Advice needed: Okay, after much, much, much debating, i've chosen laser....

tonic2 · December 8, 2003, 10:21pm

I’ve chosen laser for my bikini area, a diode lightsheer laser done at a reputable clinic.

It’s $250 each treatment for the first 4 treatments, then $150 for each treatment thereafter. I plan to do them the 4 weeks apart for the first 6 treatments (that’s 6 months) and then 1 once a month for the following 2. Then 4 months later i plan to do touchups every 4-6 months ($150 each) for life if i have to.

ANy comments, opinions or advice on this plan of action…PLEASE!! This is a lot of money for me. 8 treatments is a month of salary, but i it’s really a problem for me.

I have light brown skin (type IV) and thick coarse black hair, i plan on lightening the area (w/ combination of 4% HydroQ and Retin-a) for 4 week prior to first treatment in the hopes of lowering my chance and/or degree of hyperpigmentation.

[ December 08, 2003, 02:48 PM: Message edited by: Tonic2 ]

Balius · December 10, 2003, 7:28am

Your treatment choice sounds good but I might suggest you lengthen the time between treatments to around 6 to 8 weeks as this will make each treatment more finacially effective. At 4 weeks you will have hairs but of the ones that were previously treated a lot of them will still not be back growing. If money is not a major concern and you want to be treated more often then that is a fine option and you can stay with the 4 week rotation.

Chris

tonic2 · December 10, 2003, 12:17pm

Now i’m worried about triggering new hair follicles random places. DAMN! IF only it weren’t for that. The highest risk as i understand it is for olive and darker skins. I am both. Anyone know how great is this risk? Rare, very rare, common? any idea? big thank you.

blast · December 10, 2003, 6:39pm

T-
I can’t speak on risk with the diode, sorry. But you might want to look into a ndYAG long pulse laser. It is considered safer on darker skin. My tech is aggressive but very experienced and worked up to a fluence of 42 (on skin type IV-V). You may have to receive more treatments and hence more cost will ensue. I can attest to its safety and effectiveness in permanent reduction – in the right hands.
-b

hairfetish · December 10, 2003, 9:49pm

I also urge you to consider finding a facility that has an NdYag long-pulse laser. This can be used very safely and effectively on darker skin types. The Lightsheer must be used at too low a fluence to be effective on dark skin types (and Fitzpatrick IV is too dark) - and may actually stimulate hair growth, according to a recent article in Dermatology Times, vol. 24, No. 11, November 2003, pg. 69. You will need approx. 5 treatments, spaced 6-8 weeks apart. I hope this information helps.

Zambo · December 11, 2003, 12:00am

<blockquote>quote:<hr />Originally posted by hairfetish:
I also urge you to consider finding a facility that has an NdYag long-pulse laser. This can be used very safely and effectively on darker skin types. The Lightsheer must be used at too low a fluence to be effective on dark skin types (and Fitzpatrick IV is too dark) - and may actually stimulate hair growth, according to a recent article in Dermatology Times, vol. 24, No. 11, November 2003, pg. 69. You will need approx. 5 treatments, spaced 6-8 weeks apart. I hope this information helps. </blockquote>I don’t know if I agree with this as RJC2001 is a skin type IV and had great results with the Lightsheer.

As I understand, the maximum joule usage for a skin type V (I believe) is 25, can anyone confirm this?

Also, I posted over at cosmetic enhancement forums (!!) and asked about a comparison between the nd: YAG and the diode laser and this is the response I got from DoctorEngelhard. I was enquiring about the difference between skin type IV and V and the use of the Lightsheer (diode) and Coolglide (nd: YAG). Essentially, I was noting that the Lightsheer absorbs the melanin better than the nd: YAG but the nd: YAG requires higher fluences so–which was better. A laser that absorbs more melanin at lower fluences or a laser that can use higher fluences (as I deduced effective hair removal correlates with the fluence used). This is the response he provided:

"You cannot directly compare fluences between different wavelength laser systems.

Melanin pigment is most strongly attracted to the wavelength produced by Ruby lasers and more weakly attracted to Nd/Yag wavelengths, with Diodes and Alexandrites falling in between.

An average Fluence used by an Alexandrite system may be 20 Joules, as compared to 28 Joules with a Diode or 50 to 60 Joules with an Nd/Yag.
Does this make the Nd/YAG “more powerful”? No. It just means that more power is necessary with the Nd/Yag, as the pigment does not absorb this wavelength as strongly.

[snip]

So some questions…

is the Dr right?

Can a Lightsheer be used EFFECTIVELY on skin type V (at reduced fluence level)

If not, does that mean the nd: YAG is an option for more effective hair removal for skin type V as it’s safer to use higher fluences.

If someone could sort this mess out for me I’d be grateful as I’m still confused!

blast · December 11, 2003, 6:02pm

I am confused too. I read that post by DoctorEngelhard before. I realize that different laser systems can’t be compared joules to joules, if you will. My practitioner now uses ndYAG for darker skin types but I found an older clinical study where he used a diode with long pulse width on someone who was closer to a type V and had goods results (you can probably find it in medline under Dr. Adrian Laser Hair…). I’ve heard LHR referred to as an art. With so many variables to consider, again, I think it comes down to you Dr’s skills. I can say that I’ve had 4 treatments with the ndYAG, about a 50-60% reduction, and its been 2 months since the last blast. If this holds, I’ll be satisfied.

[ December 11, 2003, 10:03 AM: Message edited by: blast ]

Zambo · December 12, 2003, 8:09am

<blockquote>quote:<hr />Originally posted by blast:
I am confused too. I read that post by DoctorEngelhard before. I realize that different laser systems can’t be compared joules to joules, if you will. My practitioner now uses ndYAG for darker skin types but I found an older clinical study where he used a diode with long pulse width on someone who was closer to a type V and had goods results (you can probably find it in medline under Dr. Adrian Laser Hair…). I’ve heard LHR referred to as an art. With so many variables to consider, again, I think it comes down to you Dr’s skills. I can say that I’ve had 4 treatments with the ndYAG, about a 50-60% reduction, and its been 2 months since the last blast. If this holds, I’ll be satisfied.<hr /></blockquote>Great post. In the immortal words of RJC2001 - any hair that hasn’t grown back after two months is not growing back PERIOD. (Ok, he does add, “in my experience” but I just love that saying!)

50-60% after 4 treatments is pretty damn good! A couple more and you could get up to 80-90% hopefully and finish off with electrolysis!

With regards to the diode and nd: YAG, I think some clarification is necessary! Though I do have a link to a study which shows individual patient results and they make VERY interesting reading.

It’s between the Lyra Nd: yag and the lightsheer and in some cases a type V responds better to the diode than the nd: YAG and in other cases it’s the other way round.

ON AVERAGE, though, they reduce the hair about the same.

but this doesn’t count anaomlies or individual cases as noted

could someone therefore clear up this business between the diode and the nd: yag systems?

We’ve established that the diode absorbs more melanin in the hair follicle BUT the nd: YAG uses higher fluences (which have been shown to correlate with great hair loss in some studies)

so if you’re a type V do you go for the diode which absorbs more or the nd: yag where you are able to use higher fluences.

it seems, for saftey issues, the nd: yag is more suitable BUT if the diode can only SAFELY go up to 25-30 joules on a type V skin then why bother using it? Surely a skin type V is better to go with the nd: YAG where a fluence of 30-40 can be used, maybe more and greater hair loss achieved.

The “doctor” doesn’t seem to agree with that though.

Can someone please clairfy the situation?!!!