This document provides information on permanent laser hair reduction using an Nd:YAG laser system. It discusses the hair growth cycle and how lasers work to damage hair follicles. The ideal laser system is described as providing safe and effective treatment for all skin and hair types. Treatment protocols are outlined for different skin types, including recommended fluence and pulse duration settings. Expected results showing long-term hair reduction are presented. Risks are discussed and post-treatment care is described. In summary, this document serves as a guide for clinicians on best practices for laser hair removal.
Laser Hair Removal
Also known as light based hair removal and laser hair reduction
Laser hair removal is a convenient, noninvasive method for permanently reducing or removing unwanted facial or body hair. It leaves the skin looking smoother and silkier than waxing, electrolysis or razors and is a gentle technique that can treat larger areas effectively with minimal discomfort and with no downtime. Today, laser hair removal is one of the most common aesthetic procedures performed in the United States.
If aging, acne, or too much time in the sun has left your face with blotches, scars, wrinkles, or lines, laser skin resurfacing may help your skin look younger and healthier.
Laser skin resurfacing removes skin layer by layer with precision. The new skin cells that form during healing give the skin a tighter, younger looking surface.
Dr Sachdeva's Dental and Facial aesthetic center is one of the leading clinics in Delhi. So hurry up and come book an appointment with us Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Humanity’s fascination with body art has been with us for millennia. Although most patients are pleased with the appearance of their tattoos, patient surveys have shown that these decorative markings are sometimes obtained impulsively, before the age of 18 or while under the influence of alcohol or recreational drugs. It is therefore not surprising that many will eventually come to regret their decision. These patients may report feelings of embarrassment, low self-esteem, and stigmatization associated with their tattoos, and many will seek removal.
QS laser treatment may effectively remove various kinds of unwanted tattoos. The laser surgeon must be educated in the nuances of laser tattoo removal to ensure safe and effective treatment. Tattoo removal was revolutionized with the invention of the laser, and the continued refinement of this technology has led to better and more-predictable outcomes, but further research is needed regarding the safety of tattoo pigments and the breakdown products formed with exposure to laser lightازالة الوشم والمكياج الدائم باليزر
Micro Needling is a minimally invasive procedure that has little downtime, is safe on all skin types and will leave skin looking smoother and younger.
Micro Needling stimulates the bodies natural healing and will rejuvenate the skin and can reduce:
Lines & Wrinkles
Sun Damage
Skin Laxity
Acne Scars
Stretch Marks
Hair Loss and more
www.MDNeedlePen.com
Laser Hair Removal
Also known as light based hair removal and laser hair reduction
Laser hair removal is a convenient, noninvasive method for permanently reducing or removing unwanted facial or body hair. It leaves the skin looking smoother and silkier than waxing, electrolysis or razors and is a gentle technique that can treat larger areas effectively with minimal discomfort and with no downtime. Today, laser hair removal is one of the most common aesthetic procedures performed in the United States.
If aging, acne, or too much time in the sun has left your face with blotches, scars, wrinkles, or lines, laser skin resurfacing may help your skin look younger and healthier.
Laser skin resurfacing removes skin layer by layer with precision. The new skin cells that form during healing give the skin a tighter, younger looking surface.
Dr Sachdeva's Dental and Facial aesthetic center is one of the leading clinics in Delhi. So hurry up and come book an appointment with us Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Humanity’s fascination with body art has been with us for millennia. Although most patients are pleased with the appearance of their tattoos, patient surveys have shown that these decorative markings are sometimes obtained impulsively, before the age of 18 or while under the influence of alcohol or recreational drugs. It is therefore not surprising that many will eventually come to regret their decision. These patients may report feelings of embarrassment, low self-esteem, and stigmatization associated with their tattoos, and many will seek removal.
QS laser treatment may effectively remove various kinds of unwanted tattoos. The laser surgeon must be educated in the nuances of laser tattoo removal to ensure safe and effective treatment. Tattoo removal was revolutionized with the invention of the laser, and the continued refinement of this technology has led to better and more-predictable outcomes, but further research is needed regarding the safety of tattoo pigments and the breakdown products formed with exposure to laser lightازالة الوشم والمكياج الدائم باليزر
Micro Needling is a minimally invasive procedure that has little downtime, is safe on all skin types and will leave skin looking smoother and younger.
Micro Needling stimulates the bodies natural healing and will rejuvenate the skin and can reduce:
Lines & Wrinkles
Sun Damage
Skin Laxity
Acne Scars
Stretch Marks
Hair Loss and more
www.MDNeedlePen.com
Microneedling, A brief review by Dr. Mohammad Baghaei Mohammad Baghaei
Microneedling is a physical method that induces modification in the SC mechanically and produces micron-sized channels or pores in the skin. This characteristic of the microneedling technique provides delivery of various molecules or therapeutic substances, including proteins, which would usually not penetrate ...
Dr. Patrick Treacy lectures on behalf of Lumenis on IPL . Intense pulsed light, commonly abbreviated as IPL, is a technology used by beauty studios and medical practitioners to perform various skin treatments including hair removal and photorejuvenation. The technology utilises a broad spectrum lightsource, with a general spectral range of 515 to 1200 nm. Various cutoff filters are commonly used to filter out lower frequencies and narrow this spectrum to target specific structures and chromophores. Because of the broad spectrum of the IPL light source they are unique, as opposed to lasers, in the ability to filter the light spectrum to target various chromophores in the skin
If you're not happy with shaving, tweezing, or waxing to remove unwanted hair and want to remove it permanently,Laser hair Removal is best . Laser Hair Removal gives to hair removing without pain and discomfort.
Hyperpigmentation on the face slide sharevanita rattan
Hyperpigmentation on the face. How to recognise the distribution of hyperpigmentation on the face and how to treat it. The classic causes of Hyperpigmentation.
The Hydrafacial is non-invasive, non-irritating skin resurfacing technology.
It is the only procedure that integrates cleansing, exfoliation, extraction & hydration simultaneously.
The Hydrafacial targets dehydration, skin texture, oiliness, congestion, comedones, fine lines and hyperpigmentation.
Lasers have been used successfully to treat a variety of vascular lesions including superficial vascular malformations (port-wine stains), facial telangiectases, haemangiomas, pyogenic granulomas, Kaposi sarcoma and poikiloderma of Civatte. Lasers that have been used to treat these conditions include argon, APTD, KTP, krypton, copper vapour, copper bromide, pulsed dye lasers and Nd:YAG. Argon (CW) causes a high degree of non-specific thermal injury and scarring and is now largely replaced by yellow-light quasi-CW and pulsed laser therapies.
The pulsed dye laser is considered the laser of choice for most vascular lesions because of its superior clinical efficacy and low-risk profile. It has a large spot size (5 to 10mm) allowing large lesions to be treated quickly. Side effects include postoperative bruising (purpura) that may last 1-2 weeks and transient pigmentary changes. Crusting, textural changes and scarring are rarely seen.
Diode laser hair removal machine with 12.20mm2 big spot,10hztony tang
Diode laser hair removal system with 12.20mm2 big spot,10hz,Diode Laser hair removal machine with Germany Laser Bars,more information,please visit www.cryolipolysis-slimming-machine.com
Microneedling, A brief review by Dr. Mohammad Baghaei Mohammad Baghaei
Microneedling is a physical method that induces modification in the SC mechanically and produces micron-sized channels or pores in the skin. This characteristic of the microneedling technique provides delivery of various molecules or therapeutic substances, including proteins, which would usually not penetrate ...
Dr. Patrick Treacy lectures on behalf of Lumenis on IPL . Intense pulsed light, commonly abbreviated as IPL, is a technology used by beauty studios and medical practitioners to perform various skin treatments including hair removal and photorejuvenation. The technology utilises a broad spectrum lightsource, with a general spectral range of 515 to 1200 nm. Various cutoff filters are commonly used to filter out lower frequencies and narrow this spectrum to target specific structures and chromophores. Because of the broad spectrum of the IPL light source they are unique, as opposed to lasers, in the ability to filter the light spectrum to target various chromophores in the skin
If you're not happy with shaving, tweezing, or waxing to remove unwanted hair and want to remove it permanently,Laser hair Removal is best . Laser Hair Removal gives to hair removing without pain and discomfort.
Hyperpigmentation on the face slide sharevanita rattan
Hyperpigmentation on the face. How to recognise the distribution of hyperpigmentation on the face and how to treat it. The classic causes of Hyperpigmentation.
The Hydrafacial is non-invasive, non-irritating skin resurfacing technology.
It is the only procedure that integrates cleansing, exfoliation, extraction & hydration simultaneously.
The Hydrafacial targets dehydration, skin texture, oiliness, congestion, comedones, fine lines and hyperpigmentation.
Lasers have been used successfully to treat a variety of vascular lesions including superficial vascular malformations (port-wine stains), facial telangiectases, haemangiomas, pyogenic granulomas, Kaposi sarcoma and poikiloderma of Civatte. Lasers that have been used to treat these conditions include argon, APTD, KTP, krypton, copper vapour, copper bromide, pulsed dye lasers and Nd:YAG. Argon (CW) causes a high degree of non-specific thermal injury and scarring and is now largely replaced by yellow-light quasi-CW and pulsed laser therapies.
The pulsed dye laser is considered the laser of choice for most vascular lesions because of its superior clinical efficacy and low-risk profile. It has a large spot size (5 to 10mm) allowing large lesions to be treated quickly. Side effects include postoperative bruising (purpura) that may last 1-2 weeks and transient pigmentary changes. Crusting, textural changes and scarring are rarely seen.
Diode laser hair removal machine with 12.20mm2 big spot,10hztony tang
Diode laser hair removal system with 12.20mm2 big spot,10hz,Diode Laser hair removal machine with Germany Laser Bars,more information,please visit www.cryolipolysis-slimming-machine.com
Key Parameters for Successful Laser Hair Removal
Excell HR Technical Properties
High Power 755nm Alexandrite
Long Pulse 1064nm ND Yag
Clinical Applications and results
My Laser Journey
My Personal Experiences with Lasers
A short history of my experience with Excell HR laser and Its advantages
Reasons for laser hair removal
Devices available for laser hair removal
Laser parameters
Indications and contraindications for laser hair removal
Advantages and disadvantages of laser hair removal
Pre procedure work up
Details of procedure
After care
New technologies
Complications
Diode laser hair removal technology is based on the selective dynamics of light and heat.The laser goes through the skin surface to reach the root of hair follicle;light can be absorbed and converted into heat damaged hair follicle tissue, so that hair loss regeneration without injury surrounding tissue. It provides less pain, easy operation, the safest, technology for permanent hair removal now
Laser Resurfacing, Dermabrasion, Chemical Peel In The Asian Ethnic ClientelePhilip Young
Laser Resurfacing, Dermabrasion, Chemical Peel in the East Asian Clientele
Philip A Young, MD Aesthetic Facial Plastic Surgery, PLLC
Face to Face
Ho Chi Minh City, Vietnam 2014
http://www.drphilipyoung.com/procedures/laser-resurfacing/
Get best Hair Transplant Surgeon in Kolkata.
Dr. Saha wants to impart his cosmetic surgery knowledge to every corner of the country and makes it accessible to as many people as possible. Visitors of this site who are looking for advice, free consultation, help or want to mitigate their quench about cosmetic surgical procedures are requested to feel free to ask any question by mail or over the phone.
If you're not happy with shaving, tweezing, or waxing to remove unwanted hair, laser hair removal may be an option worth considering.
It beams highly concentrated light into hair follicles. Pigment in the follicles absorb the light. That destroys the hair.
Dr Sachdeva’s Dental ,Aesthetic And Implant Institute is one of the leading clinics in Delhi offering laser hair removal . So hurry up and book an appointment with us Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
3. Permanent Hair Reduction
3
Hair growth has three phases
Anagen (active)
Catagen (regression)
Telogen (resting)
Growth cycle
depends on the body part,
lasts anywhere from 4 to 12 months.
Hair reduction is considered permanent when a
significant amount of hair does not return for longer than
the complete growth cycle
4. 4
Specific Targets
Lasers generate heat in
the hair shaft, which
diffuses to the stem cell
and matrix targets to
cause desired damage
5. Damage to the Hair Shaft
5
A normal follicle Immediately after treatment
6. Depth of Penetration
6
Longer wavelengths allow laser light to penetrate
more deeply for more effective heating of the hair
shaft (typical depths are 2-6 mm)
7. How Does It Work?
7
Based on the theory of Selective
Photothermolysis:
The target chromophore is melanin
Present in the hair shaft
Also present in the upper third of the follicular
epithelium
Heat generated in the hair shaft diffuses to the
follicular epithelium to cause the damage that is
desired
8. Ideal Laser System
8
Provides Permanent Hair Reduction
Safe and effective on all skin types
Effective on a broad range of hair colors
Effective on a broad range of hair diameters
9. Ideal Laser System
9
Must combine the following parameters:
Appropriate wavelength absorption by melanin
Strong enough to allow treatment of finer and lighter hairs
Moderate enough to protect epidermis even on dark skin types
Penetration to target
Appropriate pulse widths
Short pulses for treatment of finer hairs
Long pulses for safety in darker skin types
Effective spot size and fluences
Aggressive Cooling
Compression
10. Appropriate Wavelength
10
Ideal wavelength in range 750-1200 nm
Ruby (694 nm) too well absorbed by melanin to treat
darker skin patients
Nd:YAG (1064 nm) requires 3-4 times the fluence for
similar effect
11. 11
Pulse Width Considerations
If parallel cooling is used, the longer the
pulse, the lower the epidermal temperature
rise at a particular fluence setting
There is not a pulse width that is “too long” as
far as the epidermis is concerned
Thus longer pulse widths are great for dark
skin
12. Pulse Width Considerations
12
If the pulsewidth is much longer than the
Thermal Relaxation Time (TRT) of the hair
follicle, the hair follicle will not get hot
enough to be destroyed
The TRT depends on how thick the hair is
Finer hair requires shorter pulse
Coarse hair can be treated with longer pulse
13. Fluence (J/cm2)
13
Studies have shown a fluence dependent
response with hair removal results
The higher the fluence the better the response
Risk of side-effects increases with increased
fluence
Select maximum tolerated fluence for best
efficacy
14. Cooling
14
Must protect the epidermal melanin while
treating at clinically effective fluences
Treatments with an effective cooling design
can allow 3-4 times greater fluence without
epidermal damage
15. Compression
15
Reduces competing chromophore, oxyhemoglobin
Blanches vessels and eliminates energy lost into this
target
Rotates follicle closer to surface, so laser light
penetrates deeper into the hair shaft
17. Fitzpatrick Skin Types
17
I Always burns, never tans
II Always burns, sometimes tans
III Sometimes burns, always tans
IV Rarely burns, always tans
V Moderately pigmented
VI Black skin
18. Patient Skin Types
18
It is critical to understand the skin type of the
patient to provide the best results
Look for the presence of tan
Tan skin does not respond the same way as natural
dark skin
Tan skin should be treated with the 100 ms option
19. Patient Skin Types
19
Nd- YAG is cleared to treat all skin types
(Fitzpatrick I-VI).
It can treat tanned skin, but avoid treating
patients with a recent severe or lengthy
exposure.
20. Patient Hair Types
20
• Terminal hair, not vellous hair
• Pigmented hair
– Black, brown, red, dark blonde can achieve
a long lasting result.
– Light blonde or white can experience
temporary loss for up to 3 months.
– Recommend electrolysis as a treatment for
permanent removal of discrete white hair
21. Number of Treatments
21
Temporary hair removal achieved in a single
treatment
Amount of long-term hair reduction varies
between patients
Higher fluence results in increased long-term
hair reduction
Typically 3-5 treatment are required for
nearly complete long-term hair loss
Darker skin may require more treatments
22. Treatment Intervals
22
• Wait for regrowth (harder to schedule)
• 1 month/2 months (dependent on body
location - face will be shorter time between
treatments than body)
• Take hair growth cycles into consideration…
23. How often are treatments?
23
1 treatment every 6-10 weeks depending on
body part.
Location Telogen
Months
Anagen
Months
Total
Months
Back 3-6 3-6 6-12
Thigh 3-6 3-6 6-12
Arm 3-5 1-2 4-7
Calf 3-4 4-5 7-9
Axilla 2-3 3-4 5-7
Upper Lip 1-2 3-4 4-6
Bikini 3-4 2-3 5-7
24. Setting Expectations
24
No two patients are alike, treatment outcome cannot
always be predicted: Never give promise of 100%
reduction
Clearly define permanent hair reduction
Describe need for multiple treatments:
3-5 treatments generally required
For darker skin types IV-VI, 6-10 sometimes required, since
lower fluences are used
Provide expectations in writing (e.g. patient consent)
that patients can sign, retain copy
25. Potential Patient Risks
25
Scarring: has not been reported in clinical
studies
Hypo- or Hyperpigmentation rare and transient;
usually clears in 2- 6 months; fluence and skin
type dependent
Perifollicular erythema /edema - common,
resolves in hours/days
Local blisters - high fluence/dark skin
26. Patient Contraindications
26
History of keloidal scarring
Active infections: herpetic lesions, cold sores (place on
anti-viral medication pre-tx)
Tattoos, permanent make-up, pigmented lesions (can
treat around them)
Use of photosensitizing medications such as Accutane
(isotrenoin), tetracycline
Electrolysis, waxing or plucking in last 6 weeks (target
has been removed)
Pregnancy
27. ParaFmlueetenrc eSe: leTchteio hnighest tolerable fluence will provide the
27
greatest efficacy
Pulse width: If the hair shaft is not relatively large and the
skin is not relatively dark, then the Auto Mode will provide
the highest efficacy; Optimal pulse width may change after 1
or more treatments
Optimizing fluence and pulse width safely is our goal
28. Recommended Settings - Lighter Skin Types
Skin
Type
28
Starting Fluence
(Test Spots)
Tolerated
Fluences
Pulse Duration
I 32 J/cm2
Wait 15-30 min
Increment 2-5 J/cm2
15-60J/cm2 Auto
30 ms high hair
density
II 28 J/cm2
Wait 15-30 min
Increment 2-5 J/cm2
15-60J/cm2 Auto
30 ms high hair
density
III 24 J/cm2
Wait 15-30 min
Increment 2-5 J/cm2
15-45J/cm2 Auto – finer
30 ms – coarser or
high hair density
29. Recommended Settings Darker Skin Types
29
Skin
Type
Starting Fluence
(Test Spots)
Tolerated
Fluences
Pulse Duration
IV 16-20 J/cm2
Wait 15-30 min
Increment 2-3 J/cm2
10-40J/cm2
20-70J/cm2
30 ms finer hair
100 ms coarser hair or
higher density
400 ms coarse hairs
V 12-16 J/cm2
Wait 48-72 hours
Increment 2-3 J/cm2
10-35J/cm2
20-60J/cm2
100 ms
400ms coarse hair or hair
not responding to lower
fluence
VI 8-12 J/cm2
Wait 48-72 hours
Increment 1-2 J/cm2
10-30J/cm2
20-40J/cm2
100 ms
400 ms
30. 30
Skin Type Starting Fluences (Test Spots)
Tolerated
Fluences
Pulse
Duration
All Skin
Types –
Tanned
Skin
Use low range of fluences
recommended for one skin type
darker than patient’s skin type
(e.g. treat tanned skin type III as
skin type IV).
Perform test spots on areas with
same degree of tan as area to be
treated.
n/a 100 ms
Recommended Settings Tanned Skin
31. Eye Safety
31
• 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
– Laser light focused by the lens of the eye onto
retina has a high fluence
• Proper eye protection MANDATORY for ALL people in
the room!
32. Pre-Treatment Steps
32
Take baseline photographs
Help patients remember density and diameter of
hair before treatment
Mark area to be treated
Never use black marker, red is best
Shave area, remove all cut hair, sanitize skin
Depilatory cream can be used, but may irritate
skin
Perform test spots
33. Local Anesthesia
33
Assess discomfort tolerance during test spots
Most often used for male backs, front necks
Other typical areas for low-threshold patients:
Upper lip, bikini lines
Frequently used local anesthesia:
Emla, Ela-max
Dental sensitivity:
Gauze, dental guards (especially with dental work)
34. Operator Techniques
34
Secure wrist strap!
Pick and place
Most effective in smaller areas
Slide and glide
Allows more rapid coverage on larger areas
Thin (< 1 mm) layer of gel enables friction-free movement
Pattern in gel enables tracking of treated areas
Keep the ChillTip flat on the skin surface and at a 90o
angle
Inspect and clean tip frequently during treatment!
35. Clinical End Points
35
Look for laser-tissue interaction, don’t just
depend on written parameters
End-points that indicate fluence and/or
pulsewidth must be changed:
Skin graying
Skin separation
End points listed on following slides are
normal and desirable
36. Positive Clinical End Points
36
Perifollicular erythema:
– Initial redness from ChillTip and pressure decreases
– Erythema around treated hair increases after a few
minutes
37. Positive Clinical End Points
37
Perifollicular edema
Swelling around the follicle (bumps) several
minutes after treatment
38. Positive Clinical End Points
38
Singed hair:
Hair from follicle ejected or vaporized
Can see singed hair on skin or on tip
Gel becomes brownish
Odor of singed hair present
39. Patient Results – Long Term
39
Before 46 months after last treatment
2 treatments at 30 J/cm2, 30 ms
2 treatments at 40 J/cm2, 30 ms
Chin, Female Skin Type IV
40. 40
Patient Results – Long Term
Before 24 months after last treatment
40 J/cm2
Treatments 1-3: 30 ms
Leg, Female Skin Type II
44. ND YAG Results
44
Female, Skin type II - Bikini
Pre 8 months after 3 Tx
45. IPL Results
45
Female, Skin type IV - Axila
Pre 4 months after 3 Tx
Courtesy C. Dierickx, M.D.
46. Patient Results
46
Before 4 months after last treatment
22-24 J/cm2
Treatments 1-3: 30 ms
Axilla, Female Skin Type V
47. Patient Results
47
Sacral Region, Female Skin Type V
Before 3 months after last treatment
22 J/cm2
Treatments 1-4: 30 ms
48. Post-Treatment
48
Sunburned sensation is common
Suggest cool compresses or soothing cream
of gel (e.g. aloe vera)
Describe crusty spots that may occur
Clean area 2x daily with mild soap
Sunscreen for 6 weeks over area
Describe singed hair and shedding process
49. Richards-Meharg Table (Hair Growth Cycle Duration)
49
AREA OF BODY ANAGEN TELOGEN
Scalp 2-6 Years 3-4 Months
Beard/Chin 1 Year 10 Weeks
Upper Lip 16 Weeks 6 Weeks
Eyebrows 4-8 Weeks 3 Months
Ear 4-8 Weeks 3 Months
Legs 24 Weeks 16 Weeks
Arms 18 Weeks 13 Weeks
Axilla 4 Months 3 Months
Pubic 3 Months 4 Months
50. 50
Pseudofolliculitis Barbae
Commonly referred to as “razor bumps”
Not a true “folliculitis”as name implies
Inflammatory foreign body response to a sharp
hair shaft
51. ND- YAG Treatment of PFB in skin types IV-VI
51
Mean % Reduction of Lesions from Baseline
79%
86%
Study by Fran E. Cook-Bolden, MD
Ethnic Skin Specialty Group
New York, NY, USA
0.86
0.84
0.82
0.8
0.78
0.76
0.74
Male Female
Female
Male
52. Potential Risks
52
Perifollicular edema/erythema
Favorable post-treatment response
Usually resolves w/in 24 hours
Local blisters - too high fluence, dark skin
Hyper/Hypopigmentation
Transient, should clear within 2-12 months,
Fluence and skin type dependent
Scarring – Extremely rare
53. The ND-YAG laser System
The first system FDA cleared for hair
removal that was designed for hair removal
from the ground up
The clinical trials influenced the design and
parameters chosen
54. ND-YAG Clearances
54
FDA cleared to advertise “Permanent Hair
Reduction”:
For all skin types (I-VI), including tanned skin
Long-term studies have proven the efficacy
Also FDA cleared for the treatment of leg veins,
benign pigmented lesions and pseudofolliculitis
barbae
56. diode Contradiction
56
The low absorption by melanin makes it potentially
safer in darker skin but it requires a thick, dark hair
to be effective
Therefore for thin and medium hair, and brown
hair, the diode has limited effectiveness
For lighter skin patients there is no advantage to
the 800 nm wavelength