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

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

c) 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 temperature sampling interval is an interval within the range of 0.01-10.0 msec.

3. The method of claim 1 , further comprising:

d) applying a contact cooling element comprising a cooling window to a first skin area, wherein the target skin area is within the first skin area, wherein the cooling window comprises a thermally conductive material that is transmissive to infrared energy and to the therapeutic laser pulse; 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;

2) Cooling the target skin area during the delivery of the therapeutic laser pulse; and

3) cooling the target skin area from a third surface temperature at the termination of the therapeutic laser pulse to a fourth surface temperature using the contact cooling element.

4. The method of claim 3 , wherein performing at least one cooling action comprises cooling the cooling window using a thermoelectric cooler (TEC) thermally coupled to the cooling window.

5. The method of claim 3 , wherein the cooling window comprises a material selected from sapphire, ZnS, diamond, and ZnSe.

6. The method of claim 3 , further comprising:

f) determining a surface temperature of the target skin area a plurality of times, at a temperature sampling interval of 100 msec or less and based on infrared energy radiated from the target skin area, during the step of performing at least one cooling action.

7. The method of claim 6 , wherein performing at least one cooling action comprises cooling the target skin area within the first skin area, prior to initiating the application of the therapeutic laser pulse, from a first surface temperature of body temperature to a second surface temperature within the range of −10° C. to 20° C.

8. 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 a target treatment temperature.

9. The method of claim 8 , wherein the target treatment temperature is a user-selectable temperature in the range of 35° C. to 85° C.

10. The method of claim 1 , wherein the time interval between the first timepoint and the second timepoint is a time interval within the range of 0.01-200 msec.

11. 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 therapeutic laser pulse has an energy fluence of at least 2 J/cm2.

12. 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.

13. The method of claim 1 , wherein the therapeutic laser pulse has an energy fluence within the range of 2-100 J/cm2.