DE102005034971B4 - Medical-therapeutic or cosmetic surface laser device - Google Patents

Abstract

A medical-therapeutic or cosmetic surface laser device (10) for irradiating a skin surface, comprising a laser head (12) in which at least three uncollimated laser diodes (14) are arranged, which are aligned at a predetermined distance between the laser head (12) and the skin surface to be irradiated is irradiated only that skin surface which is smaller than or equal to the surface bounded by the radiation exit openings (46) of the laser diodes (14), characterized in that the laser diodes (14) each have a divergent elliptical beam exit, the main axis (54) of the elliptical cone of radiation of at least each laser diode (14) arranged externally in the laser head (12) is aligned by rotation such that the skin surface is uniformly irradiated, the laser diodes (14) being rotated in their seats for this purpose Main axes (54) of the elliptical radiation surfaces to Mit point of the skin surface are aligned.

Description

The The invention relates to a medical therapeutic or cosmetic Surface laser device according to the preamble of claim 1.

Medical therapeutic or cosmetic surface laser devices that Light in the visible, in the infrared and in the near ultraviolet range Radiating are known in a variety of configurations.

The Use of, for example, infrared radiation to medical Purposes has long been known. In the absorption of IR radiation elevated the kinetic energy of the molecules. In living tissue has this increase accelerating influence on the course of biochemical reactions as well as on the circulation, namely Circulation, and thus on the oxygenation of the tissue. Surface laser devices are suitable Therefore, it is particularly good for triggering biochemical or bioelectric Effects in irradiated living tissue. Here, the irradiation On the one hand, the cross-linking of molecules to complex structures and on the other hand stimulation of microcirculation and cellular metabolism cause. This biostimulation, for example, causes a revitalization of the skin. It is known that active ingredients of a cosmetic or homeopathic Product, drug or herbal remedy by radiation with a laser, in particular with a diode laser, brought to it can be the epidermis and, consequently, the skin cutaneous barrier. Therefore, find medical-therapeutic or cosmetic surface laser devices in particular Use in conjunction with a cosmetic or homeopathic Product, a drug, an herbal remedy or the like.

Usually, such medico-therapeutic surface laser devices comprise a laser head in which a plurality of laser diodes are arranged. The radiation emitted by these laser diodes strikes a skin area to be irradiated that is greater than 1 cm ² .

A Laser diode is a semiconductor device related to the light emitting diode (LED), which generates laser light. In a laser diode is the stimulated Emission for light amplification used. Laser diodes therefore have a much higher output power compared to LEDs and, unlike LEDs, produce coherent light with a spectral Width of only 1-3 nm. Depending on the desired wavelength For this purpose, various semiconductor materials are used.

The lifetime of commercial laser diodes is usually 10 ⁵ hours.

The wavelength the radiation emitted by the laser diode is substantially dependent from the temperature and the current flowing through the laser diode. By stabilizing these parameters can be a good wavelength and power stability the laser diode can be achieved.

The emitted light output can vary between a few depending on the type of diode one hundred μW vary in the kW range.

It Uncollimated and collimated laser diodes are known. The collimation denotes the parallel direction of light rays. By means of a Lens, the so-called collimator, allows the scattering of reduce the radiation emitted by the laser diode. Uncollimated laser diodes have a scattering of the emitted radiation, which is up to 15 °, partially also up to 20 ° can.

at medical-therapeutic or cosmetic surface laser devices such a divergent radiation quite desired, as already irradiated a larger area of skin can be. Become usual therefore no such surface laser devices Used collimators. Rather, so-called beam widening come used, which increase the scattering of the emitted radiation. at so-called point laser devices, which are not the subject of this patent application and, for example in acupuncture use, however, is a collimation absolutely necessary.

Of the Beam exit or the beam profile of a laser diode is elliptical. The beam intensity a laser diode is correspondingly by an elliptical distribution characterized.

Medical-therapeutic or cosmetic surface laser devices are usually evaluated according to their intensity per cm ² irradiated skin area. To achieve a certain medically therapeutic or cosmetically required intensity, laser diodes are usually arranged very closely, with little distance from each other.

From the DE 20 2004 017 131 U1 For example, a corresponding device for treating the skin is known, which has a plurality of lighting means, in particular in the form of LEDs. Instead of the LEDs but also laser diodes can be used. The device is particularly suitable for the treatment of skin diseases and for cosmetic applications. In the DE 20 2004 017 131 U1 But also a problem of such medical-therapeutic surface laser devices is addressed. Wavelengths in the infrared range can lead to a disturbing heat load on the patient during the irradiation. In particular, when the individual laser diodes quasi rest on the skin surface to be irradiated, it can cause burns.

Another disadvantage of such medical-therapeutic or cosmetic surface laser devices is that with such a close arrangement of laser diodes, such as in the 1 and 2 of the DE 20 2004 017 131 U1 The observance of the ideal operating temperature of 20 ° C and the low maximum permissible operating temperature of 60 ° C of the laser diodes is hardly possible.

A increase the temperature deteriorates the power of a laser diode. At worst, this falls out.

adversely is also that in such medical therapeutic or cosmetic Surface laser devices Part of the skin area meeting radiation is reflected and no longer for treatment to disposal stands. The irradiation intensity decreases so. The reflectance of the skin depends on the one hand from the wavelength and on the other hand of the skin type "light / dark". uncontrollably In addition, radiation reflected in any direction may be beyond also damages elsewhere in the body or even with the user of the medical-therapeutic or cosmetic Flächenlasergerätes cause.

From the EP 0 320 080 B1 Another medical-therapeutic or cosmetic surface-laser device is known, which comprises an arrangement of radiation sources, which are arranged substantially in a plane at fixed distances from each other. Each of these radiation sources provides visible or infrared radiation of a predetermined wavelength. The radiation sources are mounted in a unit that is positioned directly on the skin, so that the radiation sources are located directly on the skin or almost on the skin. The disadvantage of this is the already mentioned heat load of the patient when using IR radiation sources. In addition, the surface of the skin must be free of oils and other substances to prevent reflection, absorption, diffraction or refraction of the radiation on these oils or other substances. At least two of the radiation sources are selected and arranged to provide different wavelengths of sufficient intensity to penetrate the skin of a patient at separate locations while converging at a subcutaneous site with sufficient power to provide a biostimulating effect at that location while the device is positioned on the skin. The radiation sources may be laser diodes with, for example, a diode in the center of the array, other diodes distributed evenly around the circumference of a circle having a first radius about the center of the array and, in turn, other diodes alternately and equidistant around the circumference of one array Circle are distributed with a second radius around the center of the arrangement. The radiation sources are selected to emit an average power density of at least 10 mW / cm ² in said plane and provide a power density of at least 120 mW / cm ² at a location on the surface of the patient's skin.

From the US Pat. No. 6,663,659 B2 a medical-therapeutic or cosmetic surface laser device for irradiation of a skin surface is known, which comprises a laser head, in which at least three uncollimated laser diodes are arranged, which are aligned such that irradiated at a predetermined distance between the laser head and the skin surface to be irradiated only that skin surface which is smaller than or equal to the area bounded by the radiation exit openings of the laser diodes. AT 406 547 B discloses another laser device with a laser diode, wherein the radiation cone of this laser diode is elliptical.

Based on this prior art, the present invention seeks to further develop a medical-therapeutic or cosmetic surface laser device according to the preamble of claim 1 such that when maintaining the optimal for the laser diode operating temperature a precisely defined area of skin of at least 1 cm ² can be irradiated , with as few reflective rays as possible to escape from the region of said skin surface.

This object is achieved with a medical-therapeutic or cosmetic surface laser device solved according to the preamble of claim 1 by the features of the characterizing part of claim 1. Further developments and advantageous embodiments of the invention will become apparent from the dependent claims.

According to the invention are at the medical-therapeutic or cosmetic surface laser device, the laser diodes aligned such that at a given distance between The laser head and the area of the skin to be irradiated are only exposed to that area of the skin which is less than or equal to that area of the radiation outlets the laser diode is limited.

The from the radiation outlets the laser diode limited area may vary depending on the arrangement and number of laser diodes be designed. The area of the skin to be irradiated is hereby preferably arranged almost congruent below this surface.

The Invention is based on the recognition that laser diodes have a divergent have elliptical radiation exit. The radiation of each laser diode So spreads from the radiation exit window of the laser diode up to the impact on the skin surface conical, with the elliptical Floor space this cone on the skin surface rests. It has been shown that in the case of the state of the art known alignment of the laser diodes, in which the cone axis perpendicular on the skin surface meets, a not inconsiderable part of the skin surface Radiation is reflected and thus no longer for treatment the skin area to disposal stands. The irradiation intensity decreases so.

The radiation intensity decreases according to the prior art and the more, the farther the laser head with the laser diodes away from the area of the skin to be irradiated is arranged. Due to the divergent elliptical radiation exit increases although the area the skin being irradiated, the radiation intensity decreases but off.

Farther the invention is based on the finding that the radiation intensity within an ellipse decreases from the center of the ellipse to the outside. This means that the skin area to be irradiated according to the prior art often not even and is homogeneously irradiated.

Thereby, that the laser diodes are aligned according to the invention, that essentially only that skin area is irradiated, the smaller or equal to that area is limited by the radiation exit openings of the laser diodes is increased, the irradiation intensity on the skin surface and a uniform and ensures homogeneous radiation distribution.

The Alignment of the laser diode thus causes that essentially one well-defined skin area and only this is irradiated. The size of the skin area is through the arrangement of the laser diodes quasi predetermined.

The required alignment of the laser diodes has the consequence that reduce the reflections on the skin, leaving more Radiation is available for the treatment of the skin.

By the alignment of the invention The laser diode will leak the radiation from the to be irradiated Area of the predetermined, limited in the circumference of the skin surface prevented.

A Development of the invention provides that the center beams of the Radiation cone at least the outside arranged laser diodes in individually definable angles to the skin surface Lot are aligned.

According to the invention the major axis of the elliptical cone of radiation is at least everyone in the laser head outside arranged laser diode aligned by rotation such that the skin area evenly irradiated becomes.

at The elliptical cone of radiation is a cone with an ellipse as a base. The called main axis refers to the extent to the ellipse.

Thereby results in a homogeneous radiation distribution on the area of the skin to be irradiated.

Conveniently, as few laser diodes as possible and as many laser diodes as necessary are provided to uniformly irradiate the skin surface. The fewer laser diodes are used, the lower the thermal load in the laser head and the lower the risk that the laser diodes fail due to exceeding their operating temperature.

Between Laser head and skin area is according to one Further development of the invention, a spacer of predetermined length arranged.

The Length of the Spacer is in this case of the divergence of the laser diodes emitted radiation, the type and orientation of the laser diodes and depending on the type of treatment or desired treatment goal.

Preferably is the distance between the radiation exit opening of a laser diode and the skin area more than 1 cm.

Farther It is envisaged that the laser diodes for emitting radiation in the infrared range are designed.

Preferably is in the laser head at least one aligned to the skin surface bulbs provided for the emission of radiation in the visible range.

at this illuminant is preferably a pilot light, which is operated simultaneously with the laser diodes and serves to indicate to the user of the area laser device when the laser diodes are operated and in which direction the Laser diodes emit their radiation.

A advantageous embodiment of the invention provides that the laser head designed as a module and connected to other modules of this type is.

Thereby let yourself the medical-therapeutic or cosmetic surface laser device to surprising easy to adapt to differently sized surfaces of the skin to be irradiated.

Preferably the laser head is rectangular or round. These forms have the advantage that the laser diodes arrange symmetrically to let.

At least the outside in the laser head lying laser diodes are preferably circular or in the form of a rectangle arranged.

The The invention provides that the laser diodes in their seats so are rotated, that the main axes of the elliptical radiation surfaces for Center of the skin surface are aligned.

Thereby becomes a uniform irradiation the skin area reached.

Preferably the seats of the laser diodes are sunk in the laser head such that the center rays of the laser diodes by 2 to 10 degrees in the direction the central axis of the entire beam of all laser diodes inclined are.

Become the laser diodes are inclined so that the center rays of the elliptical Beam cone in the direction of the central axis of the entire beam of all Laser diodes show, then one achieves that the outer rays of the entire beam all laser diodes impinge perpendicular to the skin.

To the law of reflection "angle of incidence equal failure angle "reduced this orientation of the radiation axes the emergence of reflected Laser radiation from the area of the skin area to be irradiated.

The surface laser device is designed such that skin surfaces of at least 1 cm ^{2 can be} irradiated. Furthermore, it is provided that the laser diodes are designed for pulsed or continuous emission of the radiation.

The laser diodes are designed and arranged according to an expedient embodiment of the invention such that they provide an irradiation intensity of more than 30 mW / cm ² , preferably of more than 50 mW / cm ² , on the skin surface.

Advantageous is also in that at least one laser diode is provided with a beam widening is.

According to one Development of the invention is arranged on the laser head casing provided in which arranged a control electronics for the laser diodes is.

Farther is provided that the laser diodes and the laser head by a cooler to be cooled preferably by a generated by a fan airflow, which is directed to the side of the laser head, which faces away from the skin surface is, or by a Peltier element.

Of the Fan is preferably arranged in the housing.

Conveniently, occurs during air cooling generated exhaust air through openings from, which are arranged in the laser diode-bearing laser head.

alternative or additionally Can the air cooling generated exhaust air through openings leak out, on the sides of the housing are arranged.

A Continuation provides that arranged on the laser head casing divided by an intermediate wall into two chambers, which as Supply air or exhaust air chambers act.

Preferably consist the sides of the case made of breathable Material.

According to one advantageous embodiment of the invention is the spacer a tube comprising the radiation, preferably a plexi tube, or a box comprising the radiation, which or which at Laser head attached, preferably flanged or screwed is.

The Pipe or the box is preferably an annular termination of the laser head and configured to prevent the lateral leakage of radiation prevented.

The Tube or box is preferably on the skin surface facing opening with one for the Radiation permeable Disc closed.

Especially Preferably, the disc is curved inward, so concave.

Thereby are deflected on this disc impinging rays inward, allowing a reflection of the radiation from the area to be irradiated the predetermined, clearly limited in the scope skin area decreased becomes.

Especially let yourself In this embodiment of the disc, the surface laser device easier on the Skin lead.

Preferably the disk is pressed into the pipe or box.

According to one Development of the invention, the exhaust air through openings leak out in the side walls of the pipe or box are arranged.

A Further development of the invention provides that the laser head a device for determining the temperature, preferably individual or more thermistors, bimetals, and / or other temperature sensitive ones Sensors are used.

Thereby can the for the power of the laser diodes optimum operating temperature by Zu- or switching off the cooling device to be controlled. At critical temperature levels, the laser device may temporarily turn off except Operation.

following the invention will be explained with reference to embodiments which are shown in the drawing. In this show

1 a schematic representation of a surface laser device in longitudinal section,

2 a schematic representation of the resting on the skin surface end of a surface laser device in longitudinal section,

3a) a schematic representation of the resting on the skin surface end of a surface laser device in longitudinal section,

3b) a schematic representation of the in 3a) shown end of a surface laser device in plan view,

4a) a schematic representation of the resting on the skin surface end of a surface laser device in longitudinal section,

4b) a schematic representation of the in 4a) shown end of a surface laser device in plan view,

5 a schematic representation of a laser head module in plan view,

6 a schematic representation of several interconnected laser head modules in plan view and

7 a schematic representation of a round laser head in plan view.

The alignment according to the invention of the main axes of the elliptical radiation cones of the laser diodes is specifically in the 5 to 7 to expression.

In 1 is schematically a medico-therapeutic or cosmetic surface laser device 10 shown for irradiation of a skin surface containing a laser head 12 includes, in the laser diodes 14 are aligned according to the usual manner known in the art.

Regardless of the known per se alignment of the laser diodes shown there 14 has the medical-therapeutic or cosmetic surface laser device 10 between the laser head 12 and the skin surface not to be irradiated, not shown here, a spacer 18 predetermined length, the length is more than 1 cm. The spacer 18 serves to ensure a constant optimal for the effect of the radiation exit openings of the laser diode to the skin surface at any time of the irradiation. This distance, that is to say the length of the spacer, is selected as a function of the type and number of laser diodes used, the shape of the laser head and the desired effect of the radiation.

The medical-therapeutic or cosmetic surface laser device 10 also includes one on the laser head 12 arranged housing 24 in which the control electronics 26 for the laser diodes 14 is arranged. On the housing is an on / off switch or button 40 arranged in the depressed position the flow of current through a power cord 42 through the laser diodes 14 allows and the laser diodes 14 thus starts operation.

For an optimal operating temperature of the laser diodes 14 ensure these and the laser head 12 by means of a fan 28 generated airflow, which is on the side of the laser head 12 directed, which is remote from the skin surface, cooled. This is the fan 28 casing 24 is arranged, by an intermediate wall 32 in a supply air chamber 34 and an exhaust chamber 36 shared. The ventilator 28 itself is pressed by pressing the button 40 activated. Preferably, the pages are made 30 of the housing 24 from a completely or partially air-permeable material.

The spacer 18 is a plexi tube encompassing or surrounding the radiation that is on the laser head 12 is flanged. The tube is in this case designed such that it prevents the lateral leakage of radiation. Preferably, the tube is formed such that incident radiation is reflected toward the skin surface. Preferably, the tube is impermeable to the emitted radiation.

In 2 schematically shows the resting on the skin surface end of a surface laser device in longitudinal section.

Regardless of the known per se alignment of the laser diodes shown there 14 has the medical-therapeutic or cosmetic surface laser device between the laser head 12 and the skin surface not to be irradiated, not shown here, a spacer 18 predetermined length in the form of a tube, wherein the length is more than 1 cm. The tube is in this case at the skin surface facing Opening with a transparent to the radiation disc 38 closed, which is curved inward, that is concave.

In 3a) schematically shows the resting on the skin surface end of a surface laser device in longitudinal section. In 3b) is schematically the corresponding in 3a) illustrated end of the surface laser device shown in plan view, wherein also the laser diodes 14 is emitted and irradiated on the skin surface radiation is sketched. The same reference numerals designate the same components.

Regardless of the known per se alignment of the laser diodes shown there 14 has the medico-therapeutic or cosmetic surface laser device between the laser head 12 and the skin surface not to be irradiated, not shown here, a spacer 18 predetermined length in the form of a tube.

In the 3a) and b) illustrated alignment of the laser diodes 14 is known from the prior art. The laser diodes 14 have a divergent elliptical radiation exit. The radiation 44 every laser diode 14 So spreads from the radiation exit window 46 the laser diode 14 until it hits the skin surface correspondingly conical, with the elliptical base of the cone resting on the skin surface. The elliptical base is in 3b) only to be guessed, as overlap in the center of the skin surface. It has been found that in the known from the prior art and in 3a) shown alignment of the laser diodes 14 where the cone axis 48 or the central jet is perpendicular to the skin surface, a considerable part of the radiation impinging on the skin surface is reflected and thus is no longer available for the treatment of the skin surface. The irradiation intensity is thus reduced.

In 3b) is still one in the laser head 12 centrally arranged light source 20 shown for the emission of radiation in the visible range. This light source 20 represents the so-called pilot light and indicates whether the laser diodes 14 are in operation and where the radiation of the laser diodes 14 is aligned. The pilot light 20 lights up when the button is pressed 40 with on.

In 4a) schematically shows the resting on the skin surface end of a surface laser device according to the invention in longitudinal section. In 4b) is schematically the corresponding in 4a) illustrated end of the surface laser device shown in plan view, wherein also the laser diodes 14 is emitted and irradiated on the skin surface radiation is sketched. The same reference numerals designate the same components.

The medical-therapeutic or cosmetic surface laser device according to the invention for irradiating a skin surface comprises a round laser head 12 in which eight uncollimated laser diodes 14 are arranged in a circle, each having a divergent elliptical beam exit. Between laser head 12 and the skin area is a spacer 18 predetermined length arranged.

According to the invention, the laser diodes 14 aligned so that only that skin surface is irradiated which is smaller than or equal to that area, that of the radiation outlet openings 46 the laser diodes 14 is limited. In 4a) is this skin area with the clip 50 indicated. Out 4b) becomes the scope 52 the skin area clearly.

The center rays 56 the radiation cone of the laser diodes 14 are in individually definable angles to the Lot standing on the skin surface 16 aligned.

These are the laser diodes 14 turned in their seats so that the main axis 54 the only here to be anticipated elliptical radiation surface is aligned to the center of the skin surface. The seats of the laser diodes 14 are here in the laser head 12 sunk that the center rays 56 the laser diodes 14 by 2 to 10 degrees in the direction of the central axis 16 the entire beam of all laser diodes 14 are inclined.

In 4b) is still in the laser head 12 centrally located pilot light 20 shown, indicating whether the laser diodes 14 are in operation and where the radiation of the laser diodes 14 is aligned.

In 5 is schematically a laser head module 22 shown in plan view. The there as a module 22 schematically illustrated laser head 12 is rectangular and includes eight laser diodes 14 , which are aligned so that only that skin area is irradiated, which is smaller than or equal to that area, the from the radiation exit openings of the laser diodes 14 is limited.

As in 5 schematically indicated is the main axis 54 of the elliptical radiation cone each in the laser head module 22 arranged laser diode 14 aligned by rotation so that the skin surface is irradiated evenly. It is quite possible that the elliptical radiation surfaces are chosen differently large and - if desired - overlap.

By connecting several of these laser head modules 22 can be a composite, as in 6 shown, which is then suitable for irradiation of larger areas of skin.

In 7 Finally, schematically a round laser head is shown in plan view, in which eight laser diodes 14 are arranged in a circle. Again, the laser diodes 14 turned so that the main axis 54 the elliptical radiation surface is aligned towards the center of the skin surface.

In addition, the seats or mounts, not shown here, of the laser diodes 14 so in the laser head 12 sunk that the center beams of the laser diodes 14 in the direction of the central axis of the entire beam of all the laser diodes 14 are inclined. This ensures that only the predetermined skin area is irradiated.

When have been particularly suitable for the surface laser device according to the invention infrared laser diodes of Company Tottori SANYO Electric Co., Ltd. with the following properties emerged:

properties

• • Wavelength: 785 nm (type)
• • Lower Threshold current: Ith = 30 mA (type)
• • Highest operating temperature: 60 ° C at 70 mW (CW)

• ²⁾Full angle at half maximum

Absolute Grenzdaten (Tc = 25°C) Parameter Symbol Daten Einheit Lichtausbeute CW Po (CW) 80 mW Pulse¹⁾ Po (pulse) 85 Sperrspannung Laser VR 2 V PD 30 Betriebstemperatur Topr –10 to +60 °C Lagerungstemperatur Tstg –40 to +85 °C

• ¹⁾Impulsdauer < 1,0 μs, Betriebsart 50%

Electrical and optical properties (Tc = 25 ° C) parameter symbol Condition Minute Type. Max. unit threshold current Ith CW - 30 50 mA operating current iop Po = 70 mW - 100 140 mA operating voltage Vop Po = 70 mW - 2.0 2.8 V Laser wavelength Lp Po = 70 mW 775 785 800 nm Radiation scattering ²⁾ perpendicularly qv Po = 70 mW 14 17 20 parallel Qh Po = 70 mW 6 8th 10 Angle to the axis perpendicularly DQV - - - ± 3 parallel dQh - - - ± 2 differential power dPo / Diop - 0.6 1.0 1.4 mW / mA Monitoring output current in the Po = 70 mW 12:10 12:25 0.6 mA astigmatism ace Po = 70 mW - - 10 microns

• ²⁾ Full angle at half maximum

Absolute limit data (Tc = 25 ° C) parameter symbol dates unit light output CW Po (CW) 80 mW Pulses ¹⁾ Po (pulse) 85 reverse voltage laser VR 2 V PD 30 operating temperatur Topr -10 to +60 ° C storage temperature Tstg -40 to +85 ° C

• ¹⁾ Pulse duration <1.0 microseconds, mode 50%

LIST OF REFERENCE NUMBERS

10

Surface laser device

12

laser head

14

laser diode

16

solder

18

spacer

20

Lamp

22

module

24

casing

26

control electronics

28

fan

30

housing sides

32

partition

34

chamber

36

chamber

38

disc

40

On / off switch

42

power cable

44

radiation

46

Radiation exit window

48

cone axis

50

skin surface

52

scope the skin area

54

skin axis

56

midstream

Claims (25)

Medical-therapeutic or cosmetic surface laser device ( 10 ) for irradiating a skin surface comprising a laser head ( 12 ), in which at least three uncollimated laser diodes ( 14 ) are arranged, which are aligned such that at a predetermined distance between the laser head ( 12 ) and the surface of the skin to be irradiated, only that skin surface is irradiated which is smaller than or equal to that area which is separated from the radiation outlet openings ( 46 ) of the laser diodes ( 14 ), characterized in that the laser diodes ( 14 ) each have a divergent elliptical beam exit, wherein the main axis ( 54 ) of the elliptical radiation cone at least each in the laser head ( 12 ) arranged outside laser diode ( 14 ) is aligned by rotation so that the skin surface is uniformly irradiated, wherein the laser diodes ( 14 ) are rotated in their seats so that the main axes ( 54 ) of the elliptical radiation surfaces are aligned towards the center of the skin surface. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 1, characterized in that the center beams ( 56 ) of the radiation cone of at least the externally arranged Laserdi oden ( 14 ) in individually definable angles to the solder standing on the skin surface ( 16 ) are aligned. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 1 or 2, characterized in that between laser head ( 12 ) and the skin surface a spacer ( 18 ) predetermined length is arranged. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 3, characterized in that the distance between the radiation outlet opening ( 46 ) a laser diode ( 14 ) and the skin area is more than 1 cm. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 4, characterized in that the laser diodes ( 14 ) are designed for the emission of radiation in the infrared range. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 5, characterized in that in the laser head ( 12 ) at least one light source ( 20 ) is provided for the emission of radiation in the visible range. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 6, characterized in that the laser head ( 12 ) as a module ( 22 ) and with other modules ( 22 ) This type is connectable. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 7, characterized in that the laser head ( 12 ) is rectangular or round. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 8, characterized in that at least in the laser head ( 12 ) external laser diodes ( 14 ) are arranged in a circle or in the form of a rectangle. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 9, characterized in that the seats of the laser diodes ( 14 ) in the laser head ( 12 ) are sunk that the center rays ( 56 ) of the laser diodes ( 14 ) by 2 to 10 degrees in the direction of the central axis ( 16 ) of the entire beam of all laser diodes ( 14 ) are inclined. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 10, characterized in that the laser diodes ( 14 ) are designed and arranged such that they provide on the skin surface an irradiation intensity of more than 30 mW / cm ² , preferably of more than 50 mW / cm ² . Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 11, characterized in that at least one laser diode ( 14 ) is provided with a beam widening. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 12, characterized in that one on the laser head ( 12 ) arranged housing ( 24 ) is provided, in which a control electronics ( 26 ) for the laser diodes ( 14 ) is arranged. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 1 to 13, characterized in that the laser diodes ( 14 ) and the laser head ( 12 ) are cooled by a cooling device, preferably by means of a fan ( 28 ) generated on the side of the laser head ( 12 ) directed away from the skin surface, or by a Peltier element. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 14, characterized in that the fan ( 28 ) in the housing ( 24 ) is arranged. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 14 or 15, characterized in that the exhaust air generated in the air cooling exits through openings in the laser diode ( 14 ) carrying laser head ( 12 ) are arranged. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 14 or 15, characterized in that the exhaust air generated in the air cooling exits through openings on the housing sides ( 30 ) are arranged. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 14 to 17, characterized in that on the laser head ( 12 ) arranged housing ( 24 ) by an intermediate wall ( 32 ) in two chambers ( 34 . 36 ), which act as Zuluft- or exhaust air chambers. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 16 to 18, characterized in that the sides ( 30 ) of the housing ( 24 ) consist of completely or partially air-permeable material. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 3 to 19, characterized in that the spacer ( 18 ) is a tube comprising the radiation, preferably a Plexirohr, or comprehensive box, which or which at the laser head ( 12 ), preferably flanged or screwed. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 20, characterized in that the tube or the box an annular termination of the laser head ( 12 ) and is designed to prevent the lateral leakage of radiation. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 20 or 21, characterized in that the tube or the box at the opening facing the skin surface with a transparent to the radiation disc ( 38 ) is closed. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to claim 22, characterized in that the disc ( 38 ) curved inward, that is concave. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 20 to 23, characterized in that the exhaust air exits through openings which are arranged in the side walls of the pipe or box. Medical-therapeutic or cosmetic surface laser device ( 10 ) according to one of claims 20 to 24, characterized in that the laser head ( 12 ) comprises a device for determining the temperature, wherein preferably one or more thermistors, bimetals and / or other temperature-sensitive sensors can be used.

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