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Ellman Sandstone Cheveux™ Permanent Hair Reduction 810 Diode Laser.

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Presentation on theme: "Ellman Sandstone Cheveux™ Permanent Hair Reduction 810 Diode Laser."— Presentation transcript:

1 Ellman Sandstone Cheveux™ Permanent Hair Reduction 810 Diode Laser

2 From Razor to Laser Methods of hair removal –Shaving –Waxing / plucking –Depilatories and creams (bleaches) –Electrolysis / electrothermolysis –Laser/light-based hair removal 2

3 Benefits of Laser Hair Removal Treats a large area quickly Low risk of side-effects Temporary hair reduction for all hair types Long-term growth delay Permanent hair reduction 3

4 Cheveux™ Diode Laser Absorption Spectrum of Major Chromophores in Skin

5 How Laser Hair Removal Works Laser energy is selectively absorbed by the melanin in the hair follicle and converted to heat, injuring the follicle. Most hair is permanently removed. Hair that does regrow is finer and lighter than before. 5

6 Appropriate Pulse Durations Pulse duration: key in destroying the follicle without excessive damage to the epidermis –With a pulse duration and energy chosen properly for a particular skin type, the follicle can be destroyed with minimal heat damage to the epidermis (selective photothermolysis). The larger the target, the longer the thermal relaxation time (defined as the time required for an object to cool to 50% of the temperature achieved immediately following laser exposure). –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 (e.g. 100ms, 400ms). 6

7 Who is a Candidate? The Cheveux™ is safe and effective on all skin types and tanned skin Works best on darker hair –Red or light brown hair may take more treatments to be effective –Blonde, gray and white hair do not contain melanin so treatments are not recommended Can treat any area of the body –For safety avoid treating within ocular socket/orbit or on mucous membrane 7

8 Number of Treatments Three phases of normal hair growth: –Anagen (active) –Catagen (regression) –Telogen (resting) Follicle most susceptible during anagen phase 1/3 to 2/3 of hair is in Anagen phase at any time Hair has most melanin in the bulb during Anagen phase and absorbs the most energy to disable stem cells Multiple treatments required 4 to 6 weeks apart –3-6 treatments for lighter skin patients –4-8 treatments for darker skin patients –During initial treatment, only 1/3-2/3 hair will be effected Permanent reduction typically 50-90% following multiple treatments 8

9 Pre-Treatment Pt. cannot wax, pluck or undergo electrolysis for 6 weeks beforehand –Can shave or trim 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 9

10 Pre-Treatment Patient selection –Gray or blond hair not good candidates –Avoid treating if history of pronounced keloids –Avoid treating over tattoos or permanent make-up –History of herpes simplex virus (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 10

11 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 11

12 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 12

13 Safety Footswitch clean and out of way when not in use Do not treat over paper or cloth Do not store flammables in the room Available fire extinguisher Follow ANSI standards for Class IV laser –Contact Laser Institute of America (LIA) (800) 34LASER for current ANSI and OSHA standards 13

14 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 recommended 14

15 Fitzpatrick Skin Type Classification Scale

16 Suggested Treatment Parameters 16

17 Suggested Treatment Parameters 17

18 Suggested Treatment Parameters 18

19 Suggested Treatment Parameters 19

20 Operator Technique 20 Secure wrist strap! Apply water-based gel on area to be treated (this may be kept refrigerated) Apply gel in no bigger than 12 inch square area as it tends to dry out Spot size is 9mmX9mm – laser spreads under skin Overlap 10% Larger spot sizes – deeper penetration in skin Apply slight compression Keep chilled tip flat on the skin surface at a 90 o angle -Surface skin is cooled by chilled tip (4° C) to minimize heating of skin Inspect and clean tip frequently during treatment! Caution if treating over moles or suspicious lesions

21 Observe skin for unwanted effects such as excessive erythema, blistering Perifollicular edema is to be expected – resolves in 2 hours Perform a test spot behind ear to ensure safety to skin – wait 24 hours Do not overlap over 10% or treat area twice Make sure tip is always in contact with skin when treating Place wet gauze under lip when treating Do not try to sculpt eyebrows Never treat inside orbital rim Use goggles when treating glabellar area to protect eyes Place cotton ball in ears when treating tregus Place white sponge behind ear when treating pinna Stop treatment If greying or separation Expected Sequelae and Tips

22 Positive Clinical Endpoints 22 Courtesy C. Dierickx M.D. Perifollicular erythema and edema - Bumps around follicle several minutes after treatment - Less pronounced on darker skin types

23 Post-Treatment Sunburn sensation is normal Takes 2 weeks for hair to shed If desired, cold compress, aloe or hydrocortisone cream applied after treatment Gently clean area twice daily Stop glycolics, retinoids etc Sunscreen for 6 weeks over the area Describe singed hair and shedding process Patient returns in 4-8 weeks for next treatment After completion of initial treatment touch-up treatments at 6 month intervals may be required to disable resistant hairs in treatment area 23

24 Potential Risks 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 6-12 months, –Fluence and skin type dependent Scarring – Extremely rare 24

25 Ideas For Getting Started Promote Good idea to treat staff so they can speak knowledgeably about procedure Mention availability to patients Brochures Posters in waiting room, office bathrooms, exam rooms On-hold message introducing laser Phone staff should be able to answer basic questions 25

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