The same laser: why can inadequate cooling increase the risk of burns?
The same device and similar settings can still carry different risks of skin injury. One reason is how effectively excess heat is removed. For procedures that require cooling, suitable laser settings alone are not enough if the skin overheats.
In my reel, I demonstrate this with two paper cups and a flame. The empty cup burns through, while the cup containing water withstands heating for longer because the water absorbs heat. This is an illustration, not a model of skin, but the principle is clear: delivering energy and removing excess heat both matter.
Two cups, one principle: why removing heat matters.
Cooling is about more than comfort
In many laser and IPL treatments, energy is converted into heat. We aim to treat a specific target, such as a blood vessel or hair follicle, while protecting the surrounding skin. Appropriate cooling helps reduce pain and the risk of unwanted overheating, burns and associated pigment changes or, in severe cases, scarring.
How we cool the skin at Dr USKOV Kliinik
We use several cooling methods and devices: contact cooling, cold air and chilled gel where the treatment protocol calls for it. Our clinic has a separate cooling unit that delivers air at temperatures as low as −25 °C. This is the air temperature, not a target skin temperature: the aim is not to freeze the skin.
Depending on the procedure, cooling may be used before, during or after treatment. The doctor selects the method, intensity and duration according to the device, treatment area and individual skin characteristics.
Why we have two thermal cameras
We also have two thermal imaging cameras. Where temperature monitoring is useful, they help assess the distribution of temperature across the skin surface and identify warmer areas. This gives the doctor additional information: thermal imaging does not show the temperature of all deeper tissues and does not replace observation of the skin's response.
Why colder is not always safer
Excessive or inappropriate cooling can itself damage the skin and alter treatment results. There is no single cooling routine for every laser. The doctor needs to understand when, how and how much to cool, and how cooling interacts with the treatment settings.
That is why we pay close attention to cooling management. It is part of patient safety, not a minor extra. Appropriate cooling reduces certain risks, but cannot prevent every complication. Tell your practitioner immediately if you experience increasing burning or unusual pain during treatment.
This article provides general information. The need for cooling and its settings are determined by the practitioner for each procedure.
