How safe is numbing cream?

Hair Removal Methods Laser hair removal
#21

We’ve had lots of discussions on this here, so you may want to run a search. The issue is a bit more complicated and money-driven than you seem to realize.

The laws you’re talking about were created by those same doctors who want to get a piece of the business without really contributing to it. Most of the doctors ‘on site’ are never actually there. And LHR is not taught in med school (neither are laser physics). So these doctors get the same type of “training” that a tech who is first starting out gets, i.e. 30 hrs or so laser manufacturers’ class. And then most never actually get to practice that much on actual patients to really learn how to judge how to adjust settings properly for various patients to get results (something that comes mostly from experience).

If the doctor has both the education and experience and is performing treatments himself, then it’s great. But that is rare because doctors make a lot more money doing other things for which they need more qualifications than just a 30-hr course (i.e. things they spend 10 yrs in med school for). And most get as much money from just being a ‘supervising physician “on site”’ without actually doing the dirty work (which is not what they went to school for years for). There are several doctors like SSLHR on this site who are speaking out against these other doctors who want a piece of the business without contributing much to it. Everyone touching you with the laser should understand the basics, which are also not that hard to grasp. The difference in results comes from actual experience in applying these settings to real people. Just something for you to consider.

Is the clinic giving you a reason for not treating at 16mm spot size, which is normally more effective? As you decrease the spot size, the joules have less effect. So at 12mm spot size, 25J is not that high. To give you a comparison, on GentleLASE alex, 20J is max on 18mm, but on 12mm it’s 40J. And GentleLASE has a stable pulse at 3ms.

#22

I know it’s complicated and money-driven. I think something like laser hair removal (and everything else that goes with it like numbing cream) has be regulated and there has be rules about who can and who cannot perform it. If not, anybody off the street will turn it into a businesss. Who wouldn’t ?, it’s a lucrative business. In fact, there are people who do just that by buying lasers through the internet or second-hand market. It’s not just the doctors who are trying to make a buck, but spa owners, salon owners, naturopathic doctors, etc. My state didn’t have any rules until people started to file complaints after they were burned. So, it wasn’t the doctors who got together to try to keep all the money for themselves, but the clients who were scared for their safety and wanted to get protection. You can’t just generalize and say that all the states in America have laser laws that were “created by those same doctors who want to get a piece of the business without really contributing to it.” Where’s the proof? However, I do agree that there are unreputable doctors out there who supposedly “supervise” and are “on site”, but basically make money without doing anything. Why do you recommend a low pulse for treatments? Doesn’t it make sense to increase the pulse for coarser hair and decrease the pulse for thinner, lighter hair? I don’t understand why the Gentlelase’s pulse cannot be changed and is only 3 ms.

#23

Lowest pulse width is most effective on all types of hair. Higher pulse is technically just available to protect darker skin when needed (it still reduces the effectiveness of treatment, but there is no option for darker skin and often slightly higher pulse IS enough for the most coarse hair anyway). 3ms and 18mm spot sizes are in part why GentleLASE and GentleYAG have such good feedback.

No one is disputing the need for regulations. They’re absolutely necessary. The point that we make is that regulations shouldn’t have anything to do with whether someone has a medical degree (which is often in completely unrelated field anyway), which is what this certain group of doctors is pushing. Regulations should depend on the amount of training (both in a classroom and on patients) a person has received in laser hair removal specifically and should apply in the same way to everyone who is operating a laser hair removal device.

A medical degree doesn’t make someone inherintely good at laser hair removal. This takes training and lots of practice on actual patients. Btw, this information comes from published articles and discussions/debates at laser hair removal conventions. The majority of doctors do not invest years of time and money into med school to perform hair removal on a daily basis (which can be learned in a few months at a much lower cost). So you have to ponder what their motivation is for pushing only for MDs to be able to perform the treatments. If you think they’re doing it out of the goodness of their heart, you may not have a lot of experience in the business world.

#24

We’ll be seeing more and more states legislate laser hair removal. Last year North Carolina set a precedence in legislating laser hair removal for licensed electrologists. Our bill, now law, is being used as a model in several other states. We are required to have a medical director, though not on-site. We cannot even mention topical anesthetics, prescription nor over-the-counter. We must attend approved laser schools and obtain yearly CEUs on top of our yearly electrolysis CEUs. Our rules go on and on. Any other business offering LHR must have physician on-site.

#25

Somewhere around 2003-2004, there was a great deal of misunderstanding and misinformation about who may apply lasers to the human body in Ohio. The State Medical Board was receiving reports of non-licensed persons purchasing laser equipment with assurances from salespersons that Ohio law allows the cosmetic use of lasers without a license. Physicians were permiting office staff and other persons without legal authority to use lasers under the physicians license. Both of these situations violated the Medical Practices Act. This is called practicing medicine without a license and it is illegal under Section 4731.41 of the Ohio revised code. It is illegal to use a laser in Ohio without a license.

There have been clear provisions in Ohio law for NON-PHYSICIANS to use lasers and physicians can delegate the use of light-based medical devices, but there is specific delegatory language to all this. That specific language states that there are only four classes of persons to whom a physician is permitted to delegate the use of light based medical devices, including lasers. All must hold a current license in Ohio and all must be supervised by the delegating physician. They are:

  1. Cosmetic Therapist (CT)/ Electrologist
  2. Physician Assistant
  3. Licensed Practical Nurse
  4. Registered Nurse

The physician must make sure that the person to whom she/he is delegating has proper training to safely use the laser. For a Cosmetic Therapist (CT)/ electrologist, a 50 hour course in the use of lasers for hair reduction must be completed. In the case of an electrologist,the supervision may be off site, but for the PA, LPN or RN, supervision must be on site.

Additional demands on the physician are:

There must be a physician/patient relationship. The physician must see and evaluate the patient and then prescribe the application of laser. The physician is also responsible for maintaining patient records for treatments received.

Reports have been sent to the State Medical Board of Ohio about patients suffering burns and other serious injuries, thus Ohio decided several years ago that lasers, which are medical devices that can cause serious and permanent injury if improperly applied, need to be purviewed by a licensed physician with only a small number of health care professionals acting under the supervison of that licensed physician.

I think this is reasonable and it protects the public, but I have no way of knowing if complaints are minimal compared to before the code was revised.

#26

I don’t believe that higher pulses are just available in order to protect darker skin types. I think there is a reason why so many lasers have the option to adjust the pulse duration (Gentlelase is not one of them). Anybody have any ideas?

Here is some info i found by searching online:

“Pulse duration (or pulse width) must be equal to or shorter than the thermal relax-
ation time of the target to confine thermal damage. The thermal relaxation time of
the whole follicular structure depends on its diameter and is on the order of tens of
milliseconds. Consequently, the laser source must have a range of pulse widths to
selectively damage different size follicles. Pulse width must be matched with the appropriate amount of fluence (energy per unit area) necessary to cause follicular damage.”

Source: www.aesthetic.lumenis.com/pdf/laser_principles_aspects.pdf

“CoolGlide allows the operator to adjust the duration of the pulse of laser energy to best suit the thickness of the hair shafts on different parts of your body.”

Source: www.drbrent.com/lhremoval.php

#27

The problem with this is that you’re reading the “assessment” by a laser manufacturer with a laser that has adjustable pulse width. So it’s not really unbiased. Plus, all Yag lasers have adjustable pulse width, even GentleYAG made by the same manufacturer as GentleLASE. It’s done for that same reason of adjusting to protect the skin. Depth is important, but that’s achieved with a large spot size as well due to laser creating an inverted cone effect.

SSLHR explains all the variable settings and their relationship well in this thread. Check it out: http://www.hairtell.com/forum/ubbthreads.php/topics/43946/i_am_confused.html#Post43946