There is some controversy in the therapy laser market about class 4 lasers and their performance when compared to lower power cold lasers. This controversy is mainly because class 1 through 3b manufacturers spend a lot of money and time bashing their higher powered competition to scare people away from what might be a superior product for some applications. The truth is that both types of systems have their niche. First, lets look at the class 4 systems we sell and then we will continue the debate.

  Brand Spec Price Notes
klaser Eltech Klaser by Chattanooga 12 - 15 watt Quad Wavelength Pulse & CW $19990 - $27500 The "Gold Standard" of lasers from Italy
EVOlaser EVOlaser 9 - 20 watt Up to 4 Wavelengths Pulse & CW $9,950 - $14,500 One of the best values in class 4 systems.
Pilot Pilot Laser 9 watt 810nm Pulse & CW $7995 A simple system with a lot of power for the money
Apollo Apollo Laser .5 - 5 watt 810nm CW $5149&Up The "grab-and-go"simple Class 4 system

So when is a class 4 system the best choice. Class 4 lasers are best for users who:

  1. Want to have the option of higher dosage
  2. Need to treat very deep areas
  3. Want to treat larger area (like in neuropathy)
  4. Want superior pain control
  5. Will be treating a wide variety of tissue injuries with both high and medium dosages
  6. Want to have the shortest treatment times
  7. Have a higher volume practice
  8. Can afford a higher end laser

Class 4 system are just like other lower power system except they deliver the energy faster. In cases where the energy needs to be deliver over a large or deep area, this extra power keeps the treatment times less than 12 minutes. The extra power also allows practitioners do deliver class 3b dosages in just a couple minutes or go to higher dosages for superior pain control. All these class 4 system can deliver medium dosage like you get in a class 3b system but you also have the choice to treat larger area, deeper areas and provide better pain control. It is up to the practice to decide how to use the system.

There are 3 downsides to these system:

  1. They are more expensive than class 1 to 3b systems
  2. They must be kept moving (in general) if delivering over about 4 joules/second
  3. They have a higher risk of eye damage. This is extremely low if everyone wears safety glasses.

Class 4 Systems 30 watts and Over

Not all class 4 system are alike. Much of the bad press about class 4 laser is really about 30 watt systems and above. Once you get into systems that deliver 30 joules/second, you must keep the system moving very quickly or you risk burning the the skin. In our opinion, it is just not worth the added risk to deliver energy at these extreme rates. For this reason, we don't sell systems that deliver over 20 joules/second.

Digging Deeper into the Fear Inducing Claims

Below is a table that shows some common claims and some of the underlying facts behind the claim. Always keep in mind that almost every class 4 laser has the option to turn down the power when it is appropriate so you have more flexibility with a higher power pulsing/CW class 4 laser.

We sell Eltech Klaser, EVO laser, Apollo, and Pilot class 4 systems.

Claim

Details

There is a big difference between class 3 and Class 4 products.

Yes and No.

Yes. Once you get above 5 watts, the laser diodes are installed in a cooled housing and you use a fiber optic cable to transfer the power to the handheld probe. This adds a lot of complexity to the system.

No, the general cutoff for a class 4 laser is 0.5 (1/2) watts per beam. This means that, for example, the Avant LZ30z with 2 beams at .70 watts per beam is more powerful than some Class 4 lasers but is a class 3b. The Apollo is Class 4 but uses probes that are extremely similar to the Class 3b probes used by Thor. It is just a matter of picking individual laser diodes above or below .5 watt output. The line between class 3 and class 4 lasers is very blurry.

Class 4 lasers are not appropriate for home use.

False, however most class 4 systems do require extra training to make sure the user is safe. Many home users start out getting therapy in a doctor's office but want the convenience of therapy at home. In this case, users can simply adapt the protocol that is already working for use at home to save time and money. Systems like the Apollo cold laser use a divergent beam and a timer as the only variable so less training is required. For pain control, class 4 power lasers, with higher power and continuous wave, are hard to beat.

Too much power is not as effective for healing.

This statement has NOT be proven by an independent study; it has only been shown by studies paid for by lower power laser manufacturers who use the study to discredit class 4 systems. Higher dosages are better for pain control but higher-end Class 4 laser have adjustable power so when you want less power, you simply turn it down. When you need more power for better pain control, you turn it up.

The Arndt-Schulz curve that everyone uses to show the biphasic reponse of lasers has no numbers on it and there is very little information about the dosage at the peak.

Class 4 lasers are not worth the money.

False. Using a class 4 laser for less than 20 minutes per day, you probably don't need to spend the extra money. That being said, for many people, higher dosages and shorter treatment times are a key to great results. If you are not concerned about therapy times, flexibility or giving your patients the maximum pain relief, then a lower power product is fine. Class 4 lasers are for doctors and home users who want to have every option available without limitations for any condition. State-of-the-art class 4 lasers can be purchased for less than $12,000, however mediocre class 3b laser for over $15,000. You get what you pay for with most class 4 systems.

Class 4 lasers are better for pain control.

Class 4 lasers have shorter therapy times.

Class 4 lasers are better for treating larger areas.

Yes to all of these claims. Higher power lasers provide better pain control in a shorter period and can cover large areas much faster than a lower power lasers. The key here is not necessarily the class but the total power output of the system. Higher power allows for more flexibility. Everyone in the market seems to agree that more power is better for pain control, better for larger areas and will shorten the time it takes to get the optimum healing or pain control density.

Class 4 laser are dangerous.

Yes. In the wrong hands, a class 4 cold laser can cause damage just like a scalpel, a bad drug prescription or any of the other tool doctors use every day. This is not a good reason to not have the tool. With proper training and adherence to safety precautions, class 4 lasers up to around 30 watts are safe.

We do not recommend systems at 30 watts and over because the level of training and awareness is so high that it is not worth the extra money and risk to work at these power levels.

All the other products on the market are inferior to (insert product name here).

Though some manufactures may claim they are superior, there is not one solution that is the best for all applications. Every manufacturer has a unique value proposition. It is our job to help you find the most appropriate system for your application.

So, what conclusions can we make about class 4 lasers? The line between a class 4 and class 3 is gray. The Avant and Thor class 3b systems have similar specs and performance to the lower-end of class 4 lasers and they cost less. Because the Apollo is not a fiber optic design, it cost about half as much lower as a fiber-optic based class 4 system. Class 4 cold lasers may be the ultimate cold laser for some applications but that really depends more on the requirements of the practice.

The bottom line is that class 4 system deliver results. Many people that don't get results with a class 3b and below, will get results with a class 4. That is why they are used in hundreds of chronic pain clinics in the US.

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