DIODE

• Laser diode is very small in size and appearance

• Diode laser – gallium arsenide
• Semiconductor laser
• 800-810
CHROMOPHORE

• The chromophore employed in laser hair reduction is melanin.

• What frequency will you choose?
• Melanin absorbs light in the range of 300 to 1200 nm, and lasers in this range of wavelengths can
be effectively used for hair reduction.

• melanin captures energy from the laser and distributes it to the

surrounding follicular structures. This results in the destruction of the
hair matrix and hair bulge stem cells.
 Moa
• Lasers for skin treatment work on the theory of "selective
photothermolysis
• Thermal mediated injury of microscopic tissue targets by the
selective absorption of pulses of radiation by the targets and the
chromophores.
• melanin captures energy from the laser and distributes it to the
surrounding follicular structures. This results in the destruction of the
hair matrix and hair bulge stem cells.
WHY HAIRS HAS TO BE SHAVE
• Target absorption may not always be uniform. In these cases, the
weakly absorbing parts(epidermis/ hairs) may have to be destroyed
by heat diffusion from the highly absorbing parts. This is the
"extended theory of selective photothermolysis." causing ablation
 EXPLANATION
Skin laser hair removal works by targeting melanin. The concentration of melanin is high in both
dark skin and dark hair.
Dark hair and light skin to treat with laser.
How, ever, there are special machines and settings for people who have darker complexions or hair
that is not very dark. This is why you have to have the procedure done by a professional who
knows how to work with various complexions.
WHY THE RESULTS VARY

3 main reasons are

Skin colour – Light skin vs Dark skin
Hair colour – Black hair v/s Blonde hair
Hair type – Coarse hair vs Fine (Peach fuzz)
Several other factors are – Age, Gender, Genetics, Heredity, Hormonal changes etc.
How many session
▪Expect about 90% hair reduction in 6 treatment done over 9 -15 months period. This is considered
success.
▪session takes from 5 mins to 1 hour, depending on the body area.
▪The interval between treatments varies 3 -5 weeks
USES
• Hirsutism and hypertrichosis
• Aesthetic purposes
• Medical indications like pseudofolliculitis barbae
HIRSUTISM
Hirsutism the most common symptoms of polycystic ovary syndrome (PCOS) : testosterone face,
neck, chest, back and toes

▪Medications : Oral Contraceptives.

▪Antiandrogenic Medication (Spironolactone) : inhibits the testosterone, Flutamide : liver problems
Hair cycle
• ANAGEN - ‘Growth Phase’ or ‘Active Phase’, the Anagen Phase is when
the cells in the root of your hair are most rapidly dividing so more
new hair is formed.
• During the Anagen Phase, your hair grows around half an inch a
month [about 6 inches a year], and fast in summer than
winter(vasoconstriction)This phase of the Hair Growth Cycle lasts an
average of 3-7 years — so a full-length hair growth averaging 18 to 30
inches.
• CATAGEN - Following the Anagen Phase, your hair cycle enters a
short transitional phase known as the Catagen Phase, which signals
the end of active hair growth and cuts individual hairs off from the
blood supply and from the cells that produce new hair. Approximately
3% of all hairs are in this stage at any time.
Telogen Phase - The third stage of your natural hair growth cycle is the
telogen Phase, a resting period when strands remain in their follicles
but are not actively growing. An estimate of 10-15% of your hairs are in
the Telogen Phase at any given moment.
• Approximately 3 months or 100 days.
• EXOGEN - The final stage of the Hair Growth Cycle, when individual
hair strands are released from their follicles and fall out. Now the
whole process can begin again
• Each hair follicle is independent and goes through the growth cycle at
different times — otherwise all your hair would fall out at once! Instead, you
only shed a certain number of hairs a day – 80 to 100 hairs on a healthy head
of hair.
• Hair loss, hair thinning and problems with hair growth may occur when your
growth cycle is disrupted. This can be triggered by conditions such as
metabolic imbalances, illness or improper nutrition.
• For instance, around 12 weeks after restrictive dieting or a high fever, you
may experience telogen effluvium (sudden diffuse hair fall). This occurs when
your anagen (growth) phase is cut short, and many hairs enter the telogen
(resting) phase at the same time – resulting in increased hair fall 3 months
later during the exogen (shedding) phase.
• The hair matrix is only sensitive to laser treatment during the anagen
phase of the hair growth cycle; therefore multiple treatments will be
necessary in order to address all hair follicles when they are most
sensitive to treatment.
• In the initial phase of hair removal therapy, 4 to 6 sessions spaced 4
to 6 weeks apart are the minimum required to achieve adequate
results.
• Subsequently, patients may need maintenance treatments once
every 6 to 12 months as small vellus hair may grow back.
PREPARATION
• Detailed clinical history to rule out infections, drug intake, etc.
• Hormonal evaluation to assess causes of hirsutism.
• Counsel the patient to manage expectations. It must be stressed that the procedure
provides permanent hair reduction rather than removal.
• Evaluate skin and hair types to choose the right laser and parameters.
• Avoid hair epilation by plucking or waxing for 6 weeks before the procedure.
• Sunscreens may be prescribed 4 to 6 weeks before the procedure, especially on
exposed areas.
• Pre-procedure photographs, with due consent, to maintain a record for evaluation of
treatment response.
• Shave the area long enough before the procedure to allow a slight stubble to
develop; this will provide enough of a target for the laser without absorbing too
much energy in the hair shaft itself.
• Obtain an informed consent.
PROCEDURE
• Clean the area to remove oils from the skin
• Position the patient comfortably.
• Use eye protection for both the operator and the patient.
• Avoid reflecting surfaces or metallic objects near the laser.
• Individualize the parameters to each patient's skin and hair type and the
type of laser being used.
• Place the handpiece perpendicular to the skin. Ensure that it is pressed
down gently but firmly to bring the follicles close to the surface and
temporarily decrease the blood supply to the treatment area.
• Perifollicular edema and erythema is an expected side effect, and this
must be explained to the patient prior to the procedure.
POST TREATMENT

• Although most machines have inbuilt cooling systems, ice packs or

cooling agents may be used post-procedure to minimize pain and
swelling.
• In case of inadvertent epidermal injury, topical antibiotics may be
used.
• Strict sun protection and the use of sunscreens is a must.
• Topical steroid creams may be prescribed to minimize erythema and
swelling.
FACTORS

• Hair location (axillary and pubic hair respond better than hair on the
extremities and chest)
• Skin and hair color (light skin of Fitzpatrick skin types I-IV with dark
hair achieve the best results due to the lack of melanin in the skin and
the abundance of melanin to absorb laser energy in the hair follicles)
• Hair growth stage (anagen hair being most sensitive)
• Laser type
• Hormonal status
• Treatment plan
Selecting the correct lasers with the appropriate parameters, individualized to each patient, is very
important, particularly in patients with intrinsically dark skin.
Most complications are preventable when adequate precautions are taken with adjustment of the
fluence, spot size, wavelength, and the use of appropriate cooling.
Thus, it is all the more important that trained personnel with a thorough knowledge of the
mechanisms, techniques and complications carry out these procedures.
COMPLICATIONS
• Adjacent epidermal structures other than melanin within the hair
bulb can compete for absorption, and may cause laser energy to be
absorbed by pigment in the epidermis. This hampers the effectiveness
of the treatment and causes adverse effects due to adjacent epithelial
damage.
• Common adverse effects - erythema, pain, and burning.
• More severe adverse effects -
• blistering
• crusting
• dyspigmentation
• purpura
• scarring
• Paradoxical hypertrichosis
Discolouration (hypopigmentation/hyperpigmentation )