Abstract: An apparatus for the treatment of a soft tissue injury (eg a soft tissue injury that may be the cause, or contributes to, acute or chronic pain such. as sciatica) comprising; a thermal imaging arrangement to scan, a least a portion of a patient to provide a thermal image; a processing arrangement to review the thermal image to determine a point or region of thermal anomaly on the patient; a laser treatment device to provide a laser beam (eg for low-level laser treatment); and a guidance arrangement for the laser treatment device to guide the laser beam to the point or region of thermal anomaly on the patient as determined by the processing arrangement; to thereby treat the patient.

Abstract: The present disclosure provides apparatuses and computer readable media for measuring sub-epidermal moisture in patients to determine damaged tissue for clinical intervention. The present disclosure also provides methods for determining damaged tissue.

Abstract: There is provided a method for treating pigmented lesions comprising a composition which comprises at least one oxidant, at least one photoactivator capable of activating the oxidant. The composition may further comprise at least one healing factor chosen from hyaluronic acid, glucosamine and allantoin, in association with a pharmaceutically acceptable carrier.

Abstract: A treatment device for fractional laser-based skin treatment includes an emission window having an elongated area and predefined locations that are arranged in an elongated array which extends along a treatment axis of the window. A treatment generator has a treatment laser for emitting laser light towards skin tissue from the predefined locations in the emission window for generating, in use, laser-based lesions inside the skin tissue. The treatment device also includes a motion sensor for sensing motion of the treatment device relative to the skin surface, and a controller for determining a non-zero sequence of at least one of the predefined locations from which laser light is consecutively emitted in dependence on the sensed motion. The controller allows generation of the non-zero sequence when the sensed motion of the treatment device relative to the skin surface only has a component in a direction parallel to the treatment axis.

Abstract: The present application relates to a method for setting a cutting distance (?laser13 skin13 opt(z)) between a laser beam (14) and a skin surface (5) in a laser shaving device (1), said laser shaving device having a laser deactivation threshold (?laser_skin_opt(z)), said method comprising: operating an optical system (12) to generate the laser beam; determining a skin variation value (?) indicative of the variation in the distance of the skin surface from a reference point; determining a cutting distance between said laser beam and the skin surface in dependence on at least the laser deactivation threshold and said skin variation value; and adjusting said optical system to locate the laser beam in dependence on said determined cutting distance.

Abstract: An electrode system for treating dry eye, including at least one electrode having a portion intended to be applied in contact with the eye, the eye orbit, the temple, the eyelid areas or a part of them that respectively imitates the shape of the eye surface, the eye orbit, the temple, the eyelid areas or a part of them or wherein the portion of the intended to be applied in contact with the eye, the eye orbit, the temple, the eyelid areas or a part of them has a flexible and adaptable shape so that a form-fit is achievable between the portion of the electrode and the surface shape of the eye, the eye orbit, the temple, the eyelid areas or a part of them. The portion of the electrode is fed with an electromagnetic wave of distorted sinusoidal current with a resonance frequency which includes the related harmonics.

Abstract: A laminated laser window having an inner layer transparent to light having wavelengths between 3.5 micrometers and 12 micrometers and having as an outer surface a nanometric-thick outer layer of SiO2. The window allows the passage of light within this wavelength range, for example from a CO2 laser. In The SiO2 outer layer maintains biocompatibility when used in laser devices for insertion into externally accessible bodily cavities.

Abstract: Applicator (1) and capsule (17) for such applicator. A capsule (17) for distributing, on a surface of a living body, a product containing an active component or forming a cosmetic product, the capsule having a product distribution zone and comprising: •—in a body, a supply of product which is in communication with the product distribution zone, and •—first linking means (150, 511a, 511b) for removably securing the capsule to second linking means of a housing (15) in which is disposed a light source (9).

Abstract: A new method whitens the eye by continuously wearing away colored spots on the conjunctiva, such as nevi and pigmented lesions. The method includes the steps of selecting an area of the conjunctiva to be removed, including a colored portion; selecting and activating a motorized conjunctiva remover, which includes a body and an eye attachment with a tip; and, applying the tip of the eye attachment to the selected area of the conjunctiva to continuously wear away the conjunctiva until it is cleared of the colored portion. The eye attachments can be supplied with a variety of different tips.

Abstract: A new configuration of Intense Pulsed Light (IPL) equipment includes a handpiece that allows the application of IPL directly to the eye and eyelid. The handpiece is sized and configured for precise digital manipulation. The invention also includes a distance guide for maintaining precise distances between the area to be treated and a crystal mounted in the handpiece. Eye shields protect the cornea and surrounding sclera during the application of IPL.

Abstract: A Computer Assisted and Robot-Guided Laser Osteotome (CARLO) medical device (1) for perforating hard tissue, having a photoablation laser source (31) mounted in a robotic arm (2), and optical system (37) for focusing a laser beam in a target plane of the ostetomy line featuring an autotracking navigation system (8).

Abstract: A depth camera assembly (DCA) for depth sensing of a local area. The DCA includes a polarized light generator, an imaging device, and a controller. The polarized light generator modulates one or more optical beams emitted from an illumination source to generate modulated light, and projects the modulated light into the local area as polarized light having a first polarization. The imaging device receives light from the local area, the received light including ambient light and a portion of the polarized light reflected from the local area. The imaging device reduces an intensity of the received light having polarization different from a second polarization to generate filtered light substantially composed of light of the second polarization, and detects the portion of the polarized light having the second polarization using the filtered light. The controller determines depth information for the local area based on the detected portion of the polarized light.

Abstract: The invention describes a laser device (100) comprising between two and six mesas (120) provided on one semiconductor chip (110), wherein the mesas (120) are electrically connected in parallel. The laser device (100) is adapted such that degradation of at least one mesa (120) results in a decreased laser power emitted by the laser device (100) in a defined solid angle when driven at the defined electrical input power. The laser device (100) is adapted such that eye safety of the laser device (100) is guaranteed during life time of the laser device (100). Eye safety may be guaranteed by designing the semiconductor structure or more general layer structure of mesas (120) of the laser device (100) in a way that degradation of one or more layers of the layer structure results in a reduction of the maximum optical power emitted in a defined solid angle.

Abstract: A device configured to cut hair using laser light includes a handle portion and a shaving portion. The handle portion includes a battery and a laser light source. The laser light source is coupled to and configured to receive power from the battery. The laser light source is also configured to generate laser light having a wavelength selected to target a predetermined chromophore to effectively cut a hair shaft. The shaving portion includes a support and a single fiber optic supported by the support. The fiber optic has a proximal end, a distal end, an outer wall, and a cutting region positioned towards the distal end and extending along a portion of the side wall. The fiber optic is positioned to receive the laser light from the laser light source at the proximal end, conduct the laser light from the proximal end toward the distal end, and emit the light out of the cutting region and toward hair when the cutting region is brought in contact with the hair.

Abstract: A device configured to cut hair using laser light includes a handle portion and a shaving portion. The handle portion includes a battery and a laser light source. The laser light source is coupled to and configured to receive power from the battery. The laser light source is also configured to generate laser light having a wavelength selected to target a predetermined chromophore to effectively cut a hair shaft. The shaving portion includes a support and a single fiber optic supported by the support. The fiber optic has a proximal end, a distal end, an outer wall, and a cutting region positioned towards the distal end and extending along a portion of the side wall. The fiber optic is positioned to receive the laser light from the laser light source at the proximal end, conduct the laser light from the proximal end toward the distal end, and emit the light out of the cutting region and toward hair when the cutting region is brought in contact with the hair.

Abstract: Provided is a decontamination apparatus including a base, and a source that emits UVC light at a suitable intensity to at least partially decontaminate a target object and render the target object pathogen reduced. An adjustable support is coupled to the base and includes an adjustment mechanism that can be manipulated to adjust a position of the source relative to the base. A controller is operatively connected to the source to control emission of the UVC light and establish at least one of a suitable duration of a decontamination process and a suitable intensity of UVC light to render the target object pathogen reduced.

Abstract: The present invention relates to a system for fundamentally eliminating skin damage caused by direct radiation of a laser beam on the skin of a user and inducing a somatic sensation on the skin within a safety standard by radiating a pulse laser beam on a medium attached to the skin of the user on which the somatic sensation is desired to be induced. Particularly, the present invention relates to a somatic sensation induction system which can induce a somatic sensation of various feelings delivered to a user by adjusting an absorption coefficient of a medium contacting with the skin of a user, energy intensity and a repetition rate of a radiated laser beam and the like.

Abstract: An apparatus and method is provided for skin treatment. An apparatus includes an applicator assembly that includes an applicator tip which is configured to apply a normal cyclical mechanical force to a skin surface area of a user and to deliver a skin formulation to a skin surface area of a user. The apparatus further includes an electromagnetic energy assembly that includes at least one electromagnetic energy source adjacent to or within the applicator assembly and is configured to deliver pulses of electromagnetic energy stimulus of a character and for a duration sufficient to penetrate one or more dermal layers within the skin surface area of a use.

Abstract: There is provided an imaging unit comprising at least one image sensor, a measuring instrument including at least one marker, a position computing unit, a determining unit, and an output controller, wherein the imaging unit is configured to acquire an image comprising a user and the marker, and provide the acquired image to the position computing unit, wherein the position computing unit is configured to compute a position of the marker with respect to the user based on the image provided by the imaging unit, and further provide the computed position to the determining unit, wherein the determining unit is configured to determine whether the computed position of the marker matches a retrieved measurement position, and further output the result of the determination to the output controller, and wherein the output controller is configured to provide an indication when the marker position matches the measurement position.

Abstract: An apparatus for treating tissue includes a first energy application device to direct energy at tissue of a patient to cause at least one channel to be formed and a controller to control application of energy from the first energy application device to form the at least one channel. The at least one channel may be in the shape of a spiral-like shape or may be in a flower-like shape. Mechanisms are provided to help open channels formed in the human skin structure. A second energy application source may be used to maintain the channel open after formation. The controller may cause the first energy application device to form a plurality of channels of varying depth, width and distribution over the human skin surface. The apparatus to control the application of energy may be operated using a foot-activated pedal.

Abstract: Compositions containing an effective dermatological disease-treating or dermatological condition-treating active agent and a pharmaceutically-acceptable carrier or vehicle are disclosed. Methods of using the compositions are also disclosed.

Abstract: A dermatologic treatment device having a source of electromagnetic radiation beneficial to a dermatologic treatment, and a contact element facilitating conveyance of at least some of the electromagnetic radiation emitted by the source to a skin surface. The contact element includes a hydrophilic portion that facilitates movement of the contact element to the skin surface.

Abstract: The present invention relates to a skin radiation apparatus and method. The apparatus includes a photon radiation unit for generating a line-shaped radiation pattern that extends in a first direction; a movement facility for moving the line shaped radiation pattern in a second direction transverse to the first direction; a detection unit for detecting a skin condition profile; and a control unit for controlling the line-shaped radiation pattern, dependent on the detected skin condition profile.

Abstract: The present invention relates to a process for bleaching or dyeing keratin fibers, in particular human keratin fibers such as the hair, comprising a step of application, to said fibers, of a composition (A) containing one or more chemical oxidizing agents and a step of irradiation of said fibers by means of UV-visible radiation having a wavelength ranging from 200 to 800 nm and a fluence ranging from 1 to 5000 J/cm2, after application of said composition (A); when the process is a process for dyeing keratin fibers, then one or more oxidation dyes is or are also used.

Abstract: A light irradiating apparatus is used, which is characterized by having: a probe including an irradiating unit which guides light to an object, a housing containing the irradiating unit, and a touch sensor acquiring a contact condition amount between the object and the housing; and a controller controlling irradiation with light from the irradiating unit based on a level of the contact condition amount and a change in the contact condition amount, wherein in a case where the contact condition amount is equal to or more than a first reference value while the change in the contact condition amount which occurs when the housing is pressed against the object is a positive value, the controller performs a control which enables irradiation with light from the irradiating unit when the change in the contact condition amount is equal to or more than a second reference value.

Abstract: An optical device including a first lens array is provided. The first lens array has micro-lens units arranged in an array. An outline of each of the micro-lens units is polygonal-shaped, circular or ellipsoidal. Moreover, a projection apparatus is also provided.

Abstract: An optic includes a first end, a fluorescent material, and a second end. The first end is adapted to transmit a first band of electromagnetic radiation to the fluorescent material. The fluorescent material is adapted to absorb the first band of electromagnetic radiation and emit a second band of electromagnetic radiation. The second end is adapted to contact the biological tissue and deliver the second band of electromagnetic radiation to treat the biological tissue.

Abstract: A cartridge, medical apparatus and method are disclosed. The cartridge and a holding element are for operable connection with each other to form a phototherapy apparatus. The cartridge includes a radiation source for emitting radiation towards an area to be treated of a user; a mount element for positioning the radiation source in a predetermined position relative to the area to be treated; wherein the mount element comprises a locating portion configured for locating the cartridge at a predetermined position with respect to a body portion of the user.

Abstract: A pressure sensitive adhesive composition includes 4-15 w/w % styrene-isoprene-styrene copolymer, 20-35 w/w % styrene-isoprene diblock copolymer, 4-15 w/w % tackifier, 6-18 w/w % paraffin oil, and 30-45 w/w % hydrocolloid. The size of the hydrocolloid is below 40 ?m.

Abstract: The present invention relates more specifically to a cosmetic treatment method intended in particular to improve the appearance of the skin and/or hair comprising the simultaneous and/or sequential administration: a) of at least one cytochrome C oxidase substrate and/or of at least one agent which increases the expression of the said substrate; and b) of at least one light radiation exhibiting at least one predominant wavelength which activates cytochrome C oxidase. In particular, the said light radiation exhibits at least one predominant wavelength which activates cytochrome C oxidase ranging from 550 to 1000 nm, in particular from 550 to 800 nm, preferably from 620 to 700 nm and more preferably still from 640 to 680 nm and is preferably used at a dose ranging from 0.01 to 200 J/cm2, preferably from 0.1 to 30 J/cm2, more preferably from 1 to 30 J/cm2, indeed even from 5 to 30 J/cm2.

Abstract: A method for photothermolysis that includes applying galvanic current energy to skin at an area of a hair follicle and applying pulsed optical energy to the skin at the area of the hair follicle at an energy level and duration so as to cause thermal destruction of a hair papilla.

Abstract: The invention relates to a device (1) for hair-growth control of hairs (3), in particular hairs growing from human skin (5). The device (1) has a laser source (7) for generating a laser beam (9) during a pulse time, an optical system (15) for focusing the laser beam into a focal spot (25), and a laser beam manipulator (17) for positioning the focal spot in a target position. According to the invention, a dimension of the focal spot (25) and a power of the generated laser beam (9) are such that, in the focal spot (25), the laser beam has a power density which is above a characteristic threshold value for hair-growth related skin tissue above which, for the pulse time, a laser induced optical breakdown (LIOB) phenomenon occurs in the hair-growth related skin tissue. The LIOB phenomenon results in a number of mechanical effects, such as cavitation and the generation of shock waves, which damage the hair-growth related skin tissue in positions surrounding the LIOB phenomenon.

Abstract: Embodiments include a system for determining patient cardiovascular information which includes at least one computer system configured to receive patient-specific data regarding a geometry of an anatomical structure of a patient; create a model representing at least a portion of the anatomical structure of the patient based on the patient-specific data; determine a first blood flow rate at at least one point of interest in the model by using relations of individual-specific anatomic data to functional estimates of blood flow characteristics generated from a plurality of individuals; modify the model; determine a second blood flow rate at a point in the modified model corresponding to the at least one point of interest by using the relations of individual-specific anatomic data to functional estimates of blood flow characteristics; and determine a fractional flow reserve value as a ratio of the second blood flow rate to the first blood flow rate.

Abstract: An ophthalmic laser treatment apparatus, comprising: an emitted treatment laser beam; an emitted aiming beam; an irradiation unit including a zoom lens and a scanner for scanning in two dimensions, and being arranged to irradiate both beams to the eye; an irradiation pattern setting unit including a switch for setting an irradiation pattern in which a plurality of spots is arranged; and a controller for controlling the aiming beam based on the set pattern during aiming before irradiation of the treatment beam, the controller being configured to divide the spots in the set pattern into two or more groups and switch the positions of the spots of the aiming beam at a predetermined time interval in each group to irradiate the aiming beam so that the irradiation spots of the aiming beam in a group before switching and another group after switching are not recognized simultaneously by an operator.

Abstract: Image-guided therapy of a tissue can utilize magnetic resonance imaging (MRI) or another medical imaging device to guide an instrument within the tissue. A workstation can actuate movement of the instrument, and can actuate energy emission and/or cooling of the instrument to effect treatment to the tissue. The workstation and/or an operator of the workstation can be located outside a vicinity of an MRI device or other medical imaging device, and drive means for positioning the instrument can be located within the vicinity of the MRI device or the other medical imaging device. The instrument can be an MRI compatible laser or high-intensity focused ultrasound probe that provides thermal therapy to, e.g., a tissue in a brain of a patient.

Abstract: An electrosurgical system includes an energy applicator adapted to direct energy to tissue, an electrosurgical power generating source, and a surface-contact detection device. The surface-contact detection device is operably associated with the energy applicator. The surface-contact detection device is communicatively-coupled to the electrosurgical power generating source. The surface-contact detection device includes at least one optical transmitter to generate optical signals, a lens member configured to reflect optical signals generated by the optical transmitter when the lens member is disposed in contact with tissue, and at least one optical receiver to receive optical signals reflected by the lens member. The electrosurgical power generating source is adapted to transmit energy to the energy applicator when it is determined that the lens member is disposed in contact with tissue.

Abstract: A laser therapy apparatus includes: a laser source including a light source for outputting first laser light; a laser irradiator for subjecting the first laser light to at least one of light-guiding and beamforming to convert the first laser light into second laser light, and radiating the second laser light to the exterior; a second light amount detector for detecting a light amount of second laser light; a pre-use checker for performing a pre-use check at least based on a result of detection by the second light amount detector; a pre-use check detector for determining whether a pre-use check corresponding to the current activation has been performed or not, based on past-activation information and a result of the check by the pre-use checker; and an alarm for, at the current activation, reporting a result of determination by the pre-use check detector.

Abstract: A device configured to cut hair using laser light includes a handle portion and a shaving portion. The handle portion includes a battery and a laser light source. The laser light source is coupled to and configured to receive power from the battery. The laser light source is also configured to generate laser light having a wavelength selected to target a predetermined chromophore to effectively cut a hair shaft. The shaving portion includes a support and a single fiber optic supported by the support. The fiber optic has a proximal end, a distal end, an outer wall, and a cutting region positioned towards the distal end and extending along a portion of the side wall. The fiber optic is positioned to receive the laser light from the laser light source at the proximal end, conduct the laser light from the proximal end toward the distal end, and emit the light out of the cutting region and toward hair when the cutting region is brought in contact with the hair.

Abstract: A safety interlock system and method is provided for a laser ignition system. The laser device can be disabled upon receiving an indication that the laser device has been removed from the cylinder. The removal can be inferred based on an estimated distance between the cylinder piston and the laser ignition device.

Abstract: Disclosed herein is a method of fractional treatment of tissue, the method comprising: creating at least one micro hole in a target tissue; and either a) applying pressure on said target tissue to decrease the patency of said at least one micro hole; administering material and/or fluid and/or drug onto said target tissue; releasing said applied pressure on said target tissue to increase the patency of said at least one micro hole; and propelling said material and/or fluid and/or drug into said at least one micro hole; or b) administering material and/or fluid and/or drug onto said target tissue under sub-atmospheric pressure conditions, the patency of said at least one micro hole being decreased; increasing the atmospheric pressure to atmospheric or above atmospheric conditions to thereby increase the patency of said at least one micro hole; and propelling said material and/or fluid/and/or drug into said at least one micro hole.

Abstract: The present invention encompasses methods that use heat and/or electromagnetic radiation for dermatological treatment and more particularly to a method that uses heat and/or electromagnetic radiation in combination with chromophores for fractional wounding and, in particular, discontinuous fractional damage of skin tissue.

Abstract: The invention relates to a light application apparatus (1) for applying light to an object (3). A light source (4) generates processing light (2) and sensing light (5), which are coupled into the object (3). A light detector (8) detects the sensing light (5) after having left the object (3), and a control unit (9) controls the light source (4) such that processing light (2) in a processing time interval and sensing light (5) in a sensing time interval are alternately generated. Since processing light and sensing light are generated alternately, the generation of the processing light and of the sensing light is decoupled, i.e. the processing light can be optimized for processing purposes and the sensing light can be optimized for sensing purposes. This allows improving the quality of sensing the object and, thus, the quality of controlling the application of light depending on properties of the object.

Abstract: Disclosed is a medical mask apparatus using optical fibers which can selectively project a laser beam to an entire treated portion or a local portion of skin. A medical mask apparatus using optical fibers for projecting a fine laser beam to the skin to activate skin cells and expedite circulation of blood in the skin is provided.

Abstract: A system and method of altering damaged mammalian skin using a multiphoton processes is disclosed. A femtosecond laser initiates a multiphoton event using pulse energies of 2-5 mJ thereby causing multiphoton ablation without damaging surrounding tissue. The laser is focused to the vicinity of a target organelle that occurs naturally within the damaged skin, and is related to the dermatological condition being addressed. The type of organelle depends on the condition being addressed, and may be targeted by the depth beneath the surface of the skin at which it is located. The femtosecond laser beam is focused to an intensity of least 1012 W/cm2 to initiate the multiphoton event transforms the targeted organelle to mitigate the damage to the skin.

Abstract: In some embodiments, the instant invention provides for a system that includes at least the following components: (i) an Alexandrite laser pumping subsystem; where the Alexandrite laser pumping subsystem is configured to: 1) produce wavelengths between 700 and 820 nm, and 2) produce a pump pulse having: i) a duration between 1 to 10 milliseconds, and ii) an energy measuring up to 100 Joules; where the Alexandrite laser pumping subsystem includes: 1) an optical fiber, and 2) a Lens system, (ii) a Thulium doped Yttrium Aluminum Garnet (Tm:YAG) laser subsystem; where the Tm:YAG laser subsystem includes: 1) a Tm:YAG gain medium, 2) a rod heat sink, and 3) at least one cooling device, (iii) a wavelength selecting device, where the wavelength selecting device is configured to deliver a wavelength between 1.75 microns to 2.1 microns; and where the system is configured to produce a high energy conversion efficiency.

Abstract: A hand held device generates a predetermined number of pulses of electromagnetic radiation having a predetermined electromagnetic spectrum, a predetermined duration, a predetermined inter-pulse interval, and a predetermined total energy. The pulse sequence is delivered to a skin surface to reduce or eliminate Xray or ultraviolet radiation damage to the skin surface.

Abstract: A phototherapy device includes an outlet end to be placed in contact with a person's skin, a heat exchanger, an optical structure arranged between the heat exchanger and the outlet end, and a light source arranged between the heat exchanger and the outlet end, and configured to emit light for delivery to the skin through or adjacent the optical structure. The heat exchanger may include a first heat transfer portion thermally coupled to the light source for dissipating heat from the light source, and a second heat transfer portion thermally coupled to the optical structure for dissipating heat from the optical structure. The first and second heat transfer portions of the heat exchanger may be substantially thermally isolated from each other, e.g., partially or completely physically separated from each other.

Abstract: A dermatologic treatment device having a light source emitting optical radiation beneficial to a dermatologic treatment, and a user interface selectively operating the device in at least one of a pulse mode and strobe mode. The light source emits a single optical radiation pulse in pulse mode to spot treat a portion of a skin surface during the dermatologic treatment, and the light source emits a continuous sequence of optical radiation pulses in strobe mode to treat multiple locations on the skin surface during the dermatologic treatment.

Abstract: A hair treatment (40) device is provided comprising a light-based detector (10) for detecting a hair (22) near a skin surface (21) the detector (10) comprising a light source (11), optical elements (14, 16, 17, 18) and a polarization-sensitive light sensor (12, 13). The light source (11) is provided for generating a light beam (31) with an incident polarization. The optical elements (14, 16, 17, 18) are provided for focusing the light beam (31) at the hair (22) near the skin surface (21). The polarization-sensitive light sensor (12, 13) is provided for detecting light interacted with the hair (22) or the skin surface (21) and having a predefined linear polarization. The light source (11) and/or the optical elements (14, 16, 17, 18) are arranged to cause the light beam (31) to simultaneously have multiple spatially separated foci (51, 52, 53) at or near the hair (22) or the skin surface (21).

Abstract: A laser treatment device and process with controlled cooling. The device contains a cooling element with high heat conduction properties, which is transparent to the laser beam. A surface of the cooling element is held in contact with the tissue being treated while at least one other surface of the cooling element is cooled by the evaporation of a cryogenic fluid. The cooling is coordinated with the application of the laser beam so as to control the temperatures of all affected layers of tissues. In a preferred embodiment useful for removal of wrinkles and spider veins, the cooling element is a sapphire plate. A cryogenic spray cools the top surface of the plate and the bottom surface of the plate is in contact with the skin. In preferred embodiments the wavelength of the laser beam is chosen so that absorption in targeted tissue is low enough so that substantial absorption occurs throughout the targeted tissue. In a preferred embodiment for treating large spider veins with diameters in the range of 1.