Advanced Laser Education Content - Part 5 Lightsheer

This page contains treatments advanced education content about laser and treatments. 


Methods of hair removal

  • Shaving
  • Waxing/plucking
  • Depilatories and creams
  • Electrolysis
  • Laser hair removal

Eye Safety

  • Can cause severe retinal injury
  • No treatment within bony orbit of eye (outer canthus). Treatment of eyebrows not recommended.
  • Ocular Hazard Zone: 164 feet / 50 m
  • Use occlusive goggles when treating the face

Safety

  • Enclosed room, windows covered
  • Laser safety sign posted outside door
  • Laser in standby when not actively used
  • Key removed when not in use
  • Laser beam directed only at target or calibration port

How laser hair removal works

  • Laser energy is selectively absorbed by the melanin in the hair follicle & converted to heat, injuring the follicle.
  • Most hair is permanently removed. Hair that does regrow is finer and lighter than before.

Absorption spectrum of major

  • Pulse duration selected shorter than the thermal relaxation time (TRT) of target
    • Thermal confinement to target structure
    • Results in injury/damage to target structure
  • The larger the target, the longer the thermal relaxation time
    • Finer hair has shorter TRT
    • Coarser hair has longer TRT
  • Longer pulses allow heat to safely spread from the epidermis, especially important with darker skin types.
  • Select pulse duration appropriate for skin type and hair diameter.
    • Auto is fastest pulse duration: use on fair skin for shallow hair
    • 30ms Deeper, coarse, dense hair
    • 100-400ms very dark or sun exposed skin

Who is a candidate?

  • The LightSheer is safe and effective on all skin types and tanned skin
  • Works best on darker hair
    • Blonde, gray and white hair do not contain much melanin so any effects are short term
  • Can treat any area of the body
    • For safety avoid treating within ocular socket/orbit or on mucous membrane

Number of treatments

  • Three phases of normal hair growth:
    • Anagen (active)
    • Catagen (regression)
    • Telogen (resting)
  • Follicle most susceptible during anagen phase
  • Multiple treatments required
    • 4-7 treatments for lighter skin patients
    • 5-9 treatments for darker skin patients
  • Permanent reduction typically 50-90% following multiple treatments

Pre-treatment

  • No waxing, plucking or electrolysis for at least 6-8 weeks before treatment
  • Avoid active tanning in area to be treated for 4 weeks prior to treatment
  • No self-tanning products 2 weeks prior to treatment
  • Obtain photographs

Patient selection

  • Gray or blond hair not good candidate
  • Avoid treating if history of pronounced keloids
  • Avoid treating over tattoos or permanent make-up
  • History of HSV - pretreat with antiviral medication
  • Stop Accutane for at least 6 months
  • Caution if patient on photosensitizing medications
  • Caution if history of hyper- or hypopigmentation

Laser hair removal technique

Treatment is simple and straightforward

  • Set patient expectations
  • Obtain health history
  • Informed consent signed
  • Area clean and shaved prior to treatment
  • If desired, topical anesthetic cream applied 30-60 minutes before treatment
  • Caution if lidocaine allergy
  • Settings chosen based on skin type and hair density
  • Look for the presence of a tan
  • Test spotting required

Treatment parameter: What to select

  • Pulse Width (ms)
  • Auto: 1/2 fluence rate, 5 ms to 30 ms; provides the highest efficacy for fair skin, shallow/fine hair
  • 30ms: deeper, terminal / coarse hair
  • 100-400ms: darker skin types, tanned skin, dense hair

Before treatment: perform test spots

  • Prep skin
    • Recommend patient shave area to be treated day before procedure; clinician to verify prior to treatmen
    • Apply gel if desire
    • Avoid contact between laser tip and any areas of blood from shaving
  • Press enable butto
  • Position tip on patient’s skin, apply moderate pressur
  • Depress pulse trigger to begin treatment
  • Perform test spot
  • Wait and observe tissue response
  • “Pick and Place” Technique - Place on skin, pulse laser, release trigger, handpiece is then picked up from skin, moved to the next treatment area, and lowered against the skin
  • “Bounce & Glide” Technique - Place on skin, hold trigger in ON position, the tip is kept continuously in contact with the skin and bounced along skin tissue in cadence with the audible beep that signifies firing of laser. Do not remove laser tip from skin surface when using this technique

During treatment: safety guidelines

  • Check if ChillTip is activated - Physically touch the tip to check for cooling before treating patient
  • ChillTip must be cleaned often - Singed hair can collect on tip causing excessive heating. Can occur after several pulses or up to one full run, depending on the amount of hair extrusion. Visually check the tip for any debris every 50-100 pulses, without looking directly into tip. Clean more frequently in areas of high hair density. Warning after 1000 pulses only serves as a reminder

How to clean

  • Cleaning should be performed with gauze pads moistened with distilled water or a mild alcohol solution
  • Caution: While operating the LightSheer system, never look directly into the laser aperture at the distal end of the handpiece, even if you are wearing laser safety glasses. Serious eye injury or blindness could result.

Positive clinic endpoints

Perifollicular erythema and edema

  • Bumps around follicle several minutes after treatment
  • Less pronounced on darker skin types

Post treatment

  • Sunburn sensation is normal
  • If desired, cold compress, aloe or calming cream applied after treatment
  • Gently clean area twice daily
  • Avoid irritants for several days (glycolics, retinoids etc…)
  • Sunscreen for 6 weeks over the area
  • Describe singed hair and shedding process
  • Patient returns in 6-12 weeks for next treatment