LightSheer Settings (F/IV)

[ckhs]

Hello,

I am interested in getting a Brazilian LHR done and have been browsing this forum as a resource for hair removal information. From the FAQs, I believe I am a skin type IV (Chinese), so I went for a consultation at a clinic. The technician there informed me that their laser is the Lumenis LightSheer ET laser. After asking some questions, I went ahead for a patch test on the area.

The settings she used was:

• 9mm spot size
• 30ms
• 25J/cm2

Quoting from a different topic:

You’re at least a type IV due to your genetic background.

LightSheer diode will give better results IF you can take high settings on it. Most Asians can’t.

I was curious as to what the “high settings” would be. At 25J, I felt like it was pretty painful, but I am willing to invest in some numbing cream so I can go for higher settings as long as it is still within the appropriate settings to not burn my skin.

Quoting from yet another topic:

[quote=napkin]I just started full leg and bikini laser hair removal with the lightsheer diode for light/medium asian, type IV skin.

This is what I know so far for my settings:
Legs: 25J, 30ms (i don’t know if it is 12mm or 9 mm, I’ll try to find out)

Does this seem like an effective setting? I read that it needs to be at least 25J to be effective, but I don’t think I can go higher due to burning.

ALSO, why is it that 25J is OK on my legs, but seems to burn my stomach, which is lighter in color and has less hair?

It might burn your legs as well! If I were you, I’d switch to YAG.[/quote]
Here it seems like 25J would be too high?

It’s been roughly 2.5 hours since my patch test and so far, I haven’t seen any swelling or redness. So I was wondering whether my settings were good or if not, what settings would be optimal? Or is the laser not the right one for me? I thought the LightSheer would be a good choice as the FAQs say it can treat types I-IV.

Thank you in advance for any feedback.

[mumbaigirl]

- Skin types are NOT exact.

• The problem with Fitzpatrick skin type system is that it is based entirely on how someone’s skin reacts to UV light (240 nanometers to 400 nanometers) and has really not that much to do with how it will react to 755 nanometers (alexandrite) or 800 nanometers (diode) or 1064 nanometers (YAG).

-What matters is the amount of pigment in the epidermis and the location of that pigment in the epidermis.

-The reason the Fitzpatrick skin type system is used is because there is nothing else out there and so people sort of use the general guidelines of the system… i.e, type I are very pale, type II are darker, etc. So depending on how much pigment you have in YOUR skin, you may or may not burn at 25J on LightSheer.

• Napkin seemed to have a problem taking 25J on her stomach and hence, even though she was skin type IV, I advised her to switch to a YAG laser but that does NOT mean any other skin type IV person would not be able to take 25J (or higher fluence) on LightSheer.

• You might want to go through LAgirl’s posts to find out what’s considered “high” on LightSheer ET.

[androby]

Although LightSheer (which is a diode), is said to be good for types I-IV, it really is still ideal for the lighter skin types like I-III. Now skin types are approximate and there is a range, which is why you can do test spots to see if your skin can handle good settings.

On LightSheer, the suggested minimum here on 12mm is 25J whereas on 9mm it is a little higher – more like 30-35J (pulse width also counts, of course). You can see if the tech is willing to do a test spot on 9mm at 30J, but it may not be safe for your skin type. If not, then a yag would be good. GentleYAG and Cynosure Elite (yag side) are good yag lasers.

[ckhs]

Thank you for the replies.

I did a search on LAgirl’s posts and found some posts that I have questions about.

Not necessarily. If OP is using a 9mm LightSheer, then the recommended starting fluences from Lumenis are 40j for type I, 35j for type II, 30j for type III, and 20-25j for type IV with tolerated fluences up to 60j for types I and II, 45j for type III, and 40j for type IV. Again, this is for the 9mm spot size version. (I have the PDF from Lumenis for this machine with recommended clinical settings.)

We recommend at least 25J and up on LightSheer if your skin can handle it.

You should find out whether she has a 9mm or 12mm spot size LightSheer. In terms of joules, we don’t recommend treating on anything lower than 25J on this machine. If your skin can’t safely handle that setting, you need a Yag laser instead.

Also, to use this machine well, they need to use compression and up-and-down method instead of lightly gliding over the skin.

What exactly is the “up-and-down” method? Is that pressing, releasing, pressing, releasing?

Given my reaction (or lack there of) to the patch test yesterday at 25j, would it be safe to assume that I can try higher settings? I am afraid of getting burns.

Other than pepper spots, immediate redness to the area, shedding within 3 weeks, are there any other tell-tale signs that the treatment was effective? Or do I just have to risk burning my skin and do patch tests at high settings?

[androby]

That’s right, the “up-and-down” method is lifting and moving the laser head each time. This allows for compression as well as proper overlapping so spots are not missed.

Since you said there was no redness or swelling just 2.5 hours later, you may be able to go higher, but you will just have to talk to your laser tech and see how high she is willing to test. She may not want to jump up to 30J. She should be the best judge of what setting might burn you since she can see you in person and should be qualified to operate that machine.

As far as indicators of an effective treatment go, you pretty much named it. Unfortunately, I had all those things on what I later found out where very low alexandrite settings. In other words, they do not guarantee anything. You may be afraid of burns but that’s what test patches are for, to find out what is safe for your skin and what is too much. Again, the laser tech should know what settings are within reasonable parameters for your skin. She’s not going to blast you with something totally unsafe, you know? I find that they are usually more conservative. And also, if you can’t get to at least 30J on 9mm, you might really consider finding a good yag laser.

[ckhs]

Thanks androby. I think the reason she did not try higher was cause my pain tolerance was not very high. At 25J, she asked me, “On a scale of 1 - 10 with 10 being most painful, how painful was it? 3, 4?”, to which I replied 6. So that probably stopped her from going higher. In this case, I will probably look into some numbing cream for the next time I go and suggest testing with higher settings and using the “up-and-down” method.