Page 198 - Chapter 3 - Laser/IPL Hair Removal

Chapter 3 – Fundamentals of Laser/IPL Hair Removal 2nd Edition
Another issue is the lack of proper training. Diode lasers and IPLs can generate the same clinical results as Alex and Nd:YAG lasers - if used correctly. Unfortunately, many users appear to be lacking some basic knowledge when applying their devices to the skin. Many are not taught about the importance or fluence or pulsewidth on the temperatures attained in the targets. Without understanding these important points, it is difficult to achieve good, consistent results.
Conclusion
Alex and Nd:YAG lasers are inherently 'easier' to use than diode lasers or IPLs, simply because of the shorter pulsewidths. However, longer pulsewidths can achieve the same results, but require more understanding of the photothermal processes.
Why do we get poor results?
We tried to analyse why so many operators get poor results. There are a whole range of reasons but we managed to determine that the following were the most common:
Lack of fluence
Pulsewidth too short
Some anagen follicles are missed
To cook the stem cells sufficiently such that they cannot regrow, their temperature must be raised to a point, and for the correct duration, so that ALL the cells are cooked.
But remember, a small increase in fluence will result in a large rise in temperature so increase this setting carefully!
This depends very much on your equipment but some lasers will output pulses which are very short (less than 1 ms). These are not as efficient in cooking the stem cells as longer pulses. We recommend using a pulsewidth between 1 and 100ms (or thereabouts), if possible.
CAVEAT – As the fluence increases, the importance of pulsewidth decreases rapidly.
One of the most obvious reasons why hair ‘regrows’ is simply that those follicles were missed in previous treatment sessions. This is just down to poor placement of the laser/IPL tip on the skin – it’s easy to miss areas, but careful placement will minimise this.
This is the main reason why laser/IPL treatments do not work!!
There are many videos out there demonstrating this. This will leave patches where insufficient fluence has been delivered. This is especially true with the SHR technique!
________________________________________________________________________ 198 Chapter 3, Ed. 2.0 Laser/IPL Hair Removal
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