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Hair Removal Laser

Electrology has been used for years for hair removal and currently still is the gold standard. During electrology an electric needle is inserted into each hair follicle in an attempt to destroy the hair bulb. Each individual hair has to be in the right growth phase for the treatment to be the most successful. It is moderately painful and takes multiple sessions to get permanent hair removal.

Lasers do not require each hair to be treated. The spot size of the laser varies from 8 to 18 mm and multiple pulses are delivered to cover an area such as the lip or chin. It uses no electricity and instead uses light to selectively heat the hair bulb or hair papillae and destroys it. It also uses a spray prior to laser to minimize pain and discomfort from the procedure, one of the drawbacks of electrology.

The GentleLASE is an Alexandrite laser made by Candela Laser Corporation. It relies on the latest technology to emit light at a wavelength of 755mm. It is powered by a flash lamp around a central crystal. The laser energy is delivered to the skin through a hand piece in in several sizes.

The dynamic cooling device is a technology purchased by the Candela Corporation to minimize the effects of heating on the epidermis and to minimize pain. It involves a spray of an inert gas or refrigerant to the skin that is timed to precede the laser pulse. It issafe and harmless and allows us to use higher energies to destroy hair bulbs without damaging the overlying skin.

It is impossible to give an exact number of treatments required since the anatomy and biology of the hair bulb differs in individual patients and in different anatomic areas. For example, on the scalp 80% of the hairs are in the growing mode and 20% are in a resting mode. Hairs can only be effectively treated when they are in the growing or anagen phase. On the eyebrow 80% of are in the resting phase and only 20% are in the growing phase. Likewise, chin, back, bikini line and axillae all have different ratios of hair in the growth and resting phase and the rate that these hairs turn over to complete the hair cycle differs. Furthermore, the depth of the hairs varies between anatomic areas. In certain areas, such as the back, the hairs are deeper.

When hairs are treated during the growth phase a good proportion can be permanently removed. However, further hairs will regrow. The hairs should be treated at the first sign of hair regrowth or at 2 month intervals. Eventually, after several treatments (depending on the patient and anatomic area) any hairs that regrow will either be so fine or so few that essentially further treatments will not be necessary. Therefore, the term permanent hair reduction is the goal of therapy and a patient can determine the endpoint in terms of when they are satisfied with their progress.

Most patients do not require anesthesia. This is because the dynamic cooling device provides adequate analgesia or pain relief. In areas that are extremely sensitive, such as the upper lip, topical anesthetics can be used. Finally, intralesional anesthesia usually is not required, but in a rare patient with extremely sensitive skin it could be used.

Multiple treatments with a variety of lasers have been used for hair removal. The risk of scarring is under 1% in all studies for far. The most common side effect of the GentleLASE will be temporary hypopigmentation or hyperpigmentation. This occurs mainly in the darker skin types, that is, patients who are dark skinned that rarely burn, but usually tan in the sun. Test sites may be done to determine the risk of pigmentation alterations before full treatments are done. The doctor will discuss this with you. Any residual hyperpigmentation can be treated with topical bleaches that reduce the amount of melanin formation. If these are required, the doctor will prescribe one for you. Sunblock that blocks out most of the ultraviolet spectrum will be required after the treatment. We recommend EltaMD Daily UV 40 for the face and EltaMD Sport UV 50 for the body. Finally, there is a small risk of infection if the skin blisters or gets too edematous or weepy. Topical antibiotics usually are used to prevent this from occurring. The doctor will recommend topical antibiotics after your case.

Obviously, the technology of the laser is more sophisticated than electrosurgical devices. Its purpose, maintenance, service contract and training of all personnel factor into higher cost per treatment. The cost of the treatment is determined by the size of the area and the amount of time that is required to administer the treatment. The treatments will be administered by a nurse, but a doctor will always be present in the office.

Most insurance providers will not cover hair removal either by electrology, laser or other devices. This is considered a cosmetic procedure and this office will not submit directly to any insurance plan for this treatment.

The GentleLASE Laser was designed to treat pigmented hair in light-skinned individuals. Those patients who have blond, red, gray or white hair may not respond to this laser.

The skin will become red and slightly edematous or swollen after the treatment. Usually, there is no weeping or blisters. The hair follicles will look more pronounced and will fade in the next 1 to 2 hours. A topical antibiotic or mild hydrocortisone may be the only therapy that is required following laser treatment. This may be used for the first 2 to 4 days. If sun exposure is necessary then sunblock is recommended.

Since the GentleLASE is targeting the hair bulb beneath the surface of the skin, topical bleaches, plucking or other hair removal methods may actually irritate the skin if used concurrently with the laser treatment. Please ask your doctor for recommendations.

In the first 1 to 2 weeks after the treatment the hairs will actually shed and appear to be growing. This is damaged hair shafts that are extruded through the skin and look like hair growth. This can be removed with simple washing or cleansing.

It usually takes 2 to 3 full treatments before significant hair reduction is noted.

The GentleLASE will be performed in our Danbury office.

It is our recommendation as well as that of the American Society for Laser Medicine that all lasers be operated by trained personnel and done in offices where they are specifically supervised directly by physicians. In our office, not only the physician, but certified nurses will perform this procedure.

You should avoid the sun 4 to 6 weeks before and 4 to 6 weeks after each treatment. You should avoid bleaching, plucking or waxing the hair for 4 weeks prior to treatment. It is important to shave or clip long hair 24 to 48 hours before the treatment. If you have a history of perioral herpes, prophylactic antiviral therapy will be started the day before your treatment and continued for a few days after treatment. If you are tan your treatment will be postponed.

The actual cost will depend upon the size, area and the amount of time needed to complete the treatment in this area. During your initial consultation, the exact quotation for all treatments will be given. These are considered cosmetic treatments and the payment will be required at the time of treatment. There will be no balance billing for this procedure. For payments, we accept all major credit cards, checks or cash for your convenience.

There has been no evidence that laser treatment with the 755 wavelength produces any untoward effects in patients who have been followed for 25 years post-laser therapy. This is simply a light delivering energy to a specific target – the hair bulb.

Eyes will be protected by laser specific eyewear which will be worn by the patient and all personnel in the operative suite to reduce any risk of damage to the retina with errant discharge of the laser. A light flash is still visible even with opaque eye protection. In addition, for treatment on the upper lip the teeth will be protected with saline-soaked gauze.

If you have any questions, please do not hesitate to call our office at (203) 792-4151 in Newtown.

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