pass
nd
emitting repetitive shots or over 1.5J/cm2 with
Spectra mode to the same area carbon skin ,
Select a 1064 nm Wavelength Remove the applied Spectra
it might cause a burn.
for Soft peel Lotion on surface of the face by
☞ Always use collimated handpiece
(To remove a Spectra Lotion) Soft peel.
☞ Keep the distance between the end of the
handpiece and skin within 5 cm during the Tx
End Point

▶ The reaction of skin immediately after Spectra peel

There used to observe erythema on entire area of treatment.

Colorful erythema and edema is a temporary reaction post treatment.
These would be improved by using of icepack cooling.

4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved
 III. Pigmented Lesions & Tattoo

Tx Parameters

Lesion Wavelength Spot Size Fluence Tx

Indications
divisions (nm) (mm) (J/cm2) Sessions
Ephelides/Freckles 1.7 mm 1.0 ~ 1~2
Seborrheic Keratoses 2.6 mm 0.6 ~ 1~2
Epidermis 532
Café-Au-Lait 2.6 mm 0.6 ~ 2~3
Nevus Spilus 2.6 mm 1.2 ~ 3~
Becker’s Nevi 1064 3 mm 4.5 ~ 6~
4 mm 4.5 ~
Nervus of Ota 1064 3 ~ 10
3 mm 6.0 ~
1064
Conventional 3 ~ 4 mm 4.5 ~ 3~
Dermis Tx method
• ABNOM 7 ~ 8 mm 2.0 ~ 10 ~
• Hori’s Nevus 1064
New Tx method Approach with 2-3 passes and have 3weeks Tx interval
(laser toning) (Start with 1.7~ J/cm2 and then adjust fluence by following
reaction in the case of patients before adolescent)
Black/Blue/Brown 1064 3 ~ 4 mm 3.0 ~ 3~
Tattoos Red 532 2.6 mm 1.5 ~ 3~
Eyebrow Tattoo 1064 3 ~ 4 mm 2.0 ~ 1~2
• Eyeliner Tattoo
Epidermis 1064 3 mm 2.0 ~ 1~3
• Lipliner Tattoo
Treatment interval Epidermal lesions : 4 weeks, Dermal lesion : 6-8 weeks

Tx Procedure

1 2 3 4
Apply topical
anesthetics(EMLA).
After 40 min,
remove it.

Treat the area carefully. Apply antibiotic ointment. Dressing (maintain 1~2 day)

End Point
▶ Appropriate skin reaction ▶ Appropriate skin reaction ▶ Appropriate skin reaction
immediately after 532 nm immediately after 1064 nm immediately after Tattoo Tx

1064 nm endpoint
Nevus of Ota
(Tattoo)

Seborrhei Keratoses Ephelides/Freckles

 Epidermal lesion(532nm) : Mild whitening is observed immediately after the single shot. Decrease the fluence if
severe whitening occurs. Increase the fluence if mere red or no color changes. Never treat with repetitive shots on
the same spots at any time.
 Dermal lesion & Tattoo(1064nm) : Frosting + Mild Pinpoint bleeding can occur immediately after the single
treatment. Increase the fluence slightly if no frosting occurs. Then proceed to another shot on the next area.
Decrease the fluence, if bleeding is too much.
4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved
 III. Pigmented Lesions & Tattoo

Treatment Tips for Pigmentary Lesions and Tattoo Removal

• After removing topical anesthetics, perform 2-3 test shots with recommended lowest fluence according to the type of
skin lesions.
• Mild pinpoint bleeding may occur rarely in 1064nm wavelength treatment. However, this is a normal condition
because laser beam penetrates into dermis. No need to worry.
• The treatment sessions of tattoo removal may vary depending on the types and depth of tattoo pigment particles.
Rarely, red-colored tattoos may get darken after tattoo removal treatment because red tattoos sometimes contain iron
oxide. Please do the test shots prior to the treatment.
• In the same fluence, as spot size increases, the penetration depth also increases as well. For the removal of spots,
usually the 3mm or bigger spot size is used.
• As the treatment sessions continue, gradually increase the fluence since there are lesser and deeper pigment
chromophores compared to the first session.
• If a patient underwent Spectra Peel or Soft Peel immediately prior to the removal of the pigmentary lesion, apply the
lower fluence for the removal of pigmentary lesions.
• Do not perform excessive treatment at one session. Routine treatment requires at least more than 2 sessions.

Post-treatment Care for Pigmentary Lesions and Tattoo Removal

• Apply antibacterial ointment every morning and night until crusts peel off.
• Apply artificial skin or dressing on the day of treatment. Dressing provides protection against invasion of the
microorganism until crusts form.
• Avoid water contact to the treatment area on the day of treatment. Shower or washing should be done on the next
day after treatment.
• Never scrub or stimulate the treated area by force.
• Never attempt to peel off the crust. It should peel off naturally.
• After curst peels off, always apply sun screen lotion (at least SPF 30) when you’re in outdoor.
• Apply hydroquinone at nighttime for the prevention of PIH.

Nervus of Ota Tx (Examples)

Conventional Conventional Laser toning Laser toning

Tx method Tx method Tx method Tx method
4-6weeks 4-6weeks 2weeks 2weeks

Spot size and Minimum/Maximum energy

Spot size Min Spot size Min

λ(nm) Max (J/cm2) λ(nm) Max (J/cm2)
(Φ,mm) (J/cm2) (Φ,mm) (J/cm2)
0.8 2.0 50 1 13 50
1.7 0.45 17 2 3.2 38
2.6 0.19 7.5 3 1.5 16
3.4 0.11 4.0 4 0.8 9.5
532 1064
4.3 0.07 2.6 5 0.55 6.0
5.2 0.05 1.8 6 0.36 4.0
6.0 0.04 1.4 7 0.26 3.0
6.9 0.03 1.0 8 0.2 2.2

As the recommended treatment values for each symptoms and/or effects are standards to be used for consultative
purposes only, we recommend adjusting such values for patients depending on each patient's special circumstances
and treatment history. Lutronic shall not be liable for any injuries, problems or issues that arise as a result of
negligence or inexperience in using the product supplied by Lutronic, rather than as a result of any actual defect on
the product itself as supplied by Lutronic.

4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved
 IV. SPECTRATM Operation & Maintanance

Tx Tip
Shot Count : Fluence :
Means the total accumulated quantity Energy density in per unit area Aiming Beam:
of laser emission energy(shot counts). Controll : Visually shows the aiming point of
The Reset button initialized shot count. Press a Up & Down button the treatment laser, possible
adjusting of light intensity.
Pulse Rate:
Toning:
The number of pulses which are
Basic parameter which is used
emitted in the time of a second.
in laser toning is saved.
select among (S1/ 1/ 2/ 5/ 10)
Recall : press a button.
Spot size:
Select a spot size of laser. Standby / Ready:
Automatically followed by Standby – possible to emit laser
alternation of handpiece spot size. Ready – impossible to emit laser

Wavelength: Memory:
To Select of wavelength The function is to save
and mode. (1064 / 532 / Spectra) parameters into the system as
Memory, to recall and display the
parameters on the control panel.
How to use memory save

1 2 3

In Operation mode, after entering Press Modify button. The parameters set Once the window to save the
Memory mode by pressing Memory right before in Operation mode are memory, as show in picture, will flash.
button marked M. displayed in the parameter setup section Then, press the OK button.
on the right. Set the parameter as you
wish and save in one of the memories.

4 5 6

Press Rename button at bottom to Press Modify button to check that desired Screen recalled a memory.
save a memory name. When the parameters and memory name are saved as
keyboard flashes, input a memory shown in picture.
name by using the keyboar. Recall memory : Enter Memory mode by
Once inputting a memory name is pressing Memory button on top of Operation
completed, save the memory name mode screen. Choose desired a memory from
by pressing Accept button on top. M1 ~ M8. the selected memory is highlighted
in yellow as shown in picture.
4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved
 IV. SPECTRATM Handpiece Guidelines

Connection of Handpiece

1 2

Holding a articulated arm not to be shaked, and Confirm arrows are located in both cable socket
assemble handpiece connector into the port, and attached with end of articulated arm and handpiece
turn it as shown picture tightly. cable connector. assemble connector into the port in a
strait line as shown picture

Selection of Handpiece spot size

① Holding the control of spot
size portion and Pull it down .
② Select a spot size turning to  Collimated handpiece:

1 1 ③
Right or left as you wish .
Selecting of Spot size on
Using for Laser Toning, Soft Peel and Spectra Peel

Handpiece, Spot size on  Zoom handpiece :

2
screen is Automatically
Using for Pigmented Lesions & Tatoo
matched with it

Use of Handpiece
① Hold the handpiece perpendicular to the skin
surface as shown in the photos left. Place the Zoom
beam handpiece lightly on the skin but use caution
because energy fluence can go up significantly as
the spot size exposed on the skin becomes smaller,
which will occur if the handpiece is away from the
correct Incorrect Incorrect
skin more than 2mm.
② Collimate Handpiece doesn’t matter with energy
fluence till 2cm away from the skin
Users Cleaning precedure for the Handpiece

① Separation of the handpiece: To remove the handpiece tip Use an ethanol moistened cotton swab wet over 90 %,
from the handpiece, hold the handpiece body with one hand then remove debris located on window.
and pull the handpiece tip with the other hand by turning to In this time, Do not apply force to the cotton swab as
clockwise this may damage the window coating.
② Clean the surface of the handpiece with a slightly damp
cloth. While doing this, be careful not to contact the lens.

4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved
 Post-Treatment Care Instructions

Wash with water or a mild cleanser. Do not scrub the treated area.
Usually the bronzed skin will well peel off within 5-7 days after the
treatment.
Please do not use functional cosmetics which contains Letinol, AHA
after treatment without unless given prior permission from doctor.

Avoid exercising for the first week post treatment or until initial
healing has occurred. Increased redness may result from any
activity that increases blood flow or body temperature (ex, alcohol
consumption, exercise, sauna).

Avoid using alcohol-containing cosmetics at least for 1 week after

the treatment. You may use a mild type of skin moisturizing lotion.

Apply sun block with more than SPF 30 and use umbrella, cap or
any available protections against sun light in outdoor during at least
30 days after treatment.

Please notice doctor that if you have to use any kinds of medication
for treatment of disease.

For more information, please contact to your physician below.

4100130501 / Rev 0.1 Copyright 2010 Lutronic Corporation All Rights Reserved