Page 83 - Chapter 3 - Fundamentals of Laser/IPL Hair Removal

Chapter 3 – Fundamentals of Laser/IPL Hair Removal 1st Edition
Protocols
Applying the correct protocols when using lasers or IPLs is very important. If these are not applied then either there will be a poor result or unwanted skin damage.
The protocols required to successfully remove hair must include careful choice of wavelength(s), fluence, pulsewidth, skin cooling and post-treatment care. In the Section 3.3 we discussed how to choose the most appropriate parameters (settings) on your equipment to achieve a good outcome.
However, the protocol may also include the technique adopted to apply the light energy to the skin. These include the ‘stamping’, SHR or ‘in-motion’ techniques. (It should be pointed out that ‘SHR’ does not refer to a particular type of laser or technology – it is simply a ‘technique’. Both lasers and IPL systems can be used with this technique.)
‘Stamping’ vs ‘SHR’/gliding/’in-motion’ Techniques
Royo et.al. wrote an interesting paper on the SHR technique in 2010. It was a clinical study looking into the application of ‘super hair removal’ using a low fluence output from a diode laser (more information here - https://link.springer.com/article/10.1007/s10103-010-0846-1).
The study used an 810nm diode laser with a fluence range between 5 to 10 J/cm2, in a pulsewidth range between 10 and 20ms, with a repetition rate of 10 Hz. They divided the treatment area into 10x10 cm squares and applied a ‘lateral movement of the handpiece in a constant sweeping mode’ at a speed of approximately 10 cm/second.
They delivered a maximum of 9.6 kiloJoules into each square area, resulting in an average of 96 J/cm2. Of course, this was over an extended period of time, so cannot be directly compared with a ‘stamping’ technique fluence, which typically uses between 20 and 40 J/cm2 per pulse. They didn’t say how many passes were needed to achieve this target.
Their diode laser had a water-chilled window which cooled the skin. In addition, they used a Zimmer air cooling device too.
They found that many patients reported ‘low’ pain using this technique, with a relatively small number saying it was high or very high. The vast majority reported a ‘good’ result after six months after six sessions. A small number reported ‘burns’ but these were resolved after six months.
It appears that this technique was very successful, but they appear to have been quite precise about its application. This differs from the conventional ‘stamping’ technique which fires just one shot each area of the skin, with a greater fluence.
And this is very interesting...
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