Skin is the largest organ in the body and performs a wide variety of different functions. It is composed of a predominantly cellular epidermis and an underlying dermis, which is composed of fibers of connective tissue relatively sparsely populated with cells. They play an important role in the injury of the skin.
The epidermis contains mostly keratinocytes, among which are interspersed melanocytes, Merkel cells, Langerhans cells, and other resident immune cells.
What the classifications actually mean?
Class IIIb: IIIb lasers are hazardous to the eye when viewed directly. For visible and infrared
devices emission power is limited to 0.5 W. Protective eyewear, key switch and safety interlock
are required safety features.
Class IV: Class IV includes all lasers that emit power in excess of IIIB limitations. Eye protection
is needed to limit both direct and diffuse reflected exposure. Key switch and safety interlock are
also required safety features. The majority of scientific, industrial, military, and medical lasers fall
into this category.
Power: Class IIIb lasers are limited to powers of 0.5 watts and under, Class IV therapy lasers
typically enable the user to select powers of 0.5 W – 15 W. Increased power enables the
clinician to treat a larger area in a shorter period of time – ultimately resulting in a therapeutic
dose of joules to the target tissue.
In general terms, combination therapy involves the simultaneous application of ultrasound (US) with an electrical stimulation therapy. In Europe, Diadynamic Currents are frequently utilised, but in the UK, US is most often combined with bipolar Interferential Therapy (IF).
There is a significant lack of published material in this area. And much of the information herein is anecdotal or based on the experience of those who use the modality frequently. Broadly, the effects of the combined treatment are those of the individual modalities. There is no evidence at present for any additional effects which can only be achieved when the modalities are used in this particular way.