Is this normal? Missed hair in stripes after tream

Hair Removal Methods Laser hair removal
#1

I am not sure if this is normal (so to speak). I understand there may be some hair missed each treatment but this seems a bit much. The gal I had this time (I am on my second of six treatments) seems to have potentially not overlapped enough. I think she was taking too long of strokes of the laser and “lost her line” so to speak. The center of my back and the shoulder on the right seem to have the most issues.

What do you all think? Should I complain (I called and they said it was “ok” and normal on the phone)? Is this an acceptable amount missed (I am on treatment 2 of 6 so maybe during the others it will get all areas over time?

I guess I just did not see this after my first visit. The gal I got today was newer (been there only a month or so).

Here is a link to the image (click on the thumbnail for the full version). The redness on my back stays a day or two then goes away (and the bandages there are unrelated).

Thank you in advance for the help and assistance!

Link to photo of my back:

#2

I should note that they used a “LightSheer XC”.

#3

I believe you are right…the technician didn’t space the pulses right. I had this happen once with an inexperienced technician. They did allow me to come back for touchups, but mine was much worse than yours.

#4

My guess would be that Miss Month Old Technician started treatment on your left side. Looks to me like she was bored/distracted by the time she got to your right side. Maybe it was time for her smoke break? Absolutely unacceptable. You should speak to the manager, show him/her your photo and request that they repeat treatment #2. I’m sure you are paying for Full Back, so Full Back should be treated at each visit. Your photo looks like you got about 3/4 Back. LOL :slight_smile:

#5

Thank you for your replies. I am emailing the Laser Hair Removal office my concerns and also requesting that they redo the session to correct the missed areas. My impression is that they are a good company and as such my hopes are that they will stand by their work and correct any mistakes such as this. I will keep you posted on what happens. I simply want to get what I paid for (and even more so just want the job done right to yield the best results).

Thanks again and look for an update early this week I hope.

#6

Now that’s being a good consumer! Every business needs feedback so they can continue to compete by staying up on their game. Your picture is a fantastic tool for showing them that you are serious about getting what you paid for. On a positive note, you have a lot of perifollicular redness which is a good sign as well.

#7

So I just spoke to the manager at their office. He actually looked at the same photo I had above (I fwd’d him a link to this thread). He said that having some areas in between that are not red is normal and he felt that she “did” overlap enough given her training. I was clear and voiced my concern that some areas (as noted above) were not lased and that I noticed the hair there was already growing back (as opposed to the areas that were “red” from the laser, the hair there was very low to the skin and had not begun to shed). It seems to me that those areas were missed but I guess I will have to accept that he may know more than me and/or that I am wrong or at a dead-end.

All this said, he did say that they do indeed stand behind their work and that that if I was not happy with the results at the end of the six treatments that he would offer me a free touch up laser treatment to get any areas that appeared to not have responded well (at the end of the six sessions). I can tell that his company does care about its clients. Assuming everything goes well from here out I hope that having an extra session if needed will work. I certainly do plan to give them a good online review at yelp.com if the series of treatments work out well.

What do you all think? Will an extra session at the end cover my bases even if these areas were potentially missed during this treatment? I can tell you that during the next treatment I will politely ask that they be extra careful on those regions to get them “really good” to be sure.

One last note, I hope that my next trip to the office is not too akward. I really don’t want to be “that guy” who complains about every little detail. That was not my intent – I just thought this looked like more than a few tiny misses.

#8

They should touch it up now. It’s sloppy work that he’s standing behind.

#9

Feel free to list the business if you are not satisfied to warn others in your locale.

#10

Yeah he said that those areas on my back that were “not red” in the photo may have just not had hair growing at that time. He said that he had a person come back once with “zebra like” strips of hair regrowth after the treatment and he said that was normal as he saw the person do the treatment personally and said all areas were covered.

As for me, I can tell you for a fact that there was hair evenly across my back before treatment. To me, the fact that the “lines” are so geometric and structured is not some biological fluke where the hair was not growing in that pattern. Even if the hair was not in the active growth phase, there would have been some hair in those locations below the skin (after I shaved) that would have been heated by the laser thus causing skin irritation. This would have resulted in an even amount of redness. Maybe some areas may have been “patchy” and not red but the specific geometry of these lines (as well as post op observations on hair regrowth) indicate that indeed several strips of skin were missed.

The time taken for treatment this time was also 65 minutes versus 90 minutes for the first treatment. The lady doing the treatment was 25 minutes late to start (in my 90 minute window). The manager said the log sheet had me starting at 1PM (and he said the treatment was thus the same 90 minutes as before) but I know for a fact she did not start at that time, but at 1:25PM (I was watching my watch as she was late into the room and I was getting impatient).

I agree with everything said here. I am an Electro-Optical Engineer (aerospace industry) and while I do not use lasers for medical purposes, I am very well aware of how they work and have extensive laser safety training (to prevent burns to the skin and eyes/retina/etc which ironically is what LHR does in a controlled way).

Based on my conversation on the phone today, I am not sure I can get the manager there to redo this treatment to touch up the areas missed. Maybe he is not seeing something that the rest of us are? Is there anything I can do to provide factual evidence that she missed these regions? I was thinking if I take photos of the hair regrowth, it will indicate the differential in hair growing in those missed locations (versus the lased locations). Would this be sufficient backup evidence?

Btw the clinic is:

South Coast MedSpa
http://www.southcoastmedspa.com/
Los Angeles (office I went to) & Newport Beach

I am hoping that once the series of treatments are complete I can give a terrific and supportive review, but I want to make sure that these items are resolved in the interim.

Thoughts on the next step?

#11

I just sent this email to the manager,

Damon-

I was wondering if you would be open to this. As you can tell I am just a bit worried still about the missed areas. I know you will evaluate at the end, but I am still concerned now about these regions. Being an engineer I am the type of person who pays close attention to details and items like this and they tend to “keep me up at night” so to speak.

My request is, if I were to have my girlfriend use this photo and the hair growth to go on my back and, in marker, outline the roughly 8 strips that were missed if I could go to your office and have them “lase” those regions. It would not require the entire back and shoulders to be redone. My guess is that it would take them 5-10 minutes total and maybe 8 or so passes with the laser to “fix”. This would both make me sleep better (which honestly this has been bothering a lot the past week and making me a bit anxious) and close out any concerns I would have with the previous treatment. As a business decision to you, it would cost 10 minutes of your staffs time and 8 or so passes of the laser wand. I am assume this cost would be minimal and I can assure you that it would make me exponentially more satisfied with the treatment and sleep better. I hope this cost/benefit trade is something that makes sense to you.

Thanks,
…

I am trying to be reasonable and gave a very good cost / benefit trade type option to him. It would make me exceptionally more happy myself and as a benefit to their company, they would benefit from my satisfaction and word of mouth (I would be willing to give them stellar reviews because they are addressing my concerns and provide a great service). The cost would be minimal to them with my gf identifying ahead of time the regions for them with them only needing to spend 5-10 minutes to lase them (low cost to them).

#12

I think you are being very generous with your suggestion. I’m sure your the log for this treatment did not say, full back minus 8 strips. Touch ups are usually figured into the price. No one wants to miss spots, but it can happen, and should be corrected once the missed areas are noticeable.

#13

I just heard back from the manager there. He said he was ok with me going back to see them to get those spots corrected asap. He said he would get back to me Wednesday after he checked with his on-staff doctor to be sure that there would be no medical issues with having those areas lased. I will assume that there will not be any reason not to.

I feel awkward about this situation but as you all said, there is sufficient reason to expect that the treatment should have covered these areas (and did not). My main concern now is that I am worried the office staff will give me the evil eye when I return! I hope not :-.

I want to emphasize that I do appreciate them working with me on this. My lesson so far is that in future sessions I may want to visually inspect my skin to be sure they covered everything before I leave. If not ask them on the spot to lase those areas.

#14

I understand your position as an engineer who knows about lasers use on OPAQUE metals and plastics. The skin is not opaque (go into a dark room and hold a flashlight in your palm and slowly move it towards the area under the nails. You will see the red component of white light coming through the skin which means the skin is not completely opaque). However, we are now discussing human skin which has different thicknesses in the assorted areas that grow hair. There are different number of hairs that grow in each sq. in… Texture and color vary also. All these factors have to be considered when you talk about lasers on the skin. IF YOU HAVE A WELL TRAINED OPERATOR, WHO IS LICENSED BY THE STATE WHERE HE/SHE WORKS YOUR CHANCES ARE BETTER. There is no way to PREDICT what will happen because of all the considerations that enter into this procedure just like surgery. Laser use on skin IS SURGERY as defined by FDA. Any planned procedure that alters the structure or function of tissue IS SURGERY. Lasers have to VAPORIZE AND DESTROY LIVE TISSUE, CONSEQUENTLY, LASERS ON THE SKIN IS SURGERY. IT IS NOT TO BE TOSSED OFF LIGHTLY. YOU ARE ASKING QUESTIONS BUT ARE NOT GETTING ANSWERS BECAUSE THERE AFRE NOT ANY THAT WILL SATISFY YOU. You are a scientist and lasers use scientific principles but their APPLICATION is still an ART.

#15

IF THERE WAS OVERLAP YOU WOULD BE TREATING MOST OVERLAPPED AREAS TWICE AND THAT COULD MEAN A HUGE BLISTER OF SECOND DEGREE BURNED SKIN. This treatment allows for skin to heal before you attack it again. I do not know how long it was before this healed, however, in order to work at all, there has to be HEAT delivered to the tissue that is growing the hair. If heat is inadequate, too cool, too hot, too short a time frame per flash you will not be happy with the results but that is why this works or fails.

Perhaps you were not fully informed as to what to expect by an operator who could not explain the whole story to satisfy the knowledge you have about lasers but not of hair and skin.

#16

You have a good case because you were not fully instructed as to what you could expect. ?This means information was withheld and that prevents you from making a proper decision. The operator gave you enough to proceed but not all the facts to give you the TRUTH. He considered his income instead of your comfort. Laser procedures can be extremely painful no matter what anyone tells you. A rubber band flick is not correct. Perhaps a rubber band made from a heavy duty truck inner tube is more correct.

#17

I may only be an engineer but I feel that gives me a good analytical perspective coupled with a strong understanding of lasers. As for skin interaction I would simply tell you that we do in fact have to worry about this where I work. We work with lasers that could easily blind or burn you (skin or retina). We are trained (both in school and on the job) on the risks and effects of both.

As you said, the upper layer of skin (namely lighter skin) is “partially” transparent to this wavelength of light. As the laser penetrates deeper into the skin more is absorbed. The laser energy flux (energy per unit area) combined the the absorption gradient of the skin means that the energy is absorbed gradually as it enters the skin (however a darker skin layer on top can certainly absorb more).

The hair (especially dark hair) is quite the opposite compared to light skin at this wavelength as it absorbs more energy than the skin around it. The effectiveness of the laser is primarily the ratio of the energy the hair can absorb divided by the energy the skin absorbs per unit area. This means that lighter hair (less absorption in the hair) or darker skin (more absorption in the skin) will decrease this ratio.

The goal generally speaking is to apply enough energy to the hair follicle(s) to obtain a medically significant result without causing any lasting damage to the skin around it. This is difficult because when you increase the power of the laser (that can cause damage if the skin absorbs too much energy per unit area) to obtain this goal, darker skin types will absorb more energy and prevent you from using the power required to treat the hair.

One solution to this problem is to use a different wavelength that penetrates (is absorbed less) by darker skins but still is absorbed by the hair. This change in wavelength then increases the hair/skin absorption ratio and allows better treatment options.

As for duty cycle for pulsed laser light, this simply reducing the time average laser flux. A pulsed laser can allow greater “on time” of the laser on target before creating excess heat buildup due to absorption. This is critical for many medical lasers that require a certain amount of “power” for the laser to have its desired effect, but to at the same time not to create excess heating at such a rate that a human operator could not use it. An example would be a laser at 100J/cm^2 at 100% duty cycle (continuous). If an operator moved this across the skin slowly it may cause a burn. That same laser at a pulsed at 1kHz and a duty cycle of say 20% may not cause any harm because 1) there is less energy (flux/time) and 2) the skin may be able to radiate that heat (conduct) away from the laser impact region (cooling the skin before the next laser pulse).

Anyhow, the main point is this. If you are trying to tell me that my hair naturally grows in stripes (which is why I did not see any irritation in those areas) then I will simply state that in my 30 years of living I have never noticed that on me or anyone else. Even if the hair is not in an active growth cycle the fact that it exists below the skin means that during treatment it will absorb laser energy and irritate the surrounding skin. This may not have the result of preventing future hair growth for that hair but it will still cause irritation none the less.

#18

Are you stuck in a package? We have several clincis in LA recommended on the forum.