My Laser Treatments 26/F/UK, Type IV

Those are good settings on the alex.

Sorry, I was not clear. Those are the YAG settings for my sister. They test patched her at 18mm, 25J and 40ms, they actually used 22J for the treatment.

Those are ok on the Yag for her skin type.

Hiya,

Ok, well in speaking in depth to my sister, she said a few things. Firstly, that it was barely painful. Secondly, it was not very red as we are used to and there was no welting. I will admit that my best treatments have been when my skin felt it and looked like it!

I emailed the clinic and this is the reply they gave me:

"Thank you for your feedback, its much appreciated, I just want to give you some background about the company & hopefully this will help you understand the clinic protocol we adhere to, we follow the manufacturer’s guidelines & are constantly advised by a dermatologist, the staff at premier laser clinic have regular training updates by Graham Bisset PHD.

Yes it is true S----- had a test patch done with higher settings, bear in mind this is a small area also the initial test patch is a rough gauge of a clients tolerance it is not a 100% accurate indication that a client will not react adversely when it comes to treating a larger area, hence We at premier laser clinic are advised to start with a low-med setting, as the area treated is very large, even if a client can tolerate a high setting as indicated by a test patch.

When determining the pulse duration of the treatment parameters we need to consider the difference in the diameter of the hair, we select our pulse duration dependent on the TRT or thermal relation time . The larger the structure, the longer the thermal relation time, thus longer pulse duration, also the clients skin type needs to be considered, amount of melanin content
(As you probably know clients with Asian /middle eastern decent have very coarse hair).

I have your sisters file in front of me & the practitioners notes state “ Some Redness, ok to increase setting next time”
Laser hair removal is not as straight forward as you might think especially when it comes to treating skin types 4 &above, which premier laser clinic is very experienced in, contrary to popular belief higher setting does not equal a more effective treatment (please note hair only in the anogen phase will die, & at any time only 10-15% is in the anogen phase )there needs to be a balance between effectiveness & safety, you do not want to exchange one thing for another.

Also I would like to add all the practitioners are highly qualified &asses all clients individually, I over saw the recruitment personally, so you are in good hands."

My reply:

"Thanks a lot for the info (which however, I am already aware of), it shows you really care about what you are doing, which is not my experience with other places.

The thing is, S------ told me she said a number of times that the treatment was not painful compared to what she was used to in all the other areas she has had treated. The area was also not very red afterwards, when usually we are used to redness for about 12-24hrs.

S----- also waxed about 12 weeks before her appointment, which should mean that all present hair is in anagen (it is all growing). The hair at the time of all later treatments will all be in anagen too (as the next hair cycles are growing in after treatment).Therefore, it is my understanding that providing the settings are aggressive as they can be without causing an adverse reaction and the hairs are thick enough to respond to Laser in the first place, they all have the potential of being permanently destroyed.

Please could you confirm what the test patch settings for next time were? I understand it was 15mm and 25J but the pulse width? In your opinion, is this an increase from the first treatment?

Basically, I’m sure you know that she is a student and she is living very frugally to be able to afford LHR. We do not have the money to spend on more treatments than necessary or end up with hair that could have been permanently destroyed but has just bee made finer. I hope you can understand my concern because of this."

Reply (increasingly silly):

The settings used on S----- were medium settings & within clinic protocol as it was the first treatment with us also the 18mm spot size penetrates deeper ,
With regards to pain: it is not fair to compare the Eilte MPX with the Apogee Elite, the MPX has a very advanced state of the art cooling system,40ms is less painful & pain thresholds vary across the body.

I do not understand the statement about waxing 12 weeks prior,waxing greatly disrupts the hair growth cycle, are you saying majority of the hair should be in the anagen phase, this is not true, it can increase to 20-25% no where near 80-90%, any reputable clinic will tell you, you need a course of treatments to kill the hair in the anagen phase, this is a fact not a money making scam.

money is always an important factor in the decision making process, however this is your body and the recommended guidelines for clients is around 8 sessions for your sisters skin type also hormonal level need to be considered, if you are looking for short cuts I’m sorry we can’t offer that, clients safety is paramount to us.

I assure you we know what we are doing &if your sister or cousin proceed with the treatment we gradually increase the settings.

To summarise we use the lastest technology in laser hair removal, to the point we have clients flying in especially on a regular basis to use the MPX all the lasers are FDA approved , the staff is fully qualified &licensed, we have expanded in a recession due to clients recommendations as they are very happy with the treatment & customer service.

Is it true about the MPX being less painful? For the next treatment they test patched 15mm, 25J (and I assume 40ms). Is this okay or is it a lot less aggressive than her initial treatment (18mm, 22J, 40ms)?

It is so frustrating. The good techs at Renew have left. The ones that are left seem like robots who stick to protocol.

I haven’t been on my home pc yet to edit the photo I took of her leg but hopefully I will do that today so that you can see how coarse the hair is. I KNOW she can be done in three treatments a I was (as she has no fine hair, it’s all coarse), the only problem is finding somewhere that can fulfil this with good treatments.

Have you tried all the techs at that particular branch? If so, perhaps you could try another RM branch? I remember reading posts by other people getting treated at other branches. Maybe they’ll pipe up after reading this thread and suggest names and give info about how their treatment is going?

Hi smurf, I know the other techs at the branch I we were at and they aren’t interested in the treatment they are doing in the same way that the two that have left.

I’ve tried the Croydon branch in the past for a consultation, that was rubbish. The tech we had the consult with was apparently the one who had been with them longest.

The only other one I have heard of from a different branch was from a poster here but she came to post that this tech had also left!

The only real way to know is to have treatment and we cannot afford to spend money to test out techs. The first tech I had recommended the second one to me as she knew she was leaving. The second one left abruptly; I’m thinking differences with the management because of the way they behaved when telling us she had left. If you call them and ask for someone experienced, they tell you that all their techs are equally good.

Now the main problem is that they have test patched her at low settings and those are the ones any tech would have to go by.

Renew says the same rubbish as this place, I just overlooked it because the treatment was otherwise good.

Are they using the Alex on the MPX or the Yag or both?

No, MPX shouldn’t be less painful. Dropping the spot size to 15mm makes a big difference. I would ask to be treated at that 18mm spot size with 22J starting with the next treatment.

But see how shedding goes.

I will try to clarify, sorry that it became confusing.

The machine is the MPX, there are two people in question.

My cousin: She went for her test patch, they used the Alex only at these settings: 18mm, 20ms and 14J and 16J

My sister:
They used the Yag only. The test patch was at 18mm, 40ms and 22J and 25J.
For the actual first treatment they used the lower of the two (18mm, 22J and 40ms) even though she repeatedly told them it was not hurting as she was used to for other body areas.
At the end of the first treatment, they test patched new settings for next time: 15mm, 40ms and 25J.
This is her lower leg:

18mm 22-25J on the Yag is better than the 15mm setting. That 15mm setting is pretty low on the Yag.

Thanks LAgirl, that’s what I thought. I don’t think we’ll be going back, especially since she wouldn’t explain why they test patched lower instead of higher. I think they know they are trying to increase the number of sessions needed.

This bit made me laugh, “are you saying majority of the hair should be in the anagen phase, this is not true, it can increase to 20-25% no where near 80-90%, any reputable clinic will tell you, you need a course of treatments to kill the hair in the anagen phase, this is a fact not a money making scam.

My cousin went for her first treatment (Alex on the MPX) even though I suggested maybe she should wait until we find somewhere better.

They started at 18mm, 20ms and 14J but took it down!

I’m new to the forum and am also a type IV. It’s great to see a site so dedicated to helping people with hair removal questions or just simply sharing their stories.

They initially categorized me as a borderline type III-IV & tried the Alexandrite, hoping for better efficacy. But after burning w/ the Alexandrite laser (12mm / 20ms / 20J), they decided to be safe and switch me over to the Nd Yag. I had a bikini session done with Nd Yag and wondering if my settings are reasonable. I have read a lot about maximizing the spot size and after asking my dermatologist, he advised that they considered all the parameters and felt this would be less painful and still be effective.

1st: 12mm / 40ms / 45 J
2nd: 12mm / 30ms / 45 J

I did have numbing cream and it was indeed very painful, but not enough to discourage me from continuing.

Those are high settings on the 12mm.

Bikini hair is thick and responds well. I expect it will all shed. If you have a lot that has not at 3 weeks, as the clinic for a touch up.

I am just passing by to say thank you for sharing this with us, really helpful !

@stoppit: I read you also did your legs. What settings per session did they do your legs with? I’m getting ready to start my legs and wondering if keeping it at 12mm/30ms/45J is still good or would dropping the pulse width to 20 be better since the leg hairs are not as coarse as the bikini hairs. I don’t know if I could handle the pain though at 20ms!

ninjago:

Going through this thread, I wrote this:

“I had my third leg treatments yesterday. Lower leg at 40j/20ms and upper at 40j/15ms.” - on the 12mm

I know I started off lower (lower legs were 30J) but I don’t know the pulse width.

If you can handle those settings (the ones you mentioned) on the bikini line, and you are right that the leg hair is finer so you can do with a shorter p.w., then it’s probably worth shortening it. See what your technician has to say.

Actually, reading back has been interesting. Even though my first leg settings were considered on the lower side, I did fine with them, given I was done in 3 (and a half) treatments and it’s been about 2 years now since I finished and no change.
My sister, although darker, was test patched at similar settings by Renew Medica. Now I’m thinking we should continue with them for my sister’s leg treatments given that Premier was such a disaster. Melissa does treat my friend and uses good settings on her, so it’s worth another shot.

How long did you leave the numbing cream for? It should take care of a large portion of the pain. I assume you may have not left it on for long enough last time.

Those settings are ok. They’re actually not very high since it’s a Yag and at 12mm. But they’re decent.

What specific Yag machine is this? Is the spot size adjustable?

I used BLT and left it on for 30 minutes. It does take the edge off, but I still feel the sting deeper in the skin.

The machine is the Cynosure Elite MPX. My first 2 treatments were done with the Alexandrite at 12mm/20ms/20J. For some reason, the 1st went fine but the 2nd treatment had me burned pretty bad. It was before it was warm enough to wear shorts so I wasn’t getting sun exposure. I had circular burns that covered both my lower legs and the outer bikini areas.

I’m 5 days out of my Nd Yag bikini treatment at the 12mm/30ms/45J setting and not shedding yet. Usually by 5-7 days all the hair would either fall out or be easily pulled (no tension what-so-ever). The machine can go up to 18mm but when I asked to do so, the dr. said it would be very painful and argued that they can get just as much effectiveness with the 12mm at the settings they are using.

What do you suggest? Should I lower the pulse with, assuming they don’t let me go up to 18mm? Or conversly, what settings would you suggest on a 18mm?

The max on the 12mm is 50J and I’ve never heard of that being used. So the only thing they can do is lower the pulse width or to take the spot size up to allow for more aggressive settings.

Have you started shedding yet?

4 days ago was 3 weeks post treatment for my sister and it was very obvious that there were LOTS of missed areas. I can’t even call them patches. She went in 2 days ago and the tech (a different one from the one who did the treatment) was quite shocked. I hope whoever did the treatment gets an ear-full to be honest because after the manager’s insistence that all the techs were equally good, it was a shambles. My sister had said after the treatment that she expected this as she complained to the tech at the time that she was not overlapping properly… she also told the manager who did not do anything about it.

They basically ended up re-doing her whole leg. However, they used 15mm, 25J, 40ms. Which seems lower, but in contrast to the first treatment her skin was red, with welting. Even in the late evening she was still saying it was feeling ‘hot’. So I hope it’s a good sign. It may just be because she overlapped thoroughly this time though.