The aim of this research is to design a outofocus digital microscope which can detect skin tissue damage exposed by Q-Switch Nd:YAG laser with energy dose of 29.5 J/cm2, 32 J/cm2 and 53.8 J/cm2. The skin tissue damage can be seen in the form of hole which has diameter and depth. This designed microscope is equipped with program to control the focus driver motor to move the microscope tube, brightness control of LED lighting, and program to digitally measure the diameter and depth of skin tissue damage caused by laser exposure of Q-Switch Nd:YAG. The speed of focus driver motor which moves the microscope tube is controlled by on-off pulse delay time while the brightness of the lighting is controlled by PWM signal which is generated by microcontroller. Pulse delay time between on and off is from 1 millisecond to 100 milliseconds. Measurement results have shown that the smallest displacement of microscope tube is at 23 μm/millisecond while digital measurement accuracy level of diameter and depth of the hole of skin tissue damage exposed by Q- Switch Nd:YAG laser is from 92.192% to 99:85226% and the range of measurement is 1440 um under 125 times of magnification. Keywords: Q-Switch Nd:YAG laser, energy dose, microscope tube displacement, pulse wave modulation, diameter of hole, depth of hole.