Getting to know "LASER"

Hi guys,

          As I said in the "About the Writer" section on the right side, I will make this blog specifically discussing about laser hair removal, types of laser with their pros and cons, how it works, contraindications, your hair growth cycle, and the possible side effects that can be caused if the treatment goes wrong.

        Being around in the laser industry, I know this treatment is getting more popular as it is less painful than waxing. As it is more popular and in demand, many clinics are trying to offer laser hair removal treatment. However, some of them didn't realise the side effects that can be caused by this machine and sometimes some clinics just hire their employee that doesn't have a proper knowledge about how to use laser or even just giving them a brief "How to use this laser" lecture to their employee. Therefore as a Dermal clinician, I thought that I need to give you guys a good knowledge about laser hair treatment before you commencing into one. It can also open your mind, giving you confident, and of course, saving you from getting any unwanted end results. 

           

Okay, just let me get it straight into the business. I'm gonna do it as a Q&A to make it simple:

What is Laser ?

Most of you probably didn't know what Laser is actually, it is an abbreviation from Light Amplification by Stimulated Emission of Radiation. 

How does it works ?It is going to treat hairs using light, based on selective Photothermolysis concept (it is a concept on how the laser light will choose to be absorbed by the target melanin that lies in the hair follicles so that the skin will not get burn) to target the hair follicles and causing thermal damage (heat damage). The thermal damage will cause permanent damage to the hair follicle and resulted in delay of growth until it is incapable of producing any hair. So it needs several treatments until the hair won't grow back and it is depends on your hair because everyone is different.

Why we need several treatments to get it done ?

It is because we have 3 different hair stages (Anagen, Catagen, and Telogen).

The hair stage that should be targeted is the anagen stage (growing stage) as it undergoes mitotic activity (still growing and seperating) and contains huge amounts of growth cells and melanin (colour pigment of the hair). It specifically targets the melanin of the hair that is located in the root sheath of the hair follicles without damaging the surrounding tissues. Also our hair had the 3 stages at the same time. so we need to get several treatments to ensure that all of the anagen hair are treated until it won't produce any hair.

Is laser the same with IPL ?

NO, it is different. IPL is a device that using a high intensity pulsed light to help reducing unwanted hair, vascular and pigmented lesions, and photo-rejuvenation which emitting broad wavelength with polychromatic (have many colours) light (400-1200 nm). It used selective filters to determine the wavelength, pulse duration, and fluence by emitting polychromatic incoherent pulsed light.

Which one is more effective, IPL or Laser?

It is depends on your hair types and your skin colour as both machine have different wavelengths and pulse duration. 

Is the treatment gonna be painful?

No, you might feel like a rubber band flicking into your skin and you might experienced some heating and some redness in the area but pretty much nothing. As the machine had their cooling machine installed it will reduce the discomfort during the treatment.

Are there any potential damage that can be cause by the laser?

Hyperpigmenation

• Mostly burns, if the laser settings is not compatible with your skin colour and your hair type it can cause burns.
• Some post-hyper or hypo pigmentation.  
• Photosensitising medications such as retinoid and blood thining medication can be one of the cause. 
• Uveitis & iristis if the laser was accidentally directed to unprotected eyes. Bad laser technique can be fatal as it can accidentally shoot the laser into other direction therefore protective googles must be used during treatment, it can also caused burn into the area that not being treated.
• Blisters may present after the burn if it not treated carefully and leads to infections
• Paradoxical Hypertrichosis: it is rarely happens and only happens to people that have a hereditary in this condition as the laser can trigger the sudden hair growth as seen in Wolfman syndrome.
• Micro crusting  (the darkening of the skin) may also occur.
• Contact dermatitis and other skin infections can occur if the laser point is not properly cleaned.
• Leukotrichia: white patches that caused by high energy laser pulsed that kills the skin pigments and makes it white.

Are there any precautions and contraindications regarding to the treatment?

Contraindications:

• Epilepsy
• Lupus
• Cancer
• Pregnancy or planning to get pregnant as it can change the hormones and the hair might comeback after the treatment (waste of money and time), and it is also quite dangerous for the baby. So, if you want to have this treatment you can have it after you finished breast feeding your child.
• Keloid scarring
• Blood disorder
• Medications that induced photosensitivity eg. isotretinoin and minocycline, doxycycline. or any vitamins that contains vitamin A. The treatment may be considered if there is no usage 3 months post treatment and during the treatment.
• Vitiligo as it can worsen or trigger the formation in the other area of the body
• Pigmented naevi as it can progress into cancer
• Benign melanocytic lesions
• Pace maker
• Coronary and blood pressure conditions
• Hormonal condition
• Thyroid gland as it is sensitive to light
• Diabetes as it had reduced healing capacity and has sensory neuropathy (loss of ability to detect sensation)
• Grey hair, as it will not be effective but other treatment like electrolysis can be used
• Keloid and Hypertrophic scars it is an abnormal wound healing responses

Precautions:

• Allergy to the product used eg. aloe vera or coupling gel
• Sunburn
• Sun tanned skin
• Artificial tan
• Recent sunburn, tanned and artificial tan can misguided the laser light from being absorbed by the skin so it is best to remove artificial tan and wait for recent sun burnt to heal (approx. 2-4 weeks) before commencing the treatment.
• Gold therapy as it contains metal that can cause reaction with the light interaction
• Tattoos, be aware of having treatment in the area that have tattoos as it can absorb the light energy and caused skin burn.
• Oral contraceptives as it can changes the skin pigmentary so it is best to not using this 3 months before and during the treatment to get a better result
• Infections and injury in the area treated
• Open cuts on the area treated
• Clients with unrealistic expectations as there is a different between permanent hair reduction and complete hair removal, so there will not be a complete hair removal as laser can't treat grey and blonde hair but having an electrolysis after having laser can help treating the untreated hair from the laser treatment.

Is there anything to do before going for the treatment?

The reception may ask you to shave 1 day prior to treatment as we can accidentally give you some cuts if we have to shave you and avoiding open cuts. Not using artificial tan or just have a tan or sun burnt, not pregnant or planning to be pregnant (see contraindications). Not having allergies, not in certain medications, don’t have any metal implants on the body, not having any contraindications.

What is going to happens then?

You will be given a consultation session, a brief education about the laser and IPL, and then discussing the price, then you will be given a patch test just to make sure everything okay. But nowadays many clinics doesn’t give you patch test before commencing the treatment, so make sure you ask for one. Then you will discuss for the following treatment usually a week after.

What is a patch test?

Patch test is a test on a small area that can be a representative of the bigger area that wants to be treated that can be a parameter guide. It is important because it can reduce the risks of adverse reactions, and improves treatment efficacy.

What is the Post care after having a laser treatment?

The therapist may advise you to put on some cooling gel or aloe-vera to reduce the redness and the heat. There will be no sauna, no workout, no swimming for 24 after the treatment and always use sunblock on the treatment area.

What are the desired reactions after the treatment?

Some redness (Perifollicular Erythema), some chicken skin texture like (Peri follicular Oedema), warmth, and transient oedema (little bit swelling). But it will disappearing after 24 hours, so don’t worry about it as it signifies that the treatment is working.

Is there anything else regarding to the treatment?

Yes, just keep in mind to keep your eyes protected and closed during the treatment, don’t look directly to the laser, make sure the therapist clean the laser before the treatment and using gloves to prevent cross contamination and using disposable and hygienic tools.

So, basically this is just the basic things that you have to do before you commencing a laser treatment. Oh, and as a dermal therapist, please.. please.. please .. don't bring your child into the laser treatment room with you as it is dangerous, as the children may touching something during the treatment. So, as the representation of the dermal therapy out there. I beg you to not letting or insisting your child inside the laser room during the treatment.

I know it is already too much to be processed, lots of information, but I will post about the types or laser, how it really works, the pros and cons, and how to choose the perfect laser treatment for you. I will post it as fast as I can do, so make sure to follow my blog to keep update. Just to make it short, if you have a question regarding the laser or the laser treatment please feel free to comment below as I will get it back to you ASAP. Thank you for reading this post, may this post be able to give you some knowledge or maybe helping you to work on your laser essay. 

 Reference lists:

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Dereure, O. (2001). Drug induced skin pigmentation: epidemiology, diagnosis and treatment. American Journal of Clinical Dermatology, 2 (4), 253-262.

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        Goldberg, DJ 2008, Laser Hair Removal, 2nd Edition Informa healthcare, New York, USA.

Goldberg, DJ. (2007).Laser-and light-based hair removal: an update. Future Drugs Ltd, no.1743-4440, no. 10, pp. 253-260.

Harris, K., Ferguson, J., & Hills, S. (2012). A comparative study of hair removal at an NHS hospital: luminette intense pulsed light versus electrolysis. Journal of Dermatological Treatment, 25(2), 169-173.

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