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Long Pulse Laser Hair Removal Treatment Procedure


Client Pre-Qualifications

The best candidate for laser hair removal has fair skin with dark terminal (post pubescent) hairs. Skin typing for exposure to ultraviolet light can be categorized by the Fitzpatrick classification, developed by Dr. Thomas Fitzpatrick of Harvard Medical School.

Fitzpatrick classification

  • Skin Type I:  Never tans, always burns (extremely fair skin, blonde hair, blue/green eyes)

  • Skin Type II:  Occasionally tans, usually burns (fair skin, sandy to brown hair, green/brown eyes)

  • Skin Type III:  Often tans, sometimes burns (medium skin, brown hair, brown eyes)

  • Skin Type IV:  Always tan, never burns (olive skin, brown/black hair, dark brown/black eyes)

  • Skin Type V:  Never burns (dark brown skin, black hair, black eyes

  • Skin Type VI:  (black skin, black hair, black eyes)  

Types 1 through 4 are outstanding candidates. Type 5 will have excellent results as well but care must be taken to assure that the laser or IPL will not burn the skin.  This can be achieved with aggressive skin bleaching. 


Laser Treatment 1: Deep Tissue Thermolysis with Intact Follicle

With this procedure, the hair is actually shaved by a razor prior to laser application. This leaves the follicle intact, which provides a target for the laser radiation.

The skin must be thoroughly cleaned.  This allows for nearly 100% of the radiation to be sent deep inside the tissue. Radiation can be partially blocked by dirt or hair, thereby reducing the efficiency of the device.

Place the IPL optic on the skin (if using an IPL device).  If using a laser, hold it 1/2 to 1 inch from the skin. Activate the device on low pulse frequency setting (start out on the lowest setting: 3 pulses per second).  Move the the IPL optic to a new location and repeat. You should administer no more than 3 pulses per area (1cm2) on the first treatment to determine the patient's reaction. Applying 30 or more pulses to the same area may result in a surface burn. Do not over treat. Each patient will react differently to the same energy level.


Laser Treatment Variation 2: Deep Tissue Thermolysis With Follicle Extraction and Carbon Dye

Before applying treatment, remove all hair from the area by tweezing or waxing. Laser and IPL hair removal is most effective when applied to an empty follicle shaft.  Most human hair does not normally have enough pigment to allow for sufficient heat exchange to cauterize, desiccate and necrotize the cells which produce hair. To compensate for this lack of quantitative and qualitative photon targets, it will be necessary to place a high-density carbon dye inside the follicle prior to treatment.

wax hairopen follicle shaftbald skin, open poreUsing a cotton-tipped applicator, completely cover the treatment area with the special dye included in your kit. Massage the dye into the follicle pore with a firm downward circular motion. Repeat 2-3 times to saturate the follicle pore. Use an ethyl alcohol based wipe (isopropyl alcohol will not dissolve the dye) to lightly clean the excess from the surface of the skin. At this point you will have all desired follicles visibly highlighted with a dark spot (as seen above) and are ready to power up your laser for treatment. Place the laser head on the skin as shown (with the exit port nodules touching the treatment area). Activate the laser on low pulse frequency setting (start out on the lowest setting: 3 pulses per second). Move the laser and repeat. You should give no more than 3 pulses per area on the first treatment to determine the patient’s reaction. Applying 30 or more pulses to the same area will result in a severe burn (leading to blistering).

Using a cotton-tipped applicator, completely cover the treatment area with the special dye included in your kit.  Massage the dye into the follicle pore with a firm downward circular motion.  Repeat 2-3 times to saturate the follicle pore.  Use an ethyl alcohol based wipe (isopropyl alcohol will not dissolve the dye) to lightly clean the excess from the surface of the skin.  At this point you will have all desired follicles visibly highlighted with a dark spot (as seen above) and are ready to power up your laser for treatment.

Place the IPL optic on the skin (if using an IPL device).  If using a laser, hold it 1/2 to 1 inch from the skin.  Activate on low pulse frequency setting (start out on the lowest setting: 3 pulses per second).  Move the optic to a new location and repeat. You should give no more than 3 pulses per area on the first treatment to determine the patient's reaction. Applying 10 or more pulses to the same area may result in a surface burn.

After the desired area has been completed, apply a cold pack.  This will cool the dermis and soothe any uncomfortable neural activity.  Apply the post-treatment gel and advise the patient not to pick or scratch the area. The dermis will show some trauma in the form of eurythmia (reddening) which may last 12-24 hours.

Schedule the patient for their next treatment in 3 weeks. By then some of the new anagen hairs will be surfacing. Hair growth activity will diminish substantially after each application.


Important Considerations for Safe Laser Treatment


  • Treatment Around or Near the Eyes: Great care must be exercised when working near the eyes. The laser emission is powerful enough to actually penetrate the eyelid and permanently damage the eye. Having the patient close their eyes is not satisfactory protection. The use of a dark-colored damp wash cloth which is folded over four times will deflect the harmful radiation; however, only laser protective eyewear is recommended.


  • Treatment Around or Near Mucus Membranes: Laser radiation will severely damage the tissues inside the nose and ear canal. Treatment should be avoided in these areas altogether.


  • Treatment Around or Near the Genitals: Laser hair removal is safe for application to the pubic regions including the reproductive organs of both sexes. Care must be taken into consideration in these areas due to the increased level of neural sensitivity. The patient may find the process uncomfortable without a topical desensitizing spray.


  • Treatment Around or Near the Areola (nipple): Laser hair removal is safe and effective on hair growth which occurs from the areola of both sexes.

  •  
    Post-Treatment: The skin surrounding the treatment area will experience short-term erythmia (reddening) which will subside within 12-24 hours. Should the treatment area show signs of excess scabbing you may wish to reduce the overall treatment time or intensity. The application of a post-treatment cooling and healing gel (such as Aloe) is encouraged to speed healing and reduce sensitivity. Instruct the patient to refrain from applying cosmetics or sunbathing for at least 24 hours.


Laser Epilation Clinical Results

Patient #

Hair Counts

12 Week Clearance Ratio

1 female, 2 males

pre

number of treatments

post

percent

#1, Laser Shave Procedure with LP Diode

274

12

9

97%

#2, Deep tissue thermolysis with hair intact

327

8

19

94%

#2, Deep tissue thermolysis with hair follicle extraction and carbon dye

187

6

2

99%

Median improvement ratio 97%


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