Help needed, seriously considering laser

First of all I would like to say thank you to Andrea, James and all contributors who have made this site possible. This site is a great resource for anyone who wants to make informed choices regarding hair removal.
I am a 40ish male with type II or III skin. I like to ride bicycles and have problems with ingrown hairs due to the use of bike shorts. I have done a bit of research on the subject of LHR and am very glad to have found this site, where unbiased information on the subject is disseminated.
The area I would like to have treated is that which is covered by the shorts and then up to the small of my back and also a few inches above the belly button. My hair is dark; I’ve been on two consultations so far and am scheduled for a third on Thursday.
From my fledgling understanding of the subject, I believe an Alexandrite laser would produce the best and most efficacious results for my skin type and treatment area. If this is true, my best bet would be to find a practitioner who is skilled with the use of the Alexandrite laser, for best results?
Both consultations were with Dermatologists who had trained RNs as the laser technician. The first RN had 5 years experience with the Apogee Elite laser. The second had 3 years experience with the GentleLASE, however I she did not have experience with male clients in this treatment area, so I’ve eliminated this practitioner. I do not want to be treated by a technician that is in any way uncomfortable with the procedure.
My appointment on Thursday is at a facility owned and operated by a Physician’s Assistant, who is also the laser technician. She was actually highly recommended by someone on staff at the first Dermatologist’s office. The PA uses a machine by Cutera. I have conducted a bit of research on this manufacturer but am uncertain about what to expect Thursday, as far as equipment.
It was only after my first two consultations that I discovered your informative website, so I did not know to ask about spot size or joules. I think the higher the joules (based on spot size), the more effective the treatment. So I would want the most joules, without the risk of burning my skin, right? And I would want the technician to use this setting beginning with my first treatment, right?
Perhaps you could also help me on the subject of pulse length as I’m a bit unsure about this topic.
With regard to the GentleLASE and the Apogee, would my results be strikingly better with the GentleLASE. From my research so far, it seems that this is the Rolls Royce of Alexandrite lasers? I’ve recently spoken with a proponent of the Apogee and she said the Cryogen used is the GentleLASE is somehow dangerous and has been banned in Europe. Have you discovered this to be true? I’ve spent a few hours trying to verify this claim, to no avail.
I also have a question about the differing results in the areas under consideration, but perhaps that should be posted in a different section of the website.
Many thanks for all your help with these questions and all the others you have helped so tremendously. This is a truly great forum, keep up the good work.

Best regards.

Hi and welcome to the forum. Here is my feedback:

  • The hair needs to be coarse, not just dark. Is that what you have? Coarse is the type of hair on underarms and bikini, i.e. leaves a shadow and/or stubble when shaved. Laser really only works on that type of hair.

  • Cutera makes Apogee. Apogee Elite is an alex and a Yag in one machine, so it’s fine for you. GentleLASE is an alex. GentleLASE has adjustable spot size and fixed pulse width at 3ms. Apogee has adjustable pulse width and fixed spot size (usually 15mm on the Elite model).

  • For best results, they would set highest joules, lowest pulse width, and largest spot size your skin can handle safely.

  • I wouldn’t eliminate a clinic based on the fact that she hasn’t treated this specific area on a male. It’s important for a male face, but not so much for other areas.

  • I would get test spots from all clinics and write down settings. Then see how shedding goes.

  • GentleLASE is considered great based on the largest spot size on the market of 18mm and lowest pulse width of 3ms (Apogee goes down to 5ms). Cryogen is effective and we never see any issues with it. It’s unfortunate that clinics choose to bash others’ machines based on nothing (no data).

Hello :slight_smile: I just had my first session on the bikini area with a GentleLase just under a week ago… if you are comfortable going to the place that has the GentleLase, I would recommend it. It didn’t hurt a lot - nothing I couldn’t handle - while it was 16j/18mm spot size (I’ll go for a higher joule setting next time so it will hurt more). GentleLase has a larger spot size than some other lasers. That is a pretty important factor for me since it means that treatment time is shorter and so less uncomfortable. I’ve read good reviews of this machine and it seems to be fairly effective - I have access to journals through my university library and the studies I’ve read so far have had very positive results with the Alexandrite for permanent hair reduction. The only problem with these studies is that they don’t follow up any longer than 12 months after treatments :frowning:


We have a living study 12+ months after alexandrite, her name is LAGirl!

Cutera makes the Coolglide (which is not recommended for OP since it is an ND:Yag). [/quote]

Thanks to all for your speedy replies. Please forgive me, but what does OP stand for in the above quote?

I suppose I should exclude YAG machines altogether from my search and focus on Alex?

Alex or Diode will do.
Yag is for very dark skin.

OP means original poster :slight_smile: Basically the person that started the thread.

Again, many thanks for your help. I will focus on Alex.
Could I expect MUCH better results with the GentleLASE than the Apogee, or similar?

The hair in the desired treatment area is mostly coarse, except for above the belly button.

I think you can expect the same. I had one session on underarms, face and forearms with GentleLASE. I had full shedding but switched to Apogee Elite. I love the Apogee, get pretty much the exact same results, feels the same. I find Apogee is faster. May have been the person treating me with GentleLASE but seems faster on Apogee. Specification wise the GentleLASE is better in the fact that it has a fixed 3ms pulse width where Apogee starts at 5, but most techs use higher than 5 from my experience. Like I said though I’ve had amazing results from Apogee and it’s hands down my favourite machine. I highly doubt if you were to treat one half your body with Apogee and one half with GentleLASE, that you’d be able to tell any difference with treatment at all.

Sorry…typing too fast. Cutera makes Coolglide, which is a Yag. Alex is best for you.

GentleLASE is technically a bit better on specs, but what will make the difference is the settings, i.e. out of the two providers, I would choose the one that knows what they’re doing and and relatively aggressive with settings to get you good results without burning.

I wouldn’t expect much of a result on any hair that’s not coarse, i.e. above your belly button. So go in with appropriate expectations.

Many thanks, I’ve canceled my appointment with the clinic that uses Cutera and have booked an appointment at Ideal Image. Some on the forum may have had experience with this national chain. They offer the GentleLASE and are comfortable treating desired areas even with male clients. My appointment is at 11 am tomorrow.

Ideal Image has good machines. The only complaints are usually about their prices, which are pretty high. So I would definitely compare prices with clinics in the area. And don’t forget that prices are not set in stone. You can negotiate, especially if you bring in quotes from other providers.

Thank you so very much LAgirl, not only for your responses, but for this website as a much needed resource for those who desire to make informed decisions regarding hair removal. It is easy to see how an uninformed prospect could get less than their monies worth in LHR.
Today during the consultation at Ideal Image, I used many of the questions you have graciously outlined, in addition to several of my own questions. I must say some of the questions (esp. 21-24) made the consultant wiggle a bit. I will not bore with details unless someone would like to know more of my experience.
The short of it is this; they wanted to sell a package of nine treatments. They have two rooms for treatment, one with a GentleLASE and one with a GentleYAG. I did receive a free test patch. The technician used spot size 18mm at 12 Joules on the GentleLASE. The technician is a P.A. and verified my self diagnosed skin type as right in-between Fitzpatrick type II and type III. She said the initial treatment would be at these settings and increase by 2 Joules in subsequent sessions. The initial 5 sessions are recommended to be spaced 10 weeks apart. I did inquire about starting with a higher Joule setting and received a negative reply. The test patch hardly fazed me in the least. I did mention to the tech. that I understood if the laser does not hurt a bit the results are not going to be optimal. She said that is just not true.
I have formed a rather strong opinion about this visit, some positive things, some negative. I will refrain from sharing these until I receive response from the forum and those with much more knowledge than I.

After arriving home I sent the following email to the first office I visited to request more info. I will delete the names for privacy:

Hello Sxxxx,

Thank you for your help in my research on the topic of laser hair removal. Since my consultation with Axxxx and Dr. Hxxx I have been studying the subject fairly diligently. Subsequently I have a few questions to ask at this time.

I would also like to thank you for recommending Vxxxx. They use a YAG laser only and research indicates that for the majority of the areas upon which I desire treatment, the Alexandrite laser would be more efficacious. For this reason I have eliminated Vxxxx from my choice of providers.

Since my visit to your office, I have also been on two other consultations. Both of these offices use the GentleLASE and one office had the GentleYAG also.

The questions I have for you at this time are technical in nature and are as follows:

  1. What Fitzpatrick skin type was noted by Dr. Hxxx upon initial consultation?

  2. Is the machine you use an Apogee Elite? If so can you verify this unit is used to produce both an Alexandrite and a YAG laser?

  3. What spot sizes do you have to choose from?

  4. If I were to use Pxxxx as the provider for these services, what spot size and Joule setting would Axxxx recommend for my initial treatment?

  5. Most units produced by Cynosure offer adjustable pulse lengths, what pulse length would be recommended for initial treatment?

Once again, many thanks for all of your help in this process.

Very kind regards,


Once again, many thanks to all contributors for your input and guidance. Without this website and the information available here, I believe this process might be like shooting from the hip.
With best regards

It’s a bit silly, all technicians should know that the best is as high as possible without burning, if you can’t feel anything then that can’t be right with that machine…
On the other hand, one reason they won’t risk it is because there is a very fine line between good treatment to burning the patient. Most places would be very scared of crossing it.

However, I’ve seen it with my own eyes before, some places (maybe many) would prefer to treat using a lower setting just for you to be needing more sessions.

For a test patch, maybe next time (if they only go up to 14j but you think you can take higher) ask them to do a test on a patch of skin that isn’t usually visible with much higher joules - e.g. 18-20j @ 18mm. See how it goes, and then insist on asking them to move up to whatever you can stand at the third session. 9 sessions seem like a lot for one area - most people recommend 6, though 9 wont hurt in case of eradicating more hairs :slight_smile:

I wouldn’t get treatments on GentleLASE with anything under 14J 18mm, and really at least 16J on 18mm would be best. Max on this machine is 20J on 18mm. I would try to convince them to do test spots at higher settings so they can see your skin can handle it without burning. I agree with Odi above. Unfortunately, those are the reasons some clinics use lower settings.

Apogee Elite only has largest spot size of 15mm. And if that’s the name of the machine, it’s definitely an alex and yag in one. The other machines that are Apogee are just alex machines, without the Yag. The “Elite” model is the one that has a Yag.

Generally, you can’t expect clinics do give you settings over email. They need to assess your skin in person.

On Apogee Elite, I would be asking for joules and pulse width and spot size. On GentleLASE, pulse width is fixed at 3ms, and spot size and joules are adjustable.

I would not buy a package at any clinic right away. I would recommend to do one treatment without a committment and see how things go. If you like them and everything is good (good shedding, not many missed spots etc), then you can buy a package then. I also wouldn’t commit to more than 6 treatments from the start. Most coarse hair on bikini, underarms, etc don’t require more than that if settings are always good.

Not sure if you checked out our tips for finding a clinic, but Candela’s website (maker of GentleLASE) has a provider search. You can enter your zip code and find some near you. Also, GentleMAX is their machine that combines Alex and Yag in one. The pulse width is adjustable on it.

Actually the Apogee Elite has a spot size of 12mm. Definitely for the YAG. Not sure if the Alex part has a difference spot size.

Actually the Apogee Elite has a maximum spot size of 15mm but has many size attachments. Apogee Alex does 15mm, 12mm, 10mm, 7mm and 5mm and Apogee Yag does 15mm, 12mm, 10mm, 7mm, 5mm, 3mm and 1.5mm.

I always receive treatments with the 15mm. My first couple on my face were with the 12 but we switched to the 15mm since it goes deeper. My tech has a whole drawer with different size attachments.

I should be retiring. You guys want to take over? :wink:

Hahaha I was just thinking to myself it’s sad that I know the specifications like that. Don’t worry you’re still the laser queen!