Coldlasers.Org now offers more FDA cleared class-4 options than any other seller. Over the years, there has been some controversy in the therapy laser market about class-4 lasers and their performance/safety when compared to lower power cold lasers. This controversy is mainly driven by class 1 - 3b manufacturers spending their money and time bashing their higher powered competition to scare people away from what can be a superior product. We offer lots of class 1m through 3b options so we know that class 4 systems are not for everyone but in many cases, higher dosages provide better, faster and more consistent results. That is why class 4 systems are the "standard" in most laser-dedicated neuropathy and pain clinics. The truth is that all the options we sell have their niche. First, lets look at the class-4 systems we sell and then we will continue the discussion.

  Brand Spec Price Notes
ReGen Laser ReGen Laser 25 to 60.3 watts, Up to 4 Wavelengths Pulse & CW $10,950 - $19,950 One of the newest and best system on the market.
EVOlaser EVOlaser 9 - 27 watts, Up to 4 Wavelengths Pulse & CW $8,950 - $14,995 One of the highest perfomance class 4 systems at a reasonable price.
Pilot Pilot Laser 9 watt 810nm Pulse & CW $7,995 Out of production.
Apollo Apollo Laser .5 - 5 watt 810nm CW $5,149 & Up A great balance of simplicity and safety.
AccuRay Accuray

45 - 60 watt dual or quad-wavelength

$18,995 & Up Very similar to EVO FX.
AccuRay EVO FX 45 watt tri-wavelength $24,000 For those who need maximum power.
klaser Eltech K-Laser 12 - 30 watt Tri/Quad wavelength $19,990 - $45,000 Built in Italy/ great quality but we no longer sell it.

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 dosages
  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 high to medium dosages
  6. Want to have the shortest treatment times
  7. Have a higher volume practice
  8. Can afford a higher-end more flexible laser

Class 4 system are just like other lower power systems except they deliver the energy faster. Technically, they do not push the energy deeper. The ability to deliver a photo-chemical reaction deep in the body is based on RATS: reflection, absorption, transmission, scatter and this is controlled by the wavelength of light. More powerful systems deliver the energy faster so that you can get to your target dosage (at depth) in a shorter time. If the goal is to deliver maximum energy at depth and get a photo-chemical reaction, you want your highest power wavelength to be in the 810nm range. This is the wavelength with the highest efficiency at producing a photo-chemical reaction in deep in tissue.

In cases where the energy needs to be delivered over a large problem area, this extra power keeps the treatment times at a fraction of the time for class 1m - 3b systems. The average class 4 system is 5 to 50 times more powerful than a lower class laser.

Dosage equals average power X treatment time so if you targeting the same dosage, a 10-watt laser will accomplish in 1 minute what it takes 1-watt needs 10 minutes to accomplish.

The extra power also allows practitioners to deliver class 3b dosages in just a couple minutes or go to higher dosages for superior pain control. You can also use the extra power to distribute energy over a larger area which often helps support the surrounding inflammation to help people feel better faster.

If desired, class 4 system can deliver medium dosage like you get in a class 3b system and lower power systems but class 4 systems give you the choice to treat larger areas, deeper areas, do shorter treatment times or 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 1 joule/second/cm2
  3. They have a higher risk of eye damage. (This is extremely low if everyone wears safety glasses)

Class 4 Systems Over 30 watts

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 over-heating the the skin. In our opinion, these system are only for very busy practices. It does not make financial sense to buy a machine over 30 watts unless you will be using more than 4 hours a day.

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 K-Laser, EVO laser, Apollo, Pilot and Accuray class 4 systems.



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 complexity to the system but does not change the mechanism of PBM.

No, the general cutoff for a class 4 laser is 0.5 (1/2) watts per diode. 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 response of lasers has no numbers on it and there is very little information about the actual dosage (joules/cm2) at the peak of the curve.

Class 4 lasers are not worth the money.

False. Class 4 laser are more flexible and provide shorter treatment times and faster results. If you are NOT concerned about therapy times, flexibility or maximum pain relief, then a lower power product will cost less. 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 $10,000, however there are several mediocre class 3b laser for over $15,000. You get what you pay for with the class 4 systems that we sell. If you have a busy practice, a class 4 system will have a better return-on-investment (ROI) than a lower class laser because it is so much faster.

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. If used incorrectly, a class 4 cold laser can cause damage just like you get if you stare at or lay out in the sun to long. This is not a good reason to not have the tool. With proper training and adherence to safety precautions, class 4 lasers are safe.

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.

Delivery rate has an impact on efficacy. No. In our opinion, there is no difference in efficacy between using a 1 watt for 10 minutes or a 10 watt laser for 1 minute. They both deliver the exact same dosage (600 joules). Higher delivery rates allow for treating larger areas and deeper area in a reasonable amount of time.

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-power class 4 lasers. 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 therapy laser for many applications but that really depends more on the requirements of the application or 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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