Fluence/Lower Energy or joules & increase the frequency of the shots, this is called SHR mode. High fluence diode lasers with contact cooling have lately transpired to be the powerhouse to get rid off of the unwanted hair. However, High fluence laser hair removal is linked with discomforting pain and adverse after effects, particularly when treating dark or tanned skin.
A new and distinctively unique diode laser with low level fluence (5-10 J/cm2) with a high repetition rate at 10 Hz using multiple passes in continuous motion technique has become a gold standard technology to remove unwanted body hair effectively, safely and painlessly.
Also, as per the clinical experiments conducted on 25 patients, Permanent laser hair removal with low fluence & high repetition rate in comparison to traditional one pass high fluence (25-40 J/cm2) diode laser (LightSheer ET) turned out to be more effective and relieving for skin type’s I-V.
Hair counts from laser with low level fluence when done six months following the 5th treatment were estimated to be comparable with an 85-91% hair reduction. The fast, multiple pass in-motion technique was quicker and connected with notably less pain. Multiple passes of diode laser at low fluences but with high average power significantly lead to permanent hair removal with less pain and lesser side effects, particularly on darker skin, which high fluence laser is unable to treat optimally. On the other hand, there was one external burn on the peripheral skin with the high energy diode treatment.
For e.g. in conventional/skamping mode, we need 70-80 joules/sec. per sq. cm and frequency is kept to 1 pulse for effective results & to reduce the hair. In Fluence we reduce the joules to 10 joules & frequency is increased to 7 pulses. It is also known as in motion diode. We keep moving the handle & that is why it is known as Inmotion.
We make use of Non-overlapping pulses like the 650 µs Nd:YAG laser that are directed at the patient’s treatment site at fluencies between 4 to 8 J/cm2. The laser energy is directed with an 8 mm beam diameter scanner. 1 or 2 passes of the laser treatment are administered at each session with no epidermal air cooling technology used before, during or after treatment. Follow-up treatments are arranged for each patient at 1 month intervals for an average of 6 treatments. All treatments are performed by a specialist physician and/or a under the direct supervision of a licensed dermatologist.
Each patient is assessed for improvement both before and instantly after each treatment session and 6 months following their final treatment. Clinical images are taken at each session visit and are systemized such that the same camera, lighting, and exposure conditions are used in each visit for every patient. Assessment of efficacy of using laser technique is identified by both physician evaluation and patient’s satisfaction surveys.
More than a 50% reduction in hair follicles can be noted by most patients with dark skin and coarse hair in an average of 6 treatments at 1 month interval. There are no permanent pernicious events observed with laser technologies for permanent air removal.
Most women with hormonal irregularities do not realize that many of their symptoms (like unnatural hair growth on body and face), sometimes even after electrolysis or laser therapies, are directly associated with their hormones. Hormonal issues should be ruled out with a checkup with Gynae or an endocrinologist.
There are certain signs of hormonal issues that if remain persistent indicate hormonal imbalance and should be treated well on time. These include:
Many Women with these and similar signs may not even regard hormonal imbalance as a cause. Hormonal imbalance symptoms have a wide range that includes more symptoms like heart palpitations, depression etc. and can only live with their hormonal irregularity symptoms for as long as before the issue starts to menace their health and quality of life.
Knowing the hormonal source of your symptoms, disturbing hormones, and the ambiguous array of issues it can generate, can lead you to the path of feeling relieved. When your body’s hormones are balanced, your symptoms will subdue and you will experience much better overall health, and a lot more happiness.
If conditions above mentioned are present, then medical examination should be there for Testing Hormone Levels. These tests include:
Much unwanted hair growth on a human body takes place as an outcome of hormonal imbalances, which are rectifiable. Satirically, many actually expose a potential underlying hormonal issue during a visit with a gynecologist or an electrologist (a person who performs electrolysis). Make sure to consult your doctor about common side effects of each of the following therapies before you say “yes” to hormone therapy.
However, if there are edocronological problems, then we give Spirolacton and Oral contraceptive pills.
There are certain lasers that do not work well for women with hormonal issues such as polycystic ovaries disease, people with grey hair or fine blond hair. But with the novel permanent lasers, using a low energy technique it is now possible to get rid of some ridiculous kinds of hair growth as well as if you just have, coarse hairs on your chin.
There are two kinds of hairs present on the human body, vellus hair and terminal hair. Vellus hair is short, fine, downy and covers most part of the body. It covers almost the entire surface of the body except for the palms of the hands and the base of the feet. Vellus hair is virtually invisible and most people do not see it, since being utterly thin and fine.
On the contrary, terminal hair is thick, clearly visible and heavily pigmented. This is the hair type, people are most concerned about & really want to get rid of with the help of laser hair removal and is often present in the pubic, legs, chest and underarm areas.
Note: Grey hair does not respond to lasers too.
The type of hair a patient has, will largely ascertain the effectiveness of the treatment. Laser hair removal for terminal (thick hair) is often the most effective, as it is convenient for the laser to target the melanin in the hair and kill the follicle. Laser hair removal for vellus (fine or thin hair) is not as effective, although there are laser energy techniques available that will grant even those with light-colored, fine, hair to enjoy the advantages of laser hair removal.
Other conditions like cancer of the ovaries and adrenal glands can contribute to excessive hair growth. Low level Laser treatment has been proven promising in treating these conditions and reducing and/or removing hair permanently.
As per the hair growth cycle that occurs in humans like hair at the bikini area, leg, and underarms are in the active phase for about 4-6 weeks, at which mark they enter the mature phase. Since not all hairs will be in the same phase at a same point of time, laser treatments are needed to extend out over a period of six weeks or more.
The laser energy source is dramatically allured to pigment, like that found in darker hair. Blonde hair does not have adequate pigment to allure the laser’s heat, making conventional laser hair removal questionable on fair skin, blonde or even gray hair.
There are specially designed lasers that have proven productive in eliminating unwanted hair for fair skinned and blonde haired women and men. The Alexandrite Laser comes into action at a higher intensity than conventional lasers, exploding the patient with the pigment that he/she require to enjoy permanent hair reduction and removal.
Laser hair removal for dark/brown/black skin can be even more challenging than for those with pale skin. The issue with treating darker skin tones is that the laser has a tough time distinguishing the skin from the hair, since the skin and hair color are often the same. Permanent Laser hair removal for dark/black hair works most effectively or to its level best when the skin is a contrasting, lighter color.
One of the main issues that take place with permanent laser hair removal for brown skin is discoloration. Sometimes with inappropriate administration laser beam power, the surrounding skin tissue can get damaged instead of the hair, thus causing permanent discoloration and scarring of the skin.
However, there is an effective solution for dark skinned patients who want to enjoy permanent laser hair removal and reduction. The Nd:Yag laser is best for patients with darker skin and minimize the risk of burns, discoloration and scarring.
Olive skin and dark hair or pale skin and dark hair combinations are the best to treat when it comes to permanent laser hair removal. Because there is an apparent differentiation between the hair and skin colors, the laser has no difficulty determining the hair follicle and intensely attacking it.
One of the prime points of problem in laser treatment is the skin’s reaction to ultraviolet light. Created by a Harvard-trained dermatologist, the Fitzpatrick scale is taxonomy of various skin types and their reactions to UV light. This helps dermatologist and laser therapist in identifying the chances of discoloration, burns and scarring and other undesirable events during laser hair removal treatments.
The scale measures as follows:
This scale is significant in identifying the intensity of laser used in the process. Brown and dark brown skin, like the type that is found in African American, Mediterranean, and Indian populations, can be damaged and scarred permanently if the inappropriate laser is used.
Individuals with light or white skin can also encounter damage in case of wrong laser administration. A low intensity laser can prompt hair growth, while one with too high a setting can blaze up the skin.
Permanent hair removal with accurate low energy/fluence laser takes several sessions to fully remove unwanted hair. Due to the thickness of the follicle and altering hair cycles, it can take a while to notice permanent results. The first 3 sessions are generally done in intervals of 4-6 weeks.
Increasing hair growth on body and face with Laser Hair Removal is called parodoxical hypertrichosis and is a scarce reaction to treatment for permanent laser hair removal. This extra hair growth will noticeably appear on your skin until treated. Paradoxical hair growth is the activation and promotion of hair growth in areas on, or surrounded to areas treated with laser hair removal, or intense pulsed light (IPL) devices.
In our suggestion it appears that stronger treatments are needed to reverse the extra hair growth. An experienced dermatologist or a laser hair surgeon is necessitated to refrain away from unpredictable side effect increases.
If we use very less energy during laser hair removal than paradoxical growth could happen. While doing LHR treatment practitioner should do cooling at surrounding areas to prevent burn.
Paradoxical hair growth has been characterized to low fluence at or near the boundary of the treatment area. Researcing into the low fluence link with paradoxical hair growth, we first assess the scientific knowledge about the spreading and absorption of light in tissues to test the theory. Then we evaluated scientific research studies to check whether low fluence was the most potential cause of unwanted hair growth. Starting with the Igarashi’s very popular diagram depicting forward scattering of light in turbid tissue, the primary direction of light going into tissue is forward scattering, and the bulk of useful light does not travel sideways in tissue very far outside the contact area with the tissue.
Some of the work examined dispenses of light in mathematical simulations and this also verified that even when you apply very high concentrations of photons of light in the tissue, the larger amount of the light is forward scattering. Very less light moves sideways or laterally beyond 2 mm from the periphery of the treatment area that is probably to have a biological affect, including activation of hair growth.
However, it should be known that oedema and perilesional erythema is most commonly noticed well outside of the 2 mm periphery of the treatment area, and it appears to be one of those cases where the answer is possibly gazing at us in the face, but we are really refraining away from the most logical cause.
However, there are several other factors that can contribute to unexpected hair growth after laser hair removal or IPL photofacial. These conditions can include:
Response on Non-Androgen dependent area is better with novel laser technique with low energy/fluence. Androgen dependent hair requires more sittings.
Androgens are the main regulator of alterations in human hair growth. They promote the production of pigmented terminal hair in many areas post puberty, including pubic and axillary hair in both genders and beard growth in men. Androgens also contribute to the reverse metamorphosis of big, terminal, scalp follicles to small vellus ones producing little, light-colored hairs and causing balding. Both balding along with beard growth can occur in the same individual signifying an endocrine paradox.
Now you must be thinking how does the same hormone (Androgen) trigger hair growth on the face while taking it away on the scalp.
The different androgen-insensitivity syndromes uncover another paradox. Androgen receptors are needed within hair follicles for all androgen-dependent hair growth to take place.
However, the enzyme 5alpha-reductase type 2 which metabolizes testosterone to the more dominant androgen, 5alpha-dihydrotestosterone, is only imperative for androgen function in male specific follicles like the beard and balding scalp. In this 2nd paradox axillary and women pubic hair will grow good in 5alpha-reductase deficient people.
Both these paradoxes demonstrate that androgen action within person’s follicles is particular to the individual follicle i.e. associates to its gene expression. Androgens are thought to act on the chiefly epithelial hair follicle via the mesenchyme-extracted dermal papilla located at its base.
Cultured dermal papilla cells extracted from follicles with varying responses to androgens
Understanding these factors accurately allows the dermatologist or laser therapist to facilitate the development of better laser technique treatments for androgen-dependent hair growth problems.
At our centre, the Physician evaluates on the basis of both the overall clinical improvement and photographic comparison of the earlier session to establish the percent reduction in the hair count. Hair reduction is determined as a percentage of the number of hairs present on the treated site at each follow up compared with the number of hairs at the previous session. We follow a quartile hair reduction grading system based on viewing photographs taken in each session: 1indicating less than 25%; 2: 25 to 50%; 3: 51 to 75%; 4: 76% to 100%. Unfavorable results (dissatisfactory) were depicted as quartile grading score of either 1or 2 (meaning <25% or between 25-50% reduction in the number of hairs respectively). Grading results are considered favorable (satisfactory) of either a 3 or 4 indicating a 50-75% or 75-100% reduction hair.
Patients scored subjective satisfaction at each visit by selecting favorable, Unfavorable, or neutral on self-assessment surveys. Subjects are also guided to note any hazardous cutaneous reactions including consistent erythema , pigmentation, scarring, and changes in the surrounding skin at each visit.
There is no single best laser technology or device but the 650-microsecond pulsed Nd:YAG 1064 nm laser is effective for permanent laser hair removal in low fluence and can produce greater levels of patient satisfaction. Any adverse reactions reported are constrained to temporary erythema, mild transient edema, and/or rarely hypopigmentation, which resolved.
In simulated consumer use, the full body and face permanent laser hair removal in low fluence exhibits an essential, measurable and maintainable reduction in unwanted body and facial hair with scarcely any adverse side effects.
1, NRI Complex, Mandakini,
Chittaranjan Park, South Delhi,
New Delhi - 110019