Transcript Slide 1

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GentleYAG
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GentleYAG – 1064nm
Indications
Laser Hair Removal
Linear Vascular Lesions
Skin Tightening
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– Second Laser
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Hair Removal
Laser Hair Removal
• How does it work?
– Targets the pigment in the hair follicle.
– Heat is absorbed and destroys the cells
lining the hair follicle specifically around the
bulb, bulge, and vascular supply.
Permanent Hair Reduction
The FDA allows us this definition:
“long-term stable reduction in the
number of hairs re-growing after
a treatment regime”
How Effective is it?
• Studies have shown up to 80% reduction in
hair after a series of treatments
• The 1064nm wavelength will NOT treat
white, blonde, or gray hairs!
• Some reds hairs will not achieve desired
efficacy.
• Patients should be informed of all possible
outcomes prior to treatment
Hair Anatomy
Follicle
Epidermis
Sebaceous Gland
Bulge
Vascular Supply
(Matrix)
Bulb
**Bulb/bulge are critical structures responsible for hair re-growth
Cycles of Hair Growth
• What are the 3 cycles of hair growth?
– Anagen: Hair is actively growing
– Catagen: Hair is dormant
– Telagen: Hair is falling out
Hair Biology
Anagen
Catagen
Telogen
How Many Treatments?
• Different areas have different percentages
of hair in the Anagen phase.
– Face, Axilla, Bikini have approximately 2035%
– Trunk and Extremities have approximately 1020%
Time to Retreat?
• As a rule:
– Face/Axilla/Bikini: 4-6 weeks
– Trunk: 8-10 weeks
– Arms & Legs: 10-12 weeks
• Or within 7 days of when regrowth is
observed.
Hair Growth Information
Telogen
Duration
Follicles
Density
/ cm²
Depth of follicle
Body Area
% Anagen
Hair
% Telogen
Hair
Axillae
30%
70%
3 months
65
3.5-4.5 mm
Brow and
Ears
10-15%
85-90%
3 months
50
2-2.5 mm
Beard
70%
30%
10 weeks
500
2-4 mm
Upper Lip
65%
35%
6 weeks
500
1-2.5 mm
Scalp
80-90%
13%
3-4 months
350
3-5 mm
Trunk
10-20%
80-90%
4 months
70
2-4.5 mm
Pubic Area
20-30%
70%
3 months
70
3.5-4.5 mm
Arms
20%
80%
18 weeks
80
2-4.5 mm
Legs &
Thighs
20%
80%
6 months
60
2.5-4 mm
Breast
30%
70%
3 months
65
3-4.5 mm
Bottom Line
• For best results, multiple treatments will
be needed.
– For most areas 4-6 treatments are necessary to
achieve desired hair clearance.
– One may need more or less than 6 treatments
depending on hair type, previous methods of hair
removal, and skin color.
• Results may vary from patient to patient
and to various degrees of efficacy.
Pre-Treatment Instruction
• Before
– Shave hair 24-48 hours prior to treatment
– If the patient has a history of cold sores/fever blisters, an
anti-viral can be prescribed
– If there is concern over pigmentary changes, a
prophylactic bleaching cream can be used weeks prior
to treatment
Pre-Treatment Instruction
– NO Plucking – 6 weeks prior or after
– NO Waxing – 6 weeks prior or after
– NO Tweezing – 6 weeks prior or after
Patients should only shave
Clinical Endpoints
• PFEs
– Perifollicular erythema: The treatment area should
appear red
– Perifollicular edema: There should be swelling around
each hair follicle
• Some patients will experience a hive like response
• Lighter hairs may not respond as significantly
Post-Treatment Instruction
• After
– Cool compresses can be used to reduce patient
discomfort & swelling
– Aloe vera
– Topical Cortisone cream
– Sun block of 30+ SPF
Treatment Technique
• 3 Things to ALWAYS remember while treating:
– FLUSH: The distance gauge should be flat and in
contact with the skin’s surface
– PERPENDICULAR: The hand piece should be 90°
to the skin’s surface
– OVERLAP: Pulses should be overlapped at 2030%. Think of the Olympic Rings
Complications
• There are risks and
complications that can
occur from laser treatment.
• Use of conservative DCD
settings are important.
• Complications are rare!
•
•
•
•
•
•
•
•
Heat rash
Bruising
Scarring
Infection
Hyper-pigmentation
Hypo-pigmentation
Swelling
Welting
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Vascular
& Linear
Telangiectasia
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– Second level
1064nm Wavelength
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GentleYAG does what?
1064nm
– Facial Vessels
– Leg Veins
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Leg Telangectasia or Spider Veins
• Sclerotherapy is the
GOLD STANDARD for
the treatment of leg veins
• The 1064nm wavelength
can clean up what
Sclerotherapy does not
• Veins < 3mm in size are
treatable
Special Considerations
• Vitamin E, Aspirin, Ibuprofen, Fish Oils or other
Blood thinners may increase the likelihood of
bruising. Avoid for several days if possible, if not,
practitioners should perform test spots
• When treating lower extremities diabetic patients
should have clearance from their primary physicians
• Darker Skin Types should only be treated with the
1064nm wavelength
Pre-Treatment
•
•
•
•
Squeaky clean skin!
No tanned skin!
No Topical anesthetics
Topical Alpha-hydroxy
– Can be used for 1-2 weeks prior to treatment
• Measure vessel size
Clinical Endpoints – 1064nm
• Facial Vessels
– ONLY the 1.5mm spot size should be used on
the face
– Vessels should disappear and erythema the end
result
• Leg Veins
– Vessels should disappear
– Wheal & Flare or Cat Scratch appearance after
about 5minutes
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Post treatment
• Apply pressure to treated area after a few
pulses
• Cool Compresses
• Topical Cortisone Cream
• Encourage sun block 30+ SPF
• Avoid activities that cause vasodilatation or
increase blood pressure for 3-5 days
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– SecondReduction
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Wrinkle
& Skin Tightening
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How does it work?
1064nm
– Bulk deposition of heat can cause both
collagen contraction & collagen stimulation
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3 Techniques for Skin Tightening
• New Taylor
– 18mm, 50ms, 18 J/cm² with the DCD turned off – 3
Passes
• Keys
– 10mm, 50ms, 20 J/cm², DCD off, Double Pulse/3
Passes
• Painting
– 8-10mm, .25-.5ms, 12 J/cm², DCD off, 7-10 Hz
• All deliver bulk heating into the dermal layer of skin
Clinical Endpoint?
• The use of an Infra-Red
Thermometer allows us to
achieve a surface temp of
40°-44° C
• This translates to an
approximate dermal temp
of 65° C
• This is the temperature
that can cause collagen
contracture
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– Second level
Thank You
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