Procedure

Nd:YAG Laser

A laser that reaches deeper than most and is absorbed least by skin pigment. At 1064 nanometers it is the wavelength that makes hair removal and vessel treatment safer on deeper skin tones.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
A gloved hand guiding a laser handpiece along a patient's lower leg

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This is the laser I bring up first when someone with a deeper skin tone has been told, usually wrongly, that laser is not for them: 1064 nm passes through surface pigment far better than shorter wavelengths do. That is a physics advantage, not a magic setting, and it still needs a provider who uses it regularly. The trade is real — the target absorbs this wavelength weakly, so the energy has to be higher, making it the most uncomfortable of the common lasers and making cooling and a careful operator matter more, not less. And laser hair removal is hair reduction: fewer, finer, slower-growing hairs, not bare skin forever.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledNd:YAG, 1064 nm laser, long-pulsed Nd:YAG, Q-switched Nd:YAG, neodymium YAG. Device names include GentleYAG, Excel V, Cutera CoolGlide, Clarity, Laser Genesis
DowntimeUsually none to two days. Redness and small bumps around each hair follicle for a few hours to a day after hair removal; redness and swelling for one to three days after vessel work
SessionsAbout 6 to 8 for hair reduction, 4 to 8 weeks apart, then top-ups once or twice a year. Two to four for facial or leg vessels
Typical costRoughly $100 to $250 a session for a small area such as the upper lip or underarms, and several hundred dollars for large areas such as legs or back. Vascular sessions are usually a few hundred dollars. Rarely covered by insurance
Results timelineShedding of treated hairs over one to three weeks, with the visible thinning building across the course. Vessels fade over two to six weeks
PainThe most uncomfortable of the common lasers. A deep hot snap that carries on for a second or two after each pulse, because the heat is being delivered deeper
Skin tone safetyThe 1064 nm wavelength is the least absorbed by melanin of the lasers in routine use, which is why it is the usual choice for hair reduction and vessels on deeper skin tones. Safer does not mean risk-free

What It Is

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Nd:YAG stands for neodymium-doped yttrium aluminum garnet, the crystal inside the machine that makes the light. Its main output is 1064 nanometers, in the near infrared — invisible, which is one reason eye protection is not optional in the room. A second crystal can halve the wavelength to 532 nanometers, producing green light. That version is sold under its own name, the KTP laser, and behaves quite differently: shallow, strongly absorbed by pigment and blood, and used on surface vessels and brown spots. Nd:YAG lasers split into two families by pulse length, and the two do almost unrelated jobs. Long-pulsed machines fire for thousandths of a second and treat hair reduction, leg and facial veins, venous lakes on the lip, and gentle non-ablative skin treatments sometimes sold as Laser Genesis. Quality-switched, or Q-switched, machines fire for billionths of a second and treat tattoo ink and brown pigment. So Nd:YAG is a family, not one treatment. If someone says they have an Nd:YAG, ask which pulse length and which wavelength — that is what decides what it can do for you.

How It Works

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A laser picks a color of light that a target absorbs more than its surroundings do. The target heats, is damaged, and clears. For hair the target is melanin in the shaft and follicle; for vessels it is hemoglobin.

What makes 1064 nm different is that everything absorbs it weakly — melanin, hemoglobin and water all take up less of it than of shorter wavelengths. That has two consequences, running in opposite directions.

The first is why this page matters. Surface melanin absorbs very little 1064 nm light, so the pulse passes through rather than heating it, which makes 1064 nm the safest of the routinely used wavelengths on deeper skin tones. At 532, 755 and 810 nanometers, surface melanin absorbs strongly, so on deeper skin tones much of the energy burns the surface instead of reaching the target underneath.

The second consequence is the cost of the first. The target also absorbs 1064 nm weakly, so more energy is needed to damage it — more heat, more discomfort, more reliance on surface cooling. A genuine trade, not a free upgrade.

Longer wavelengths scatter less on the way through skin, so 1064 nm reaches deeper. That is why it is used on deep follicles, larger leg veins, and vessels a pulsed dye laser cannot reach.

Skin is about two millimetres thick on the face. How deep a treatment reaches decides what it can change, and whether it treats all of the skin or scattered columns of it decides how long you take to heal.

How it works
Compare
Skin basics
EPIDERMISDERMISFAT0.05 mm — pigment0.5 mm — texture + pores1.0 mm — collagen1.5 mm — deep dermisPEELNEEDLINGNON-ABLATIVE LASERABLATIVE LASERGOES BELOW THE SKIN

This works below the skin altogether, in the fat or the muscle beneath it. Nothing applied to the surface reaches here, which is the whole reason the procedure exists — and why it is done by injection, by needle or with a blade rather than with a cream.

A peel or a scrub takes the skin off evenly from the surface down. Everything above the line goes and nothing below it is touched, which is why peels suit surface pigment and rough texture, and why the whole face flakes for a few days after.

Needles make hundreds of separate channels and leave the skin between them untouched. That untouched skin is what heals the rest, so recovery is quick — but a needle only injures the skin to start repair. It removes nothing.

The light passes through the surface and heats a column underneath it. The surface stays whole, so you leave red rather than raw — and it takes a course of sessions rather than one.

The laser removes columns of skin outright: the white gaps here are tissue that is gone, and new skin grows in from the sides. The strongest of the four, and the longest to heal.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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Ingrown Hairs
Strong evidence
The specific device used for hair removal on deeper skin tones, at a wavelength of 1064 nm. It passes more safely through pigment in the skin to reach the hair, and it is used routinely for razor bumps. Ask what wavelength a clinic uses, ask how often they treat skin like yours, and have a test patch first, because settings and cooling matter more than the marketing.
Close-up of a cheek with pink flushing and fine visible red blood vessels beside the nose
Rosacea
Moderate evidence
A longer wavelength that reaches deeper, larger vessels — the thicker blue-red threads beside the nose that pulsed dye laser sometimes leaves behind. It is also the device more often chosen for deeper skin tones, because it passes over surface pigment more safely. It is less useful for general background redness.

Not the Best For

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Close-up of the lower cheek, nose and mouth of a young person with medium-brown skin, turned three-quarters away from the camera against a pale blue background. Scattered flat dark brown marks are spread across the cheek, with a few small raised spots still active among them.
Post-Inflammatory Hyperpigmentation
Limited evidence
Low-energy 1064 nm treatment is the laser most often chosen for pigment in deeper skin tones, because that wavelength passes through the surface and reaches the deeper, gray-toned pigment. Several sessions are needed and results are modest. Settings matter more than the machine, and this should be done by someone who treats your skin tone regularly.
Nail Fungus (Onychomycosis)
Nail Fungus (Onychomycosis)
Limited evidence
Laser devices are cleared to temporarily increase the amount of clear nail, which is not the same thing as curing the infection. Studies are small, short and mostly measure appearance rather than clearance, and the fungus commonly returns. It is usually several sessions, paid for out of pocket, and it is a reasonable thing to consider only when tablets are genuinely not an option.
Melasma
Melasma
Limited evidence
Used at low energy over several sessions to break up pigment that creams reach poorly. It can lighten stubborn patches, and the improvement often fades over the following months if creams and daily sun protection are not carrying on behind it. Pushed too hard it causes patchy loss of color or rebound darkening, so settings stay low and a test patch first is sensible.
Close-up of the lower cheek, mouth and jaw of a young person with light skin, turned three-quarters away from the camera against a pale blue background. Scattered flat pink-red marks cover the cheek and run down towards the jaw. The skin surface is smooth and even, with no raised spots and no change in texture.
Post-Inflammatory Redness
Limited evidence
Reaches deeper vessels and passes through surface pigment more safely, which is why it is often the vascular laser chosen for deeper skin tones. Results on these marks are less predictable than with a pulsed dye laser. A test patch first is the sensible way to find out whether it suits your skin.
Plantar Warts
Plantar Warts
Limited evidence
A laser that heats the blood vessels feeding the wart and cuts off its supply, used for foot warts that have failed simpler treatments. It reaches deeper than freezing does. It is done with local anesthetic, it is sore for several days afterwards, and it usually takes more than one session.

Pros and Cons

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Pros
  • Safest on deeper skin tones Surface pigment absorbs very little 1064 nm light.
  • Reaches deeper Coarse deep follicles and larger vessels other lasers miss.
  • Very little downtime Normal life the same day, after a few hours of pink.
  • One machine, several jobs Hair, vessels, pigment and texture on one platform.
Cons
  • It hurts more The most uncomfortable of the common lasers.
  • It ignores light hair Blond, red, gray and white have too little pigment.
  • Reduction, not removal Hair returns finer, with yearly maintenance.
  • Less precise on fine surface vessels A pulsed dye or KTP laser is neater.
  • Safer is not safe Burns, blisters and pigment changes still happen.

How to Prepare

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4 weeks before4 weeks before3 to 5 days before
Hair removal
4 weeks before
Do not wax, pluck, thread or use an epilator. The laser aims at hair still in the follicle, so pulling it out wastes the session.
Sun and tanning
4 weeks before
Avoid sun, sunbeds and self-tanner on the area. A tan adds surface pigment and raises the risk of a burn, even at this wavelength.
Actives and shaving
3 to 5 days before
Stop retinoids and exfoliating acids. Shave a day or two before — shaving is the only hair removal that keeps the target. No lotion, deodorant or tanner.
At the visit
On a deeper skin tone, ask for a test spot. A good provider usually offers one without being asked.

What Happens

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ArrivingThe treatmentLeaving
Arriving
Skin is examined, photographed and cleaned, and hair areas shaved again if needed. Settings come from your skin tone, the hair or vessel treated, and how you responded last time. Test pulses in a discreet spot are standard on a first visit. Hair needs no numbing; cream for 30 to 60 minutes is used for sensitive or large areas and vessel work. Your provider will ask about these things.
The treatment
Everyone wears eye protection — 1064 nm light is invisible and can injure the eye without warning. Cool gel or cold air goes on and the handpiece moves in overlapping passes. An upper lip takes a minute or two, a back or legs 30 to 60 minutes. Each pulse is a deep hot snap that lingers a second. Say if it is too much; settings and cooling can be adjusted.
Leaving
Pink, warm, and often with a small raised bump around each treated follicle, like goosebumps or a mild rash. That is expected, not a burn, and settles within hours to a day. Cool packs and plain moisturizer help. After vessel work the vessel may darken or vanish at once, with swelling around it.

Recovery

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Days 1 to 3Weeks 1 to 3Weeks 4 to 8
Days 1 to 3
Redness and swelling fade. Vessel areas can stay puffy and bruised-looking a little longer. Skip heat, saunas, hot showers and hard exercise while it is still pink.
Weeks 1 to 3
Treated hairs push out and fall away over one to three weeks. It looks like hair growing and people often think the session failed. Rubbing gently with a washcloth helps them out.
Weeks 4 to 8
Fewer hairs return, finer and slower. This is when the next session is booked, because only hairs in their growing phase respond and the rest need time to arrive.

Aftercare

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24 to 48 hours2 weeks
Makeup and exercise
24 to 48 hours
Makeup same day or next if the skin is intact — not on blistered or broken skin. No exercise for 24 to 48 hours; heat, sweat and friction irritate freshly treated follicles and can cause small spots.
Sun
2 weeks
SPF 30 or higher daily on exposed areas, and strict avoidance for two weeks. Sun on treated skin is the main cause of dark patches afterward.
Hair removal between sessions
Shave or trim only. No waxing, plucking, threading or epilating until the course is done, because those remove the target.

Risks

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Redness and small bumps around the follicles for a few hours are expected, not complications. The real risks come from too much energy, tanned or recently sun-exposed skin, and an operator who does not adjust settings for the skin in front of them.

Dark patches
New brown patches days to weeks later, more common on deeper skin tones and after sun. They usually fade over months, faster if treated early.
Light patches
Pale areas where pigment has been lost. Less common, slower to recover, sometimes lasting. This is the pigment problem worth taking seriously.
Blistering or crusting
Small blisters or scabs mean the surface got hotter than intended. Leave them alone and report them, because the settings need lowering next time.
Spots and folliculitis
Small pus bumps around follicles a few days later, most often on the back, chest and bikini line. Usually settles; sometimes needs a topical antibiotic.
More hair, not less
Occasionally hair thickens at the edge of a treated area, most often on the face and neck. It is uncommon, it has a name — paradoxical hypertrichosis — and it is worth reporting early rather than pushing on.

In Deeper Skin Tones

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The answer here is simple — 1064 nm is the wavelength that makes laser treatment safer on deeper skin tones.

The reason is physics, not technique. Surface melanin absorbs light strongly at short wavelengths and weakly at long ones. At 532, 755 and 810 nanometers much of each pulse is soaked up on the way in, heating the skin and causing burns, blisters and pigment loss. At 1064 nanometers absorption is much lower, so the pulse passes through and delivers its heat where it was aimed. That is why long-pulsed 1064 nm Nd:YAG is the usual choice for hair reduction on Fitzpatrick skin types V and VI, and why it often beats a pulsed dye laser for facial vessels on deeper skin tones.

Safer is not the same as safe. Burns and pigment changes still happen, and the higher energies this wavelength needs leave less room for error. Post-inflammatory hyperpigmentation — brown patches after inflammation — is common on deeper skin tones and usually fades over months. Pigment loss is less common and more stubborn.

What a careful provider actually does: a test spot at a hidden site, a wait of a week or two before treating a whole area, conservative energy on the first pass, aggressive surface cooling, longer gaps between sessions, and no treatment on skin that has caught the sun. Some prescribe a pigment-blocking cream for two to four weeks beforehand. Ask how often the provider treats your skin tone with this device — volume matters more than the brand of machine.

If You Stop

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Stopping does not undo what has been done, and there is no rebound. Follicles that were destroyed are gone.

What comes back is partial. Follicles that were only damaged recover over months to years, and dormant follicles that were not growing during the course can start producing later. Most people notice hair creeping back over one to two years after stopping, finer and sparser than it was. That is why the honest term is hair reduction.

Hormones drive this more than anything else. Pregnancy, menopause, polycystic ovary syndrome and certain medicines can bring hair back faster and in new places, whatever the laser did.

Vessels follow the same pattern. Treated vessels do not return, but new ones form, and sun exposure and rosacea speed that up. Daily sunscreen is the cheapest way to stretch the gap between sessions.

Combining Treatments

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Same day
Shaving
Shaving and trimming continue throughout a hair course.
Same day
Eflornithine cream
This prescription cream slows facial hair growth and is used alongside laser.
Same day
Hormonal treatment
For hormone-driven hair, prescribed medicine often does more than extra sessions.
Same day
Sunscreen
Daily sunscreen makes vessel results last longer.
Pause 5 days
Rosacea creams
Azelaic acid, metronidazole and ivermectin restart about five days after a session.
Wait 2 weeks
Other procedures
Wait about two weeks around a peel, microneedling, another laser or waxing here.
Wait 2 weeks
Injectables
Usually a separate visit, commonly two weeks either side.
Don’t combine
Waxing and plucking
Never between hair sessions — it removes the target.
Wait 6 months
Isotretinoin
Most providers wait about six months; for hair and vessels the wait is often shorter.

Insurance Coverage

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Insurance rarely covers any of this. Hair reduction is treated as cosmetic almost everywhere, even for a hormonal condition. Occasional exceptions exist for hair removal before certain surgeries and for recurring pilonidal disease, and coverage for vascular lesions depends on the lesion and the plan. Ask the office to check your plan before booking a course.

Ask Your Doctor

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If you are pregnant or breastfeeding
Ask the doctor managing your pregnancy or breastfeeding before booking.
If you have a deeper skin tone
Ask which wavelength the device uses, ask for a test spot, and ask how often that provider treats your skin tone.
If your hair has changed suddenly
Or grown in a new pattern. Say so — a hormonal cause is worth looking into before paying for a course.
If you have a hormonal condition
Polycystic ovary syndrome, for example. Treating it alongside laser usually changes the result more than extra sessions do.
If you are tanned
Or have used self-tanner recently. Wait. Extra surface pigment raises the risk of a burn even at this wavelength.
If you get cold sores
And the face is being treated. An antiviral started beforehand lowers the chance of an outbreak.
If you have taken isotretinoin
Say so if you finished in the last six months, and agree the timing rather than assuming.
If you have a history of keloid scars
Discuss it before treating, particularly on the chest, shoulders and beard area.
If you take a sun-sensitizing medicine
Doxycycline, some diuretics and others make skin more reactive. List everything you take.
If you have a photosensitive condition
Lupus, for example. Check with the doctor managing it first.
If you have blond, red, gray or white hair
The laser cannot find it. Ask about electrolysis rather than buying a course.
If you notice thicker hair
At the edge of a treated area. Report it early rather than booking more sessions.

At-Home Versions

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Shaving
Good alternative
Cheap, works on every hair color, and the only hair removal allowed during a laser course, because it leaves the follicle intact. It does not make hair grow back thicker; the blunt cut end just feels coarser.
Waxing, threading and epilating
Good alternative
Lasts longer than shaving. Must stop at least four weeks before a laser course and stay stopped throughout, because pulling the hair out removes what the laser aims at.
Depilatory creams
Okay alternative
Dissolve hair at the surface. Common cause of chemical irritation, especially on the face, so patch test first and do not use on skin treated in the last week.
Eflornithine cream
Good alternative
Applied to the face, it slows regrowth rather than removing hair, and it is sometimes used alongside a laser course. Growth returns when it is stopped.
Home IPL devices
Okay alternative
These are lower powered and use broad-spectrum light, so they need repeated use for a modest effect. Most are labeled not for use on the deepest skin tones, and they do not work on light hair. Read the tone chart on the box before buying, not after.
Threading a needle or DIY electrolysis kits
Bad alternative
Do not. Untrained use burns, scars and marks skin, and infections from shared or unsterile needles are a real risk.

How It Compares

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Alexandrite laser at 755 nm
Better
Absorbed strongly by melanin, so it is fast and efficient on fair skin with dark hair, and carries a substantially higher burn and pigment risk on deeper skin tones. Faster and less painful than Nd:YAG where it is appropriate.
Diode laser at 800 to 810 nm
The same
Sits between alexandrite and Nd:YAG in both efficiency and pigment risk. Newer diode devices with strong cooling are used on deeper skin tones by experienced providers, though 1064 nm remains the more conservative choice.
Intense pulsed light (IPL)
Intense pulsed light (IPL)
Worse
For hair reduction, strong for facial redness. Broad-spectrum light rather than a laser, so more of it is absorbed by surface pigment. Generally not used for hair on deeper skin tones, and results depend heavily on the operator.
Electrolysis
Electrolysis
Different job
The only method that permanently destroys individual follicles. Works on any hair color, including blond, gray and white, which lasers cannot touch. Slow and treated hair by hair, so it suits small areas rather than legs or a back.
Pulsed dye laser at 595 nm
Better
More precise on fine facial vessels and the diffuse flush of rosacea than Nd:YAG, and less suitable on deeper skin tones for the same reason it is more precise — pigment absorbs it more.
Sclerotherapy for leg veins
Better
An injected solution rather than light, and often more effective than laser on larger leg veins. Bruising and brown staining along the vein are common afterward, and the two are sometimes combined.
Shaving, waxing and depilatory creams
Worse
Effective, cheap, and temporary. No risk of pigment change, but nothing lasting either, and waxing has to stop four weeks before any laser course.

Finding a Provider

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Who may operate a laser varies enormously by US state. Some restrict it to physicians, physician assistants and nurse practitioners; others allow nurses, laser technicians or estheticians under supervision that is sometimes remote and nominal. Look up the rules where you live rather than assuming a clinic is regulated.

Ask specific questions. Which wavelength, and what is the machine called. Long-pulsed or Q-switched. How often do you treat my skin tone with it. Will you do a test spot and wait before treating the whole area. What settings will you start at, and what would you do if I got a burn or a light patch. A provider who treats deeper skin tones routinely answers all of these without hesitating.

Red flags: a promise of permanent removal, no eye protection for you or staff, no test spot on a deeper skin tone, no questions about your medicines or sun exposure, pressure to buy a large package on the first visit, and a provider who cannot name the wavelength of the machine in their hand.

Myths

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  • “Laser hair removal is permanent.” It is permanent reduction, not permanent removal. Hair comes back finer, sparser and slower, and most people need a top-up once or twice a year. The US Food and Drug Administration allows these devices to be marketed for permanent hair reduction, a narrower claim than the one usually advertised.
  • “Laser is not safe on deeper skin tones.” This is the myth this device answers. At 1064 nm surface pigment absorbs very little of the light, which is why long-pulsed Nd:YAG is the standard choice for deeper skin tones. It needs an experienced provider and conservative settings, not avoidance.
  • “Lasers use radiation, so they cause cancer.” The light here is visible and near infrared. It does not have the energy to damage DNA the way ultraviolet or X-rays do, and it does not reach beyond the skin.
  • “All laser hair removal machines are the same.” They are not. Wavelength, pulse duration and cooling differ, and the right machine for your skin tone and hair type is the whole question. Ask which wavelength is being used.
  • “It works on any hair color.” It does not The laser finds pigment, so blond, red, gray and white hairs are invisible to it. No number of sessions changes that.
  • “If it hurts more, it is working better.” Discomfort tracks how much energy is going in, which is not the same as how well the target is hit. Pain is not a quality check, and an unbearable session should be adjusted, not endured.

Questions Patients Ask

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Is Nd:YAG safe for deeper skin tones?

It is the wavelength usually chosen for them. At 1064 nanometers surface pigment absorbs very little of the light, so the pulse passes through rather than heating the skin. It still needs conservative settings, good cooling, a test spot and a provider who treats deeper skin tones regularly. Safer than the alternatives is not risk-free.

Is laser hair removal permanent?

It is permanent reduction. Hair comes back finer, sparser and slower, and most people need a top-up once or twice a year. Anyone promising permanent removal is overstating what these devices are cleared to claim.

Why does it hurt more than other lasers?

The target absorbs this wavelength weakly, so more energy has to be delivered, and deeper. That is the trade you accept for the pigment safety. Numbing cream, cold air and slower passes help, and settings can be adjusted if it is too much.

Why can I not wax between sessions?

The laser aims at pigment in the hair sitting in the follicle. Waxing, plucking and threading pull that hair out, so the next session has nothing to find. Shaving cuts at the surface and leaves the follicle full.

Will it work on my blond or gray hair?

No. Lasers find melanin and light hair does not have enough of it. This is not a settings problem and more sessions will not fix it. Electrolysis works regardless of hair color.

How many sessions before I see anything?

Treated hairs shed over one to three weeks after each session, which looks like regrowth and is not. Most people notice genuine thinning after three or four sessions, and the plan is usually six to eight before maintenance.

References

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