Systems and methods for controlling therapeutic laser pulse duration

1. A method of treating the skin of a patient with a therapeutic laser pulse, the method comprising:

a) applying a contact cooling element comprising a cooling window to a first skin area of the patient, wherein the cooling window comprises a thermally conductive material that is transmissive to infrared energy;

b) cooling at least a target skin area within the first skin area from a first surface temperature to a second surface temperature by direct contact with the cooling window prior to initiating the application of a therapeutic laser pulse to the target skin area;

c) initiating the application of a therapeutic laser pulse to the target skin area through the cooling window at a first timepoint;

d) determining a surface temperature of the target skin area a plurality of times during the application of the therapeutic laser pulse based on infrared energy radiated from the target skin area through the cooling window, at a temperature sampling time interval of 100 msec or less; and

e) terminating the application of the therapeutic laser pulse to the target skin area at a second timepoint based at least in part on the plurality of surface temperature determinations, wherein each of the plurality of surface temperature determinations occurs during a single therapeutic laser pulse having a pulse duration comprising the period from the first timepoint to the second timepoint.

2. The method of claim 1 , wherein the cooling window comprises a material selected from sapphire, ZnS, diamond, and ZnSe.

3. The method of claim 1 , wherein cooling at least a target skin area comprises cooling the surface of the target skin area from a first surface temperature of body temperature to a second surface temperature within the range of −10° C. to 20° C.

4. The method of claim 1 , wherein cooling at least the target skin area comprises cooling skin in contact with the cooling window using a thermoelectric cooler thermally coupled to the cooling window.

5. The method of claim 1 , wherein the temperature sampling time interval is an interval within the range of 0.5-2.0 msec.

6. The method of claim 5 , wherein terminating the application of the therapeutic laser pulse comprises terminating the application of the therapeutic laser pulse at the second timepoint based on a predicted time interval from the first timepoint at which the surface temperature of the target skin area will reach a second temperature, wherein the predicted time interval is determined based on the plurality of surface temperature determinations.

7. The method of claim 1 , wherein terminating the application of the therapeutic laser pulse comprises terminating the application of the therapeutic laser pulse when at least one of the plurality of surface temperature determinations indicates that the target skin area has reached or exceeded a third surface temperature.

8. The method of claim 7 , wherein the third surface temperature is a temperature in the range of 35° C. to 85° C.

9. The method of claim 7 , wherein the third surface temperature is a user-selectable temperature in the range of 45° C. to 65° C.

10. The method of claim 1 , wherein the pulse duration is a time interval within the range of 0.01-200 msec.

11. The method of claim 1 , further comprising repeating steps c-e one or more times, wherein the target skin area for each repetition of steps c-e comprises a target skin area within the first skin area that is non-contiguous with every other target skin area for each sequence of steps c-e; wherein prior to each repetition of steps c-e, the non-contiguous target area is selected using a scanner whose position is adjusted by one or more motors.

12. The method of claim 11 , wherein repeating steps c-e one or more times comprises using a mirror to direct the laser pulse for each repetition of steps c-e to a different target area within the first skin area that is non-contiguous with every other target area for each sequence of steps c-e.

13. The method of claim 1 , wherein initiating the application of a therapeutic laser pulse comprises initiating a laser pulse from a diode laser, and wherein the pulse has an energy fluence within the range of 2-100 J/cm 2 .

14. The method of claim 1 , wherein initiating the application of a therapeutic laser pulse comprises initiating the application of optical energy having a wavelength within a range of from about 1700 nm to about 1740 nm.

15. The method of claim 14 , wherein the wavelength is about 1727.5 nm.

16. The method of claim 1 , further comprising:

f) determining a skin type of the patient, wherein the skin type is indicative of a melanin concentration of the patient's skin.

17. The method of claim 16 , wherein cooling at least a target skin area within the first skin area comprises cooling the target skin area to a second temperature, wherein the second temperature is based on the determined skin type of the patient.

18. The method of claim 16 , wherein determining a skin type of the patient comprises:

a) applying light from a multi-wavelength light source to a second skin area;

b) analyzing reflected multi-wavelength light from the second skin area; and

c) determining a skin type of the patient based on the analyzed reflected multi-wavelength light.

19. The method of claim 1 , wherein the patient is a patient having one of acne vulgaris or hyperhidrosis, and wherein terminating the application of the therapeutic laser pulse comprises terminating the laser pulse at a second timepoint based on a surface temperature indicative of one of a sebaceous gland reaching a target sebaceous gland temperature and a sweat gland reaching a target sweat gland temperature.

20. A method of treating the skin of a patient with a therapeutic laser pulse, the method comprising:

a) applying a contact cooling element comprising a cooling window to a first skin area of the patient, wherein the cooling window comprises a thermally conductive material that is transmissive to infrared energy;

b) initiating the application of a therapeutic laser pulse to a target skin area within the first skin area through the cooling window at a first timepoint;

c) determining a surface temperature of the target skin area a plurality of times during the application of the therapeutic laser pulse based on infrared energy radiated from the target skin area through the cooling window, at a temperature sampling time interval of 100 msec or less;

d) terminating the application of the therapeutic laser pulse to the target skin area at a second timepoint when at least one of the plurality of surface temperature determinations indicates that the target skin area has reached a third surface temperature, wherein each of the plurality of surface temperature determinations occurs during a single therapeutic laser pulse having a pulse duration comprising the period from the first timepoint to the second timepoint; and

e) performing at least one cooling action selected from

1) cooling the target skin area from a first surface temperature to a second surface temperature using the contact cooling element prior to initiating the application of the therapeutic laser pulse to the target skin area; and

2) cooling the target skin area from the third surface temperature to a fourth surface temperature using the contact cooling element after terminating the application of the therapeutic laser pulse to the target skin area.

21. The method of claim 20 , wherein performing at least one cooling action comprises cooling the target skin area from a first surface temperature to a second surface temperature prior to initiating the application of the therapeutic laser pulse, the method further comprising:

f) determining a surface temperature of the target skin area one or more times during the step of cooling the target skin area from the first surface temperature to the second surface temperature based on infrared energy radiated from the target skin area through the cooling window.

22. The method of claim 21 , wherein initiating the application of the therapeutic laser pulse to the target skin area is based on at least one of the plurality of surface temperature determinations during the step of cooling the target skin area from the first temperature to the second temperature, at a temperature sampling time interval of 100 msec or less.

23. The method of claim 21 , wherein initiating the application of the therapeutic laser pulse to the target skin area through the cooling window at the first timepoint occurs when the one or more surface temperature determinations indicate that the target skin area has been cooled to the second surface temperature.

24. The method of claim 20 , wherein performing at least one cooling action further comprises cooling the target skin area from the third surface temperature to the fourth surface temperature after terminating the application of the therapeutic laser pulse.

25. The method of claim 24 , further comprising:

g) determining a surface temperature of the target skin area one or more times during the step of cooling the target skin area from the third surface temperature to the fourth surface temperature based on infrared energy radiated from the target skin area through the cooling window.

26. A method of treating the skin of a patient with a therapeutic laser pulse, the method comprising:

a) applying a contact cooling element comprising a cooling window to a first skin area of the patient, wherein the cooling window comprises a thermally conductive material that is transmissive to infrared energy;

b) cooling at least a target skin area within the first skin area from a first surface temperature, using the contact cooling element;

c) determining a surface temperature of the target skin area a plurality of times during the cooling of the target skin area based on infrared energy radiated from the target skin area through the cooling window prior to initiating the application of a therapeutic laser pulse to the target skin area;

d) initiating the application of a therapeutic laser pulse to the target skin area through the cooling window at a first timepoint based on one or more of the plurality of surface temperature determinations of the target skin area;

e) determining a surface temperature of the target skin area a plurality of times during the application of the therapeutic laser pulse based on infrared energy radiated from the target skin area through the cooling window, at a temperature sampling time interval of 100 msec or less; and

f) terminating the application of the therapeutic laser pulse to the target skin area at a second timepoint when at least one of the plurality of surface temperature determinations indicates that the target skin area has reached or exceeded a third surface temperature during the application of the therapeutic laser pulse, wherein each of the plurality of surface temperature determinations occurs during a single therapeutic laser pulse having a pulse duration comprising the period from the first timepoint to the second timepoint.

27. The method of claim 26 , further comprising:

g) cooling the skin area from the third surface temperature at the second timepoint to a fourth surface temperature using the contact cooling element after terminating the application of the laser pulse to the target skin area.

28. The method of claim 27 , further comprising:

h) determining a surface temperature of the target skin area one or more times during the step of cooling the target skin area from the third surface temperature to the fourth surface temperature based on infrared energy radiated from the target skin area through the cooling window.