Which sign indicates that energy is too high during a pass (e.g., blanching), and what should you do?

• A. Pain or discomfort without blanching indicates high energy; adjust slight.
• B. Skin blanching or whitening indicates excessive energy; reduce fluence or increase spot size and reassess.
• C. No skin response; continue with current settings.
• D. Redness alone requires more energy.

Answer: (B)

Blanching, the whitening of the skin during a pass, is the signal that the energy being delivered is too high for that area. When the skin turns white, it means the epidermis is absorbing more energy than it can safely handle, increasing the risk of burns or pigment changes. The best course is to reduce the fluence (energy per area) or increase the spot size so the same energy is spread over a larger area, then reassess with proper cooling and a test pulse on a small area before continuing. While pain or discomfort can also indicate excessive energy, blanching is the clearest, most direct cue; lacking a blanching response or seeing only redness does not necessarily mean the energy is too high.