Yorkshire's Largest Skin Clinic / Good Skin Days Reviews

The A-Z of Laser Hair Removal

Our unique A-Z guide to laser hair removal is written and edited by the team at our clinic in Leeds.  We hope it’s useful and interesting to everyone out there who is considering laser hair removal or wants to know more about treatment they’ve already had.

Click the letters of the alphabet to skip to that section:

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B
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D
E
F
G
H
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Alexandrite laser – this operates at a specific wavelength of 755 nanometres and is widely recognised, along with the Diode laser at a wavelength of 810 nanometres, as the lasers of choice for skin types 1-3 (see F – Fitzpatrick Skin Scale and Felix von Luschan scale) with dark hair. All lasers must carry CE marking, this is irrespective of where the laser was manufactured.If you visit any registered medical facility, all lasers must be PAT (Portable Appliance Testing) tested on an annual basis. Operators of Class 4 medical grade lasers have a legal duty of care to comply with the necessary Electricity at Work Regulations. These regulations state that operators are responsible by law, for the prevention of any harm coming to employees, tenants or customers when using electrical equipment that they provide within an organisation. There are also insurance implications of not having an up to date PAT programme in place. Failure to carry out the necessary testing can result in insurance companies refusing to pay out after an accident or a fire.?Any item that has a mains voltage plug attached to it should be tested.The largest (installed base) number of Alexandrite lasers in the UK are made by Cynosure Inc and Candela Inc. These are both US based laser manufacturers from the Boston, Massachusetts area. There are other manufacturers, some of which are entirely legitimate and there are also low-cost machines, coming from the likes of China and Taiwan which are poor quality, some with falsified CE markings. A good question to ask any operator, clinic or beauty salon is how much did they pay for their machine? The lasers that we referred to previously by Cynosure and Candela will be in the price bracket of £50-60,000. A further point of information is that both Cynosure and Candela have a laser on the market that incorporates not only the Alexandrite laser but also the Long Pulsed Nd:YAG which we will come to later (the Cynosure Elite and the Candela Gentle Max Pro).
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Burns – this is not a subject that most people want to talk about. Unfortunately, it is a very common experience when unqualified, inexperienced operators using cheap and/or replica lasers and IPL (Intense Pulsed Light) machines carry out treatments such as laser/IPL hair removal. The selection of an experienced and qualified laser technician is detailed more under “Operators”. However, if you are offered laser or IPL hair removal treatments without having a series of test patches carried out in advance, DO NOT GO AHEAD WITH TREATMENT AND LOOK AT OTHER PROVIDERS. Continued… 
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Cooling – cooling of the skin is very important during laser/IPL treatments and it comes in various formats. There are cold air chillers (where the cold air is blown onto the skin immediately prior to the treatment), Cryogen sprays and contact cooling (the latter could be a sapphire tip or aluminium plate). The cryogen of choice for laser dermatological indications is DuPont. All laser manufacturers will have some sort of skin cooling system for laser hair removal, whether it be an integrated part of the laser machine or a separate stand-alone unit. One of the most advanced systems is from Asclepion Laser Technologies in Germany. This is contact cooling with what is called a Peltier Cooling System. This is built into the hand piece and is in constant contact with the skin (albeit through a disposable membrane). This cools the skin immediately ahead of the laser firing. From our knowledge, we think that this is one of the most effective cooling mechanism available.
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Diode Lasers – These operate mainly on a wavelength of 810 nanometres and are used primarily for laser hair removal in skin types 1-3 and sometimes 4.The Lightsheer Diode from Lumenis  was introduced in the late 1990s and was the laser used by Boots the Chemist when they were in the laser hair removal business. All manufacturers claim that they can treat skin types 1-6 with diode lasers. As a general rule of thumb, we would have to disagree with this.The Alexandrite laser at 755 nanometres is the laser of choice for white skin types with dark hair. The Diode laser at 810 nanometres, is not far away on the light spectrum from 755 nanometres and therefore, is more suited to skin types 1-3 and possibly 4.

The laser of choice for dark skin types, 4, 5 and 6, is the Long Pulsed Nd:YAG, operating at 1064 nanometres and we will come to this later.

Diode laser technology has moved on a long way since the 1990’s. Today’s diode lasers from reputable manufacturers have a raft of advanced features. The main feature that everybody is talking about is the pain-free laser hair removal. One of the best systems on the market is the Asclepion MeDioStar Diode Laser

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Education – you would not buy a car without adequate research. The same applies to choosing a reputable treatment provider.
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Fitzpatrick Skin Scale – clearly identifies the skin type that you are, and predicts how you may respond to sunlight and lasers:http://dermatology.about.com/od/cosmeticprocedure/a/fitzpatrick.htmFelix von Luschan – Skin Colour Chart

If you’d like to know what skin type you are, please look at both of the links above.

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Ground-breaking Technology – the lasers available for hair removal continue to develop.The latest diode laser from Asclepion, the MeDioStar NeXT, comes with two blended simultaneously-emitted wavelengths of 810 and 950 nanometres. This not only targets the melanin in the hair shaft but also the vessels supplying blood to the hair follicle. This specifically targets the thin, downy hair, known as “vellus hair” and operates in basic, professional and smooth pulse modes.
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Hair –  Those who have it, want to get rid of it, those who have lost it, want it back!http://www.webmd.com/skin-problems-and-treatments/picture-of-the-hair
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Intense Pulsed Light (IPL) Machines – these are not lasers. An IPL uses short blasts of a mixed high-intensity light to penetrate just below the skin’s surface. A laser is more invasive and has a better controlled laser beam set on a narrower specific wavelength which is targeted at one specific problem condition and penetrates deeply into the skin.A word of warning – IPLs come in all shapes and sizes, with quite a lot from China and Korea, some with and some without CE markings. You can actually buy an IPL machine online which comes with a training manual and self-certification for you to complete. These can be purchased for £4-5,000! This is not recommended!
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Joules per cm2 – this is the measurement that is used to describe the power output of a laser.
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Keratin – Keratin is the key structural material making up the outer layer of human skin, hair and nails.
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Laser – LASER means Light Amplification by Stimulated Emission of Radiation.In 1917, Albert Einstein established the theoretical foundations for lasers. In 1960, Theodore H Maiman operated the first functioning ruby laser at the Hughes Research Laboratories in Malibu, California.The big advantage of skin lasers is that the laser light can be accurately focussed into small spots with very high energy values. To date, a huge array of lasers are available for all sorts of uses, these include gas lasers, chemical lasers, excimer lasers, solid-state lasers, fibre lasers, photonic crystal lasers, semi-conductor lasers, dye lasers and free electron lasers. They have many thousands of uses in every sector of modern society, including consumer electronics, information technology, science, medicine, industry, law enforcement, entertainment and the military.
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Melanin – also called pigment, melanin is the substance that gives the skin and hair its natural colourBasically, the more melanin you have in your hair, the darker the colour and therefore, the better the capability to absorb more laser light.
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Nanometre (nm) – A unit of length in the International System of Units equal to one billionth of a metre.
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Operators – a total minefield. Class 4 lasers were de-regulated in October 2010. This basically means that anybody can buy or operate a Class 4 laser or an IPL, without any training or certification. They can then put it in their beauty salon, hair salon, even their house, and start treating people. This has led to a huge increase in the number of people that have been burnt. At the time of writing, we are waiting for Sir Bruce Keogh, Medical Director of the NHS to issue his report into the cosmetic healthcare sector. This might or might not require the registration of all Class 4 lasers and IPL machines.A few questions that you should ask any potential provider:

  • Are they registered with the Care Quality Commission (CQC)?
  • Has the laser operator obtained the Core of Knowledge certification?
  • Has the operator been signed off by the laser or IPL manufacturer in the use of that particular laser/IPL?
  • How long have they been carrying out these treatments?
  • How many patients have they treated?
  • Do they have a Class 4 medical grade laser or an IPL which they are trying to pass off as a laser?
  • Do they carry out test patches prior to treatment?
  • Can they treat people with a sun tan?

If an operator answers no to test patches, look elsewhere for treatment. If they say they can treat you with a sun tan, walk away.

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Price – if it sounds too good to be true, it probably is. A high quality Class 4 medical grade laser for hair removal is going to cost in the region of £50,000-60,000. So treatments need to be priced to reflect the cost of this technology. Having said that, hair removal prices have reduced substantially over the years, in part due to the competitive nature of the sector, i.e. number of providers, but also the technology has improved dramatically in relation to spot size and speed of treatments.What can you expect to pay? Most operators offer single treatment prices and then a discounted price for pre-paid courses. The most popular areas are bikini line and underarms. Expect to pay between £80-90 for a single treatment. If you buy a package of 6 treatments, the treatment price will drop to circa £55.
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Q Switched Ruby Laser – if during your research for lasers using hair removal, you come across the Q Switched Ruby laser, do not be surprised. This was the first laser that was used for laser hair removal back in the mid 1990’s. So the story goes, a tattoo removal patient was being treated with this laser and noticed that after his treatment session, the hair did not grow back on his arm in the location of the tattoo. As with many great discoveries, this was purely by accident but has led to one of the popular cosmetic treatments worldwide. The Q Switched ruby laser has been taken over by the likes of the Alexandrite, Long Pulsed Nd:YAG and Diode lasers which are better for hair removal.
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Radiation laser radiation predominantly causes injury by thermal effects. Even moderately powerful lasers can cause injury to the eye. High powered lasers can also burn the skin. Some lasers are so powerful that a diffuse reflection from a surface can be hazardous to the eye. Laser warning signs should be displayed and all clients made aware of the dangers. Patients must wear protective eyewear during the laser treatment.
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Spot size – this refers to the diameter of the laser beam on such lasers as the Alexandrite and Long Pulsed Nd:YAG and is also known as a Gaussian beam. Ideally, the larger the spot size you can get, the better. Just be aware that some of the really large spot sizes that have been advertised by different providers are not necessarily a true statement, as the power levels need to be decreased. Diode lasers come with either a square or rectangular beam profile and come in a variety of sizes. Again, you need to be wary of the actual power levels that are available on really large spot sizes.
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Tanned skin – if you have a sun tan, basically you have increased the melanin content of your skin. It is essential that you wait a few weeks to let the tan fade before considering any laser treatment. This is because the increased level of melanin in your skin will absorb more of the laser light energy, making damage and burning more likely. This can lead to problems such as burns and hyperpigmentation. Be very wary of anybody that says that they can treat you with a tan.
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Ultra-violet light – is emitted by tanning machines, it can penetrate your clothing (ie. bikini) and change the melanin content of your skin. Again, do not consider laser treatment until your tan has faded.
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Vellus hair – this is fine, short hair that is usually no longer than 2mm, normally light coloured or translucent and non-pigmented that has developed from childhood that can be found on most areas of the body. This is the technical term for what some people call “peach fuzz”. Vellus hairs can be more prominent in women and children as they don’t have as many terminal hairs as adult males, which tend to obscure vellus hairs.
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What is Wavelength? – Most so-called “single wavelength” lasers actually produce radiation in several modes having slightly different frequencies (wavelengths). Our eyes are sensitive to light which lies in a very small band of the electromagnetic spectrum labelled “visible light”. Visible light has a wavelength range of 400-700 nanometres (nm) and a colour range of violet through to red. The human eye is not capable of “seeing” radiation with wavelengths outside the visible spectrum. The visible colours from shortest to longest wavelength are: violet, blue, green, yellow, orange and red. Ultraviolet radiation has a shorter wavelength than the visible violet light. Infrared radiation has a longer wavelength than visible red light. The white light is a mixture of the colours of the visible spectrum.
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X-ray Laser – An X-ray laser (or Xaser) is a device that uses stimulated emission to generate or amplify electromagnetic radiation in the near X-ray or extreme ultraviolet region of the spectrum, that is, usually on the order of several of tens of nanometers (nm) wavelength.
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YAG (Yttrium Aluminium Garnet) – The Long Pulsed Nd:YAG operates at a wavelength of 1064 nanometres and is widely regarded as the laser of choice for skin types 5 and 6http://www.cynosure.com/products/elite-mpx/clinicals.phphttp://archderm.jamanetwork.com/article.aspx?articleid=478428

http://www.sanomed.com.tr/assets/images/media/makaleler/fotona_estetik/longpulse_ndyagmakalesi.pdf

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Zap – slang term used to indicate the firing of a laser.

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