Choosing the best laser modality for your client
Hair removal or reduction has become a very popular esthetic procedure as more and more people seek smooth, hairless bodies. As estheticians, laser technicians and electrologists, we perform these types of services on a daily basis for our clients. While technology provides very effective hair removal methods, many states have different regulations regarding who can perform these treatments, so check with your state for specific requirements.
For the sake of understanding, it makes sense to group lasers and Intense Pulsed Light (IPL) together because they are both light based treatments and work in virtually the same manner. They are considered by the FDA to be permanent hair reduction— not removal.
• Types of lasers:
Long-pulsed ruby (694 nm)
Long-pulsed alexandrite (755 nm)
Long-pulsed diode (800 to 810 nm)
Long-pulsed Nd:YAG (1064 nm)
IPL (400 to 1200 nm)
• Hair color
Lasers and IPL target dark hair and are not effective on blonde, grey, or red hair.
• Skin type
Fair skin. Fitzpatrick skin types I, II and III. Lasers that produce wavelengths of 694 nm, 755 nm, 800 to 810 nm are suitable for lighter skin people as they absorb into melanin well.
• Dark skin
Fitzpatrick skin types IV, V and VI. The 1064 nm is better suited since its absorption into melanin isn’t as great. While some IPL devices may be used on all skin types, caution should be used on very dark clients, and the practitioner should consider using the 1064 nm laser instead.
• Area of coverage
Lasers and IPL devices can be used on all body parts, with the exception of inside the peri-orbital rim (eye socket area), under the eyebrows, and inside the nose and ears.
Settings should be according to the manufacturers’ parameters, and it is essential to perform test spots prior to full treatment. With Fitzpatrick 4-6 skin types, doing test spots and evaluating them over 72 hours is appropriate.
• How it works
At the base of each hair follicle lies the bulb of the hair. The bulb contains the highest concentration of melanin. Because the light from IPL and lasers are attracted to melanin, the bulb is the target for these devices. When the light from the laser or IPL is placed on the skin where the hair is located, the light is absorbed into this bulb and heat is created. This heat destroys or damages the hair and the stem cells around the bulge, which prevents the now damaged hair follicle from producing a new one.
In addition to the melanin in the hair follicle, the laser light also “sees” the melanin (and pigments of similar colors like a dark tattoo) in the skin equally. In the event a dark skinned person undergoes laser/IPL hair reduction, some amount of the energy could be absorbed into the skin, possibly causing a burn.
Burns can be prevented by taking the person’s skin color into account. By modifying the settings and reducing the energy, darker skinned patients can still be safely treated with IPL and laser.
• Side effects
There are common side effects associated with laser/IPL hair reduction such as peri-follicular edema (PFE), which is swelling around the hair follicles caused by heat absorption. This usually resolves in 48 hours.
Hyperpigmentation can also occur in darker skin types. Adverse reactions such as burns or blisters can be minimized by ensuring the client has not had any recent sun exposure two weeks) and isn’t wearing makeup or sunless tanner.
Epilepsy, lupus, pregnancy, recent antibiotic use or any other health issues that may be eggravated by light exposure. Clients should not have any heat or sun exposure for a minimum of 48 hours after treatment.
• Treatment time,
frequency and price
Laser/IPL treatment prices range from $50 a treatment for a small area (upper lip) to $300 for a large area (full back). Many spas offer package deals. Treatments are performed between four to eight weeks apart. Most clients require four to seven treatments and annual maintenance treatment is needed.
The combination of radiofrequency (RF) and IPL allows for the use of less optical energy because of the addition of RF, which permits for safer treatment of a greater range of skin types.
Treatment time, frequency and price are comparable to laser/IPL.
Practitioners and clients must wear the appropriate eyewear specific to the wavelength of the laser when it is the device of choice, to avoid eye damage.
Electrolysis is the only permanent hair removal technique approved by the FDA. It has been practiced since 1875 and there are three types being used by practitioners today—galvanic electrolysis, thermolysis, and the blend. Galvanic electrolysis uses a direct current to destroy the hair through chemical action. Galvanic current will convert the water and salt present in the dermal papilla into a high pH solution, which is capable of destroying the dermal papilla. Thermolysis uses RF to generate heat into the hair root, which destroys it via electrocoagulation.
The blend combines the galvanic and thermolysis currents together in the same probe destroying the dermal papilla by both heat and chemical action. By blending both modalities, treatment efficacy is improved.
• How it works
All three methods utilize a sterile metal probe that is narrower in diameter than a hair follicle. The probe is inserted into the opening of the hair follicle until it reaches the base. Electric current is then delivered at the base of the follicle using one of the three recognized modalities of electrolysis.
• Side effects
The most common side effect is redness, which is short lived. Recommend that your clients apply a compress of witch hazel after the treatment. Scabs, although rare, may also form in the follicle opening. Advise clients not to pick or scratch them.
Treatment time, frequency and price
Pricing tends to be calculated in 15-minute increments, not by body part, and runs from $65-130 an hour. Most practitioners offer packages as it takes 7 to 12 hours to treat an area, depending on size. Treatments are usually performed weekly. Depending on the client’s hair, genetics, hormones, and health, the electrologist will determine the amount of treatment needed. While the old standbys of waxing and shaving still work, technology allows us to deliver great results to our clients. Going from hair to bare is easier than we ever thought!