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Affiliate Advertising Section
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Laser Hair Removal New Treatment
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Long
Pulse Ruby Laser: The 694nm ruby laser is very well absorbed by melanin, but
its use is limited to patients with lighter skin. The Epilaser uses an
actively chilled handpiece with a synthetic sapphire lens, which not only
cools the skin but enhances optical coupling of the laser beam. The Epi-Touch
laser uses a cool gel applied to the skin, over which is placed a targeting
grid to ensure uniform application over the area to be treated. The Epi-Touch
can also be operated in Q-Switched mode for the treatment of tattoos and
pigmented lesions, a tremendous advantage considering the cost of these
devices. A non-Q-Switchable EpiPulse version is also marketed. The
Aesculap-Meditec RubyStar is an attractive compact dual mode laser with an
electrical contact cooling system.
Long Pulse Alexandrite Laser: The 755nm alexandrite laser is similar to the
ruby, except that it has a greater penetration and less melanin absorption
because of the slightly longer wavelength. The GentleLase uses a cryogen
spray cooling device, in which R-134a refrigerant is sprayed onto the skin a
few milliseconds before each laser pulse. The PhotoGenica LPIR and Apogee
lasers use a cooling gel, and have cooling tips available. The Epi-Touch
Alex uses a cooling gel and a scanning device to allow rapid treatment of
large areas.
Diode Laser: Solid state 800nm diode lasers feature a longer wavelength and
pulsewidth, theoretically offering an advantage in treating darker skinned
patients. The LightSheer obtained FDA approval for permanent hair reduction
last year, and uses an actively chilled sapphire window handpiece. The
Diomed LaserLite is available in the U.S, and, along with the
Aesculap-Meditec MeDioStar and Iriderm Apex 800, has recently been FDA
approved for hair reduction.
Q-Switched Nd:YAG: With a wavelength of 1064nm, relatively low melanin
absorption, and skin penetration up to 5mm, the Nd:YAG laser is an excellent
choice for laser hair removal, at least in theory. However, the
nanosecond-range pulse width of the Q-Switched YAG is thousands of times too
short to cause complete disruption of the hair follicle, resulting in prompt
hair regrowth. In order to enhance absorption of energy, a suspension of
carbon particles can applied before treatment, usually after hair removal by
waxing, allowing the carbon suspension to penetrate into the follicle and
conduct absorbed laser energy to the follicular structures, as in
theThermolase SoftLight system. Although safe for darker-skinned patients
and effective for short term hair reduction, the Q-Switched Nd:YAG is
generally considered the least effective laser for long-term hair reduction.
Long Pulse Nd:YAG: Unlike the Q-Switched Nd:YAG laser, long-pulse Nd:YAG
lasers generate pulse widths that closely match the thermal relaxation time
of hair follicles. Clinical investigations have demonstrated little if any
skin reaction, even in dark skinned patients, and excellent prolonged
depilation. The Lyra Laser system uses a cooling sapphire lens and scanner
for rapid treatment of large body areas, and has recently been approved by
the FDA for permanent hair reduction. The CoolGlide uses a large single spot
and cooled handpiece. The Athos and Depilase systems have just been
introduced to the US market: FDA approval for hair removal is pending.
Intensed Pulsed Light: Intense Pulsed Light (IPL) devices such as the
Epi-Lite use xenon flashlamps to generate multiwavelength noncoherent light
for hair removal and other applications. By using cut-off filters, only
longer wavelengths in the range of 600-1200nm are passed through the
handpiece, and pulsed singly or in pulse trains with variable delay between
pulses. The parameters are software-controlled after entering the patient's
skin type and hair characteristics. A chilled handpiece cools the skin and a
transparent gel provides optical coupling as well as additional cooling.
Because these are not true laser devices, individuals other than physicians
may legally operate these devices.
Photodynamic Therapy: In photodynamic therapy a photosensitizing compound is
applied topically to hair-bearing skin after waxing, to allow the compound
to enter the now-empty hair follicle. The area is then irradiated with laser
light to activate the photosensitizer, which releases toxic oxygen radicals
that damage the hair follicles. Currently in the investigational stage,
preliminary studies have demonstrated up to 40% hair loss at 6 months after
a single treatment. Photodynamic therapy has been used with limited success
for certain malignant tumors, but the lack of safe, effective, selective
photosensitizers have limited its use. |
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[ Laser
Hair Removal Procedure ]
[ Laser
Equipment and Accessory Packages ] |
 'LASER BEAMED'
Imagine
a hair-removal treatment that doesn't involve regular battles with razors,
hot wax, or lotions that smell like a chemical plant. Laser hair removal may
sound like something out of star wars but, believe me, its the greatest
beauty breakthrough since the invention of the blow-dryer.
I was initially skeptical
when I set off to investigate this futuristic sounding miracle.
Anyone who passed O level
physics will be pleased to hear that the laser works with low energy. Those
who failed the exam should content themselves with the knowledge that it's
gentler than other laser treatments and suitable for all skin colors.
How does laser hair removal work?
Lasers have been used for many years for a
variety of medical cosmetic procedures including treatment of facial and leg
veins, age spots and smoothing fine lines on the face. The laser energy is
transformed into heat, which can disable the follicle leaving the
surrounding skin unchanged.
Why is laser preferred for hair removal?
Traditional hair removal techniques, such as
shaving, plucking and waxing, provide only temporary relief. Until now, the
only long-lasting hair removal solution has been by electrolysis - which can
be time-consuming and is usually limited to small areas, because each hair
is treated individually. Laser hair removal is non-invasive, and safely
removes unwanted body hair without damaging the delicate pores and
structures of the skin. Facial and bikini areas are usually completed in
under 45 minutes; legs and larger areas can take longer.
 What
does the treatment include?
Depending on the amount of hair and area
treated, the procedure varies from patient to patient. Generally, the
treatment will include: Safety eyewear to protect the patient's eyes
during the procedure from the laser light. A small handpiece will be used to
deliver the laser light. Most experience little discomfort at the treatment
site. The sensation and the degree of discomfort varies with each person. In
some cases, topical anesthesia is an option. Your laser specialist will
discuss this before laser treatment. Depending on the size or number of
areas treated, the time will vary in length from minutes to hours. Patients
can return to work or resume their normal activities immediately following
treatment. The area may become slightly red and may last from a few minutes
to several days depending on the area and skin sensitivity.
What precautions should be taken before and after treatment?
If you are tan or have a darker skin
type, a bleaching cream should be started 4-6 weeks before treatment for our
melanin absorption lasers.
How many treatments will I need?
Hair grows in cycles. The laser is only
effective on hair in its actively growing cycle. At any one time there will
only be certain hairs in that growing phase. This means that consistent
treatments at appropriate intervals are absolutely necessary for the best
possible results. The number of treatments required depends upon your skin,
hair coloring, coarseness of the hair and density per treated area. Everyone
will require at least 2-3 treatments as the process is only effective on
hairs during their growing cycle. Additional treatment will be necessary to
treat other follicles when they re-enter the growth phase and produce new
growth.
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Power,
Wavelength and Tissue Penetration
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 The
most efficient wavelength required to achieve results by laser is in
the 670 to 890 nm (nanometer) range. This particular frequency allows for the
greatest tissue penetration without loss of photon intensity through the
dermis(2). This range is also highly selective (as well as reactive)
with follicle melanin
and carbon dye.
The amount of
power required for this range to reach the papilla
matrix varies with the
depth of the follicle pore. There are generally 3 types of hair growth:
terminal (deep), secondary (medium) and vellus (shallow). Terminal hairs
usually extend 7-8 mm into the dermis and require around 10 Joules per CM2 of
photon intensity at the surface of the skin to create adequate thermolysis in
the papilla matrix to destroy the tissue(3). Secondary hairs grow to
about 5-6 mm in depth and require ≈5 JCM2. The lightest hairs need
roughly 2 JCM2. These vellus hairs are most common on upper lips of adult women
and normally respond very well laser epilation.
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Faster Than Regular Electrolysis
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The
advent of this new technology has created enormous excitement in the field of
epilation cosmetology, and with good reason. Laser hair removal is simply the fastest
way to remove unwanted hair currently available. It is very easy and highly
effective. The laser can completely clear the leg hair growth on an average
woman in under one hour. The same area would require more than 40 hours
of needle electrolysis.
Discussion
In this study the laser treatments given
every six weeks yielded better long-term clinical results than the treatments
given every two weeks. Previous studies [1-5] have demonstrated good to
excellent results for treatment intervals between four and eight weeks. An
earlier study done by the investigators [6] demonstrated excellent long-term
hair reduction using three-week treatment intervals. Mathematical modeling
showed that better laser penetration was achievable at the hair bulb and bulge
in the absence of terminal hair shafts extending to the skin surface. It was
recognized that the success of a hair removal treatment at a shortened treatment
interval was dependent on the regeneration of melanized target structures for
the follow-up treatments [6]
The poor long-term results seen with the
shortened treatment interval would suggest that the laser treatment given only
two weeks following the initial treatment did not yet have an adequate target to
absorb the laser's energy. It is hypothesized that the hair bulb has not yet
regenerated at two weeks and hence the laser treatment was ineffective. The
six-week interval allowed adequate time for the hair bulb and follicle to
regenerate therefore providing an adequate target for the laser and hence, a
more effective long-term result.
Conclusions
The treatment intervals chosen for laser hair removal strongly affect
the efficacy of long-term results. This study demonstrates better efficacy at
the six-week treatment interval compared with the two-week treatment interval.
References
1. Bjerring P, Cramers M, Egekvist H, Christiansen K, Troilius A. Hair
reduction using a new intense pulsed light irradiator and a normal mode ruby
laser. J Cutan Laser Ther 2000; 2: 63-71.
2. Kauvar AN. Treatment of pseudofolliculitis with a pulsed infrared laser. Arch
Dermatol 2000; 136:1343-6.
3. Eremia S, Li C, Newman N. Laser hair removal with alexandrite versus diode
laser using four treatment sessions: 1-year results. Dermatol Surg 2001; 27:
925-9.
4. Gorgu M, Aslan G, Akoz T, Erdogan B. Comparison of alexandrite laser and
electrolysis for hair removal. Dermatol Surg 2000; 26:37-41.
5. Bencini PL, Luci A, Galimberti M, Ferranti G. Long-term epilation with
long-pulsed neodimium:YAG laser. Dermatol Surg 1999; 25:175-8.
6. Lloyd JR, Mirkov M. Long-term evaluation of the long-pulsed alexandrite laser
for the removal of bikini hair at shortened treatment intervals. Dermatol Surg
2000; 26:633-7
The anatomic structure in
the hair follicle that needs to be targeted for effective laser hair removal
is uncertain. The principal
regenerative structures were long believed to be in the deeper part of the
hair bulb, but recently, it's been proposed that stem cells in the bulge are
most important for regeneration of the hair follicle. Both the bulb and the
bulge contain melanin-producing cells and both structures are targeted during
laser hair removal. Shorter wavelength laser light may not penetrate deep
enough to damage the bulb structures in anagen hairs directly, although the
bulge area remains more superficial and therefore more accessible throughout
the hair cycle. It's possible that longer wavelengths may be more effective
in areas with deeper follicles. Hairs in early anagen are thought to be most
vulnerable to laser treatment because of their small size and superficial
location, and this may affect the number and timing of treatments.
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Body Site
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% Anagen (growing) hairs
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%Telogen (resting) hairs
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Duration of Telogen
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Follicle Density
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Depth of
Follicle |
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Scalp
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85%
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15%
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3 months
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350/sq.cm
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5-7 mm
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Beard
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70%
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30%
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10 weeks
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500/sq.cm.
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2-4 mm
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Upper Lip
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65%
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35%
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6 weeks
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500/sq.cm.
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1-2.5 mm
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Axilla (armpit)
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30%
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70%
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3 months
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65/sq.cm.
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4-5mm
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Chest/Back
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30%
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70%
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3 months
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70/sq.cm.
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2-5mm
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Breasts
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30%
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70%
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4 months
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70/sq.cm.
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2-4mm
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Arms
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20%
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80%
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5 months
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80/sq.cm
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2-4 mm
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Legs
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20%
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80%
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6 months
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60/sq.cm.
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2-4.5 mm
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Bikini/Pubic
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30%
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70%
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3 months
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70/sq.cm.
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4-5 mm
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Following laser treatment, 3
distinct responses have been observed clinically and on post treatment biopsy
specimens:
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Non-lethal injury to
the bulb induces catagen and telogen, inducing a prolonged dormancy.
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Some degree of injury
to the bulge induces a long term or permanent regression to a vellus hair
("miniaturization").
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Sufficient energy is
delivered to completely and selectively destroy the follicle.
An intriguing possibility is
inducing dormancy with sublethal doses of laser light to deliberately
"synchronize" all the follicles in a given area, then treating with larger
fluences in early anagen (when the follicles may be more vulnerable) to
destroy them once and for all.
Physical Considerations:
Shorter wavelengths are better absorbed by melanin, but do not penetrate
deeply into skin; in addition, melanin in epidermis acts as an optical
barrier to shorter wavelengths, "robbing" energy from the beam and causing
more redness and superficial blistering. In practice, shorter wavelength
lasers are most effective in patients with darker hair and lighter skin.
Conversely, longer
wavelengths penetrate more deeply, and are not strongly absorbed by epidermal
melanin, causing little skin reaction, but higher fluences must be used to
deliver sufficient energy to damage the hair follicles. In practice, longer
wavelength lasers are safer for patients with darker skin, but in any case
more energy can be delivered to the hair follicles if there is more melanin
in the hair and less in the skin.
In general, a larger spot
size allows more rapid coverage of a given area, and decreases incidental
scattering of photons. For a given device, there is trade-off, with less
power available as spot size increases. Many devices use a scanner, which can
rapidly target individual pulses in a give area, to decrease operator fatigue
and expedite rapid treatment of large areas.
Epidermal Cooling: All of
these laser devices use, or recommend the use of epidermal cooling to protect
the skin from heating and decrease discomfort during treatment. Heating can
take place both from absorption of laser energy by melanin as well as
backscattering in the upper skin layers. Cooling methods include application
of aqueous gel, active cooling with "chiller" tips, and cryogen spray
cooling. Pre-chilling the skin with ice or cold packs may be used with all of
these methods.
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Patient # |
hair counts |
6 week
clearance |
| 2
females, 3 males |
pre |
post |
percent |
| 1 |
274 |
9 |
97% |
| 2 |
331 |
63 |
81% |
| 3 |
327 |
19 |
94% |
| 4 |
187 |
2 |
99% |
| 5 |
411 |
54 |
87% |
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median |
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91.6% |
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For your convenience.
Confidence
